A randomized trial found better pain relief with the antiemetic combination than with the NSAID.
Medications recommended for headache treatment include nonsteroidal anti-inflammatory drugs (NSAIDs), prochlorperazine, metoclopramide, and caffeine. These authors compared two regimens in adult patients with recurrent headaches that did not meet definitions for migraine or cluster headache. In a randomized, double-blind study, 120 patients who presented to an academic emergency department received either intravenous metoclopramide (20 mg) plus diphenhydramine (25 mg), or intravenous ketorolac (30 mg).
After 1 hour, pain improvement was greater with the combination regimen (median improvement on an 11-point scale, 5 vs. 3 points). The combination regimen was also superior in sustained relief, requirement for rescue medications, and patient d…
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals