TRIPTANS FOR MIGRAINE
The triptans are very effective for the treatment of an acute migraine attack even if taken several hours after the onset of the pain. This feature makes them quite useful for you when you awaken with a fully developed migraine. However, they are most effective if taken at the onset of the headache when the pain is mild. In studies comparing the triptans to placebo, the SIDE EFFECTS were most often brief and mild to moderate in intensity, and included:
Triptans are used to abort a migraine attack. If the first dosage fails to abort the attack, a subsequent dosage can be taken 2 to 4 hours later. However, if relief does not ensue after the second dosage, it is unlikely that the medication will help the attack. At that point, rescue medication (prescription drugs such as opioids), should be taken to reduce the pain and accompanying symptoms. Additional dosages of triptans should be kept in reserve for headache recurrence as may occur the following day in 30% of those who use the medication. Usage of these medications more than twice per treatment day (24 hours) or more than 6 treatment days per month, signals a need for you to be reevaluated. At this point, a preventive medication is often prescribed as well. Pregnancy Risk Factor: Category C Adverse effect in animal studies but no human studies available. Contraindications:
Triptans may cause mild, transient elevation of blood pressure or
coronary vasospasm. These changes will not harm you. However, in documented or suspected ischemic heart disease (coronary artery disease), history of myocardial infarction (heart attack), suspected coronary artery disease and uncontrolled hypertension, these drugs are contraindicated. They should not be prescribed in the management of migraine with prolonged aura, complicated migraine or hemiplegic and basilar artery migraine (uncommon conditions, the management of which is different).
(naratriptan)
Amerge (Naratriptan) – 2.5 mg orally – may repeat once after 4 hours – no more than 2 doses should be used in 24 hours. Axert (Almotriptan) – 12.5 mg orally – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Frova (Frovatriptan) – 2.5 mg orally – may repeat once after 4 hours – no more than 2 doses should be taken in 24 hours. Imitrex (Sumatriptan) – 50 - 100 mg orally – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Nasal spray – 20 mg – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Subq injection – 6 mg – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Maxalt (Rizatriptan) – 5 - 10 mg tablets or 10 mg MLT (oral disintegration) – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Relpax (Eletriptan) – 40 mg orally – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Zomig (Zolmitriptan) – 2.5 - 5 mg tablets or 2.5 – 5 mg ZMT (oral disintegration) – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. Nasal spray – 5 mg – may repeat once after 2 hours – no more than 2 doses should be taken in 24 hours. TREXIMET (Sumatriptan 85 mg plus naproxen sodium 500 mg) – 1 tablet, may repeat 1 time in 4 hours – Please note: Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) and may cause gastric irritation as a side effect.
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