For migraine relief, administer diphenhydramine (Benadryl) 25 mg IV followed by prochlorperazine (Compazine) 10 mg IV. If the headache does not resolve in 15-30 minutes, give
ketorolac (Toradol) 30 mg IV or 60 mg IM. Resolution usually occurs within 60 minutes (IM medications may take longer). This cocktail is effective after triptans fail.
—Linda M. Watkins, MSN, FNP-C, Madison, Miss.
I usually administer the Toradol at the same time I give the Benadryl and Compazine. Because this combination is very sedating, I require that the patient have a ride home. For patients without drug insurance, ibuprofen can be substituted for the Toradol. Compazine in generic form is inexpensive.
—Sherril Sego, MSN, FNP (104-18)