Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.

Evidence: Canadian Headache Society — Updated Migraine Prevention G… 2025 · sources last checked 2026-08-20

Reference tool — not medical advice. Thresholds, targets, and first-line agents differ by guideline body and change over time — switch the lens to compare. Clinician judgement, dosing/monitoring, contraindications, and live coverage always required. Runs entirely in your browser — no data is collected.

Migraine selector

Choose the guideline lens (CHS / AHS / ACP), acute vs prevention, and the patient’s severity, comorbidities and flags — get the acute agent (NSAID → triptan → gepant if CV-contraindicated) or the preventive (comorbidity-matched orals; CGRP positioning that differs by society and Canadian coverage).

Guideline lens

Acute or preventive?choose one

Attack severity (acute)choose one

Frequency (prevention)choose one

Comorbidities (steer preventive choice)

Flags

Context

Prevention

CGRP positioning

Canada: CGRP reimbursed after failure of ≥2 oral preventives (payer-gated step-care)

Notes

  • • Start prevention when ≥4 migraine days/month cause disability, or acute therapy is insufficient/overused. Canadian public coverage for CGRP mAbs/gepants/Botox generally requires failure of ≥2 oral preventives (EAP).

Suggested drug classesPer Canadian Headache Society 2025.

Choose acute vs prevention to begin.

Switch the lens to see the CGRP divergence: AHS 2024 (first-line) vs CHS/Canadian payers (after ≥2 oral failures) vs ACP (later-line).

Guidelines

References

  1. [1]Canadian Headache Society — Updated Migraine Prevention Guideline (2025) + Acute Drug Therapy for Migraine (2013). Canadian payers gate CGRP therapy behind ≥2 oral-preventive failures. link
  2. [2]American Headache Society 2024 Position Statement: CGRP-targeting therapies are a first-line option for the prevention of migraine. Headache 2024;64:333. link
  3. [3]American College of Physicians (2025): Prevention of Episodic Migraine — CGRP agents later-line (no clinically important advantage over first-line orals). Ann Intern Med 2025. link