Adult Migraine Refills (Migraine Maintenance Therapy) in California
MD-only migraine refill visit by secure video in California, $49 flat-fee, no insurance required.
If you have an established migraine diagnosis and you are requesting continuation of a stable regimen, TeleDirectMD can review your migraine pattern, triggers, current medications, and refill needs. When telehealth is appropriate, we can send refills electronically to your preferred local pharmacy in California. If your headache symptoms suggest a dangerous secondary cause, we will recommend urgent in-person evaluation.
- $49 flat-fee visit
- MD-only evaluation and prescribing
- Continuation refills for stable migraine therapy
- Nausea support options when appropriate
- Adults only, California-based care
Clinician note: TeleDirectMD care is MD-only and guideline-based. Your visit is reviewed by a physician (Parth Bhavsar, MD). For migraine refills, we prioritize safe continuation for stable adults and careful screening for red flags that require urgent in-person evaluation.
Online Migraine Refills by California-Licensed MDs
- Headache pattern and trigger review
- Medication effectiveness and side effect review
- Nausea and hydration guidance
- Clear return precautions for dangerous symptoms
Adults only (18+). You must be physically located in California at the time of your visit. Sudden worst headache, new neurologic symptoms, fever with stiff neck, fainting, or chest pain require urgent in-person evaluation.
What Are Migraine Refills and When Are They Appropriate?
Migraine is a primary headache disorder that often causes throbbing or pulsating head pain, sensitivity to light or sound, nausea, and sometimes neurologic aura symptoms. Many adults have a consistent migraine pattern and use a stable acute therapy plan. Some also use preventive therapy.
TeleDirectMD is appropriate for stable adults seeking continuation refills and guidance. If your migraine pattern is changing or your symptoms suggest a dangerous cause, we will recommend urgent in-person evaluation.
Migraine Symptoms and Red Flags
Telehealth is best for stable refill requests. Use this table to understand what can be handled by video and what should be evaluated urgently in person.
| Finding | What it suggests | Telehealth appropriate? | Red flag requiring in-person care |
|---|---|---|---|
| Known migraines with typical pattern and stable medication response | Primary migraine, refill continuation | Often yes | New diagnosis without prior evaluation or unclear history |
| Gradual onset headache with light or sound sensitivity | Typical migraine features | Often yes | Sudden thunderclap headache reaching peak in minutes |
| Nausea with migraine | Common migraine symptom | Often yes | Severe persistent vomiting with dehydration or inability to keep fluids down |
| Headache after poor sleep, stress, dehydration, or missed meals | Common trigger-related flare | Often yes | Headache with fainting, chest pain, or severe shortness of breath |
| Visual aura that is typical for you | Migraine aura possible | Often yes | New neurologic deficit, weakness, facial droop, speech changes |
| Headache with fever and stiff neck | Possible infection or meningitis | No | ER evaluation recommended |
| New headache after age 50, or new headache with cancer or immunosuppression | Secondary headache risk | Often no | Urgent in-person evaluation recommended |
| Headache after head injury | Trauma-related headache | No | Urgent evaluation recommended |
What Else Can Look Like a Migraine?
- Tension-type headache: pressure or tight band sensation, often without nausea.
- Sinus-related symptoms: facial pressure with nasal congestion, fever, or purulent drainage.
- Medication overuse headache: frequent use of acute headache medications can worsen headaches.
- Cluster headache: severe one-sided pain with tearing or nasal symptoms.
- Secondary causes: infection, bleeding, stroke, or mass effect requires urgent evaluation when red flags exist.
When a Video Visit Is Appropriate vs. When to Go In-Person
When a Video Visit Is Appropriate
- Adult 18+ with an established migraine diagnosis
- Typical migraine pattern for you without new red flags
- Requesting continuation refill of a stable acute or preventive regimen
- No sudden thunderclap onset headache
- No new neurologic deficits such as weakness, facial droop, or speech changes
- No fever with stiff neck or severe confusion
- Physically located in California at the time of the video visit
Red Flags Requiring In-Person or ER Care
- Sudden worst headache of your life, peak within minutes
- New weakness, numbness, speech changes, vision loss, or confusion
- Fever with stiff neck, fainting, or severe persistent vomiting
- Headache after head injury
- New headache after age 50
- Pregnancy or postpartum with severe headache
- Chest pain or severe shortness of breath
Migraine Refill Approach and Treatment Options
TeleDirectMD focuses on continuation refills for stable adults. We also review hydration, sleep, trigger management, and safe use limits to reduce medication overuse headaches.
