This protocol is indicated for vestibular migraine attacks in patients who have already received an initial combination course of a triptan with a long-acting NSAID but did not meet the expected treatment milestones. A next-line parenteral approach is outlined for this clinical situation.
The preceding regimen — initial combination therapy of sumatriptan plus naproxen — was targeted at two specific goals: achieving pain-free status within 2 hours and preventing recurrence of the migraine attack. Failure to reach either of these goals is the criterion that triggers escalation to this protocol.
This protocol shifts management to a parenteral emergency route. Agents are administered intravenously — alone or in combination — with an alternative subcutaneous option when appropriate. The full selection criteria, sequencing, and agent-specific detail remain within the structured protocol.
Partial overview only — complete regimen via the link belowDOI: 10.1177/2514183X1882337