naratriptan

Class




  • Triptan




Naratriptan


Commonly Prescribed for


(FDA approved in bold)



  • Migraine



Naratriptan


How the Drug Works



  • Selective 5-HT1 receptor agonist, working predominantly at the D receptor subtype. Effectiveness may be due to blocking the transmission of pain signals from the trigeminal nerve to the trigeminal nucleus caudalis and preventing release of inflammatory neuropeptides rather than just causing vasoconstriction



Naratriptan


How Long Until It Works



  • 2 hours or less



Naratriptan


If It Works



  • Continue to take as needed. Patients taking acute treatment more than 2 days/week are at risk for medication-overuse headache, especially if they have migraine



Naratriptan


If It Doesn’t Work



  • Treat early in the attack – triptans are less likely to work after the development of cutaneous allodynia, a marker of central sensitization
  • For patients with partial response or reoccurrence, add an NSAID
  • Change to another agent



Naratriptan


Best Augmenting Combos for Partial Response or Treatment-Resistance



  • NSAIDs or neuroleptics are often used to augment response



Naratriptan


Tests



  • None required



Adverse Effects (AEs)




Naratriptan


How Drug Causes AEs



  • Direct effect on serotonin receptors



Naratriptan


Notable AEs



  • Tingling, flushing, warm/cold temperature sensations, palpitations, sensation of burning, vertigo, sensation of pressure, nausea



Naratriptan


Life-Threatening or Dangerous AEs



  • Rare cardiac events including acute MI, cardiac arrhythmias, and coronary artery vasospasm have been reported with naratriptan



Naratriptan


Weight Gain



  • Unusual



Naratriptan


Sedation



  • Unusual



Naratriptan


What to Do About AEs



  • In most cases, only reassurance is needed. Lower dose, change to another triptan or use an alternative headache treatment



Naratriptan


Best Augmenting Agents for AEs



  • Treatment of nausea with antiemetics is acceptable. Other AEs improve with time


Dosing and Use


Feb 16, 2017 | Posted by in PHARMACY | Comments Off on naratriptan

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