The first oral treatment for preventing both chronic and episodic migraines could soon be available on the NHS.
Health experts said up to 170,000 people in England could benefit from taking atogepant to prevent severe head pain, which can be debilitating.
It has been recommended for those who have not responded well to other medications or cannot have injections.
One migraine charity described it as a positive step and said it hoped access to the drug would be "swift".
The National Institute for Health and Care Excellence (NICE) has recommended the drug, which comes in tablet form, after clinical trials suggested it was effective in some adults.
In its final draft guidance,, external NICE said atogepant should be offered to people who had unsuccessfully tried three other medications, many of which need to be taken by injection or infusion.
It's not always obvious if you are experiencing a headache or the start of a migraine.
Migraines are more severe and are often accompanied by other symptoms such as dizziness, sensitivity to light, and difficulty speaking.
The pain may be throbbing pain in one side of the head and can last several days.
It is not clear how many people are affected by migraines, but the NHS believes the number to be about six million across the UK,, external with many more women experiencing them than men.
Atogepant is designed to be taken daily to prevent both chronic migraines (occurring more than 15 times a month) and episodic migraines (occurring between four and 15 times a month).
At first, it will only be available from specialist doctors in secondary care settings, rather than from GPs.
Rob Music, chief executive of the Migraine Trust, said it was good news as migraines could be very "debilitating".
"It is positive to see even more therapies emerging for people with migraine, as many still rely on treatments developed for other conditions."
However, the charity warned that many people had struggled to access similar new drugs, because of a lack of knowledge among doctors, and long waiting lists for specialists.
"We now need to ensure access is swift, so that migraine patients can benefit from them as quickly as possible," Mr Music said.
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Atogepant is a new type of anti-calcitonin gene-related peptide (CGRP) drug,, external which is specifically designed to treat migraines. They work by blocking the receptor of the CGRP protein. This is found in nerves in the head and neck and is thought to cause inflammation and migraine pain. These drugs have fewer side effects than older migraine drugs, some of which were originally developed for other conditions.
It follows the introduction of a similar drug, rimegepant, in England and Scotland.
Deborah Sloan, from Brighton, told the BBC that rimegepant had put her life "back on track" after suffering chronic migraines for 40 years. Other treatments led to severe side effects.
She said can now work again after losing two careers because of being unwell with migraines for 20 days of each month.
"I was at the end of my tether," she said. "I became so desperate, I wasn't sure how I was going to carry on. I didn't think I could take another migraine attack because they are so disabling.
"They can last three days, constantly vomiting. You're not able to do anything. You feel like you want to die, that's how I felt."
However, Mrs Sloan said she had to obtain rimegepant privately at first because of a long wait for a referral to a specialist doctor who could prescribe it.
Atogepant is expected to be made available on the NHS in England from next month.
It is already available in Scotland to prevent and relieve migraine symptoms.
