Facts About Triptans

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How Triptans Work

Triptans are a class of medications used to treat migraines that are categorized as acute. Acute medications are designed to stop a migraine attack or cluster headache after the attack begins. By stopping the migraine, acute medications help alleviate the symptoms of migraines such as pain, nausea, and sensitivity to light and sound.
Unlike other acute medications, triptans are considered selective serotonin receptor agonists, meaning that triptans work by stimulating serotonin, a neurotransmitter found in the brain, to reduce inflammation and constrict blood vessels, thereby stopping the headache or migraine.

Triptan Use

Triptans are approved by the United States Food and Drug Administration (FDA) to treat moderate to severe migraines, and in some instances cluster headaches, that interfere with one’s ability to perform daily tasks. As an acute medication, triptans are most effective when taken early in an attack while the pain is still mild and before skin sensitivity increases. Some triptan drugs may also help to prevent migraines in women who get them only around the time of their menstrual period.

Triptan Considerations

Triptans are effective in reducing migraine symptoms and are generally well tolerated; however, migraine sufferers should discuss the following with their physician before taking triptans:

  • Triptans should not be used in combination with ergotamines for the treatment of migraine, and in some instances, should not be used in combination with monoamine oxidase inhibitors (MAOIs).
  • Triptans should not be used by those who have a past history of, or risk factors, for heart disease, high blood pressure, high cholesterol, angina, peripheral vascular disease, impaired liver function, stroke or diabetes.
  • Triptans should be taken only as prescribed by a physician.

Triptan medications There are currently seven triptan medications available in the United States.

Almotriptan — Axert® (Tablet)

Recommended dose

  • One 6.25 mg or 12.5 mg dose after the first sign of migraine
  • No more than two doses in 24 hours

Most common side effects

  • Tingling of the skin
  • Burning or prickly feeling
  • Numbness
  • Dizziness
  • Dry mouth
  • Headache
  • Nausea
  • Sleepiness

Eletriptan — Relpax® (Tablet)

Recommended dose

  • One 20 mg or 40 mg dose at the start of a migraine
  • No more than two 20 mg or 40 mg doses may be taken in a 24-hour period

Most common side effects

  • Dizziness
  • Lack or loss of strength
  • Nausea
  • Sleepiness or unusual drowsiness
  • Pain or pressure sensation in the chest or throat

Frovatriptan — Frova® (Tablet)

Recommended dose

  • One 2.5 mg tablet after the start of a migraine
  • No more than three should be taken in a 24-hour period

Most common side effects

  • Dizziness
  • Fatigue
  • Headache other than migraine
  • Tingling of the skin
  • Dry mouth
  • Flushing (hot flashes)
  • Feeling hot or cold
  • Chest pain
  • Indigestion
  • Pain in the joints or bones

Naratriptan — Amerge® (Tablet)

Recommended dose

  • One 1 mg or 2.5 mg dose at the first sign of a migraine
  • No more than 5 mg in a 24-hour period

Most common side effects

  • Chest pain (severe)
  • Heaviness, tightness or pressure in the chest, throat and/or neck
  • Feeling of burning sensation
  • Sensation of warmth
  • Numbness
  • Sense of tightness around the chest and/or throat
  • Tingling of the skin
  • Dizziness
  • Drowsiness or increased tiredness
  • Nausea and/or vomiting

Rizatriptan — Maxlt®, Maxlt- MLT® (Tablet, Orally Disintegrating Tablets)

Recommended dose

  • One 5 or 10 mg dose at the first sign of a migraine
  • No more than 30 mg in a 24-hour period

Most common side effects

  • Chest pain or heaviness, tightness/pressure in the chest
  • Pounding heartbeat
  • Feeling of burning sensation
  • Sensation of warmth
  • Numbness
  • Sense of tightness around the chest and/or throat
  • Tingling of the skin

Sumatriptan — Imitrex® (Tablet, Nasal Spray Injection)

Recommended dose

  • Dosage varies depending on severity of migraines and type of delivery

Most common side effects

  • Flushing (hot flashes)
  • Tingling of the skin
  • Drowsiness
  • Dizziness
  • Weakness
  • Sensation of warmth or coldness
  • Burning at injection sites (if injection used)
  • Bitter taste at the back of throat (with nasal sprays)

Zolmitriptan — Zomig® (Tablet, Oral Ingesting Tablet, Nasal Spray)

  • Recommended dose
  • Dosage varies depending on severity of migraines and type delivery

Most common side effects

  • Chest pain (severe)
  • Heaviness, tightness, or pressure in chest
  • Feeling of burning sensation
  • Tingling of skin
  • Dizziness
  • Nausea
  • Sensation of warmth
  • Numbness
  • Sense of tightness around the chest and/or throat
  • Sleepiness or unusual tiredness
  • Muscle weakness

Triptans: An Unmet Need

A recent study of nearly 6.2 million insured patients found that many migraines were misdiagnosed or under diagnosed which can lead to inadequate treatment. When patients were diagnosed with migraine and prescribed a medication, more than half received narcotics and opioid analgesics, which are not approved by the FDA for the treatment of migraines. The consequences of inadequate treatment for disabling migraine may include productivity loss, and adverse events associated with excessive medication use.

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