Supportive Care and Self-Management
- Hydration and regular meals, especially during busy workdays.
- Dark, quiet room during acute symptoms when possible.
- Cold pack to the forehead or back of the neck can help some patients.
- Sleep regularity and caffeine consistency can reduce flares.
- Limit acute medication use frequency to reduce rebound headaches.
Common Migraine Refill Medications
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Sumatriptan | 50 mg by mouth once at onset, may repeat in 2 hours, maximum 200 mg per day | As needed | Acute migraine treatment for stable adults without contraindications |
| Rizatriptan | 10 mg by mouth once at onset, may repeat in 2 hours, maximum 30 mg per day | As needed | Acute migraine treatment alternative in selected adults |
| Naproxen | 500 mg by mouth at onset, then 250 mg every 6 to 8 hours as needed, maximum 1250 mg per day | As needed | NSAID option for pain control when safe for you |
| Ondansetron ODT | 4 mg by mouth every 8 hours as needed | As needed | Nausea support during migraine episodes when appropriate |
| Propranolol | 20 mg by mouth twice daily | Maintenance | Selected adults on established preventive therapy continuation |
| Topiramate | 50 mg by mouth twice daily | Maintenance | Selected adults on established preventive therapy continuation |
TeleDirectMD does not prescribe controlled substances. For migraine refills, we focus on continuing established therapies for stable adults. New or severe red-flag headaches require urgent in-person evaluation.
Home Care and Return to Work
Many adults can return to work once symptoms improve, but migraines can affect function and safety. Your plan should prioritize symptom control and avoidance of dangerous triggers.
- Avoid driving if you have severe symptoms, dizziness, vision changes, or sedating medications.
- Hydrate early and consider electrolyte balance if you have vomiting or poor intake.
- If your headaches are becoming more frequent or your medications are losing effectiveness, consider an in-person evaluation to update your long-term plan.
- Seek urgent evaluation for any red-flag symptoms listed above.
What to Expect From Your TeleDirectMD Refill Visit
TeleDirectMD provides adult-only, MD-only virtual care by secure video. Visits typically last about 10 to 15 minutes and cost $49 as a flat cash fee with no insurance involvement. For migraine refills, the MD reviews your typical pattern, current medications, effectiveness, side effects, and red flags.
If your request is appropriate for telehealth, we can send an electronic prescription to your preferred local pharmacy in California. If your symptoms suggest a dangerous secondary cause, we will explain why urgent in-person evaluation is recommended.
Adults only. No controlled substances.
Migraine Refills FAQ
Can I get migraine medication refills online in California?
Often, yes. If you have an established migraine diagnosis and your pattern is stable, TeleDirectMD can review your regimen by video and send appropriate refills to your local California pharmacy.
Will you start new migraine medications during a refill visit?
TeleDirectMD focuses on continuation refills for stable adults. If you need a new diagnosis, new preventive selection, or you have red flags, we may recommend in-person evaluation for a more complete workup.
What symptoms make a headache an emergency?
Sudden worst headache, new weakness or speech changes, fever with stiff neck, fainting, confusion, severe chest pain, headache after head injury, or pregnancy with severe headache are urgent warning signs.
Can you refill triptans like sumatriptan?
If you are already on a triptan and it has been safe and effective for you, TeleDirectMD may be able to provide a continuation refill after reviewing your history and contraindications.
Can you prescribe opioid pain medication for migraines?
No. TeleDirectMD does not prescribe controlled substances.
Can you help with nausea during migraines?
Yes, in selected stable adults we can discuss nausea support options and hydration guidance, and prescribe an anti-nausea medication when appropriate.
What is medication overuse headache?
Using acute headache medicines too frequently can cause more headaches over time. We review safe use limits and strategies to reduce rebound headaches.
Is TeleDirectMD available throughout California for migraine refills?
Yes. As long as you are physically located in California at the time of your video visit, you can use TeleDirectMD for migraine refill evaluation. Prescriptions are sent electronically to your local California pharmacy when appropriate.
Can TeleDirectMD provide a work note for a migraine day?
TeleDirectMD can provide a brief work note when medically appropriate as part of the $49 visit.
When should I seek urgent in-person care?
Seek urgent evaluation for sudden severe headache, new neurologic symptoms, fever with stiff neck, fainting, confusion, severe persistent vomiting with dehydration, head injury, or pregnancy with severe headache.