migraine awareness group
migraines.orgnational migraine associationmigraineur
about magnum
migraine news
migraine myths
migraine disability
migraine treatment
migraine help
migraine faqs

treatment & management

Drug Profiles:
Narcotic Injections


When are narcotic injections used?
Narcotic injections are used primarily in emergency rooms and medical offices. There are two main scenarios in which they are generally administered:
  1. When Migraine attack is not relieved by a Migraineur's usual medications and the pain and other symptoms are severe. In addition to the level of pain, prolonged nausea and vomiting should be considered an indication for seeking emergency care because of possible dehydration.
  2. When a Migraine lasts beyond 72 hours with less than four pain-free hours while awake. Under the diagnostic criteria of the International Headache Society, such a Migraine is termed Status Migrainous, and emergency care is recommended. Status Migrainous puts Migraineurs at increased risk of stroke and should not be ignored.

Which medications are used?
Although there are several narcotic pain relievers that can be used, the two most commonly used are Demerol (Meperidine HCl) and Toradol (Ketorlac). They are usually administered with Phenergan (promethazine), Compazine (prochlorperazine), or Vistaril (hydroxyzine); both to reduce nausea and because these meds potentiate the narcotics -- help them work better and more quickly.

How are narcotic injections administered?
The injections may be administered intramuscularly or intravenously. If a saline IV has been started because of dehydration, the meds will usually be injected into the IV line. If there is not an IV line, it is more common for the meds to be injected intramuscularly into the hip, but sometimes meds will be injected intravenously to act more quickly.

When these medications are administered, the patient will be kept in the emergency room or doctor's office for a short period of time to be sure they have been effective and to observe for adverse reactions. Do not drive yourself to the hospital of doctor's office for narcotic injections. You should not drive after they are administered.

More information-
For more information on these medications, please follow these links:


Information offered at this Web site by either a lay person or a health professional should not be interpreted as giving a diagnosis or a treatment recommendation. These can only be provided by a physician who has had an opportunity to interact with a patient in person and at length, with access to the patient's previous records and appropriate follow-up.