A Narrative Review of the Importance of Pharmacokinetics and Drug–Drug Interactions of Preventive Therapies in Migraine Management

Shivang Joshi MD, MPH, RPh; Stewart J. Tepper MD; Sylvia Lucas MD, PhD; Soeren Rasmussen MD; Rob Nelson PharmD, BCPS


Headache. 2021;61(6):838-853. 

In This Article


Preventive treatments for migraine are recommended for a large proportion of patients with frequent migraine attacks. These patients often exhibit a number of comorbidities, which may lead to the introduction of multiple simultaneous therapies. Although polytherapy allows for fine-tuning of treatment regimens, DDIs are important to consider in patients taking multiple medications. The development of migraine-specific evidence-based preventive monoclonal antibody treatments allows for tailored clinical management that reduces the risk of DDIs and associated AEs in patients with comorbidities compared with therapies that have multiple mechanisms of action and/or multiple targets.