|
| |
| 5HT1 agonist (Triptans) |
Precautions:
 | NOT to be given to pregnant or lactating women. |
| Contraindicated in
 | Ischemic heart disease,
Prinzmetal angina |
| Uncontrolled hypertension |
| Decreased arterial flow, Raynaud's
disease |
| Impaired hepatic function |
| Ingestion of any ergotamine-containing medication.
within 24 hours (DHE,
methysergide, ergotamine tartrate etc). |
| MAO inhibitor use within 2 weeks |
| Basilar or hemiplegic migraine or Cerebrovascular disease |
| Age over 50, particularly males |
|
| May need to assess for the presence of occult or
unrecognized coronary artery disease prior to use of triptans
| Postmenopausal women or Males over 40 |
| Hypertension, Hyperlipidemia, Obesity, Diabetes |
| Smokers |
| Strong family history of early cardiac disease |
|
|
| Help in selection of a specific medication:
| If migraine is severe or patient is vomiting
 | Sumatriptan nasal spray or injection may
be more effective |
| Zomig Nasal spray |
|
| In situation where a tablet needs to be taken
without water: Zomig ZMT, Rizatriptan (Maxalt MLT) may be more convenient to
take, just melt in the mouth. |
|
| Patient may respond differently to different
triptan. |
|
Eeletriptan
(Relpax) |
| Preparation: 20, 40 mg tab |
| Usual dose: 20-40 mg per
24 hr. |
| Half life: 5 hours |
|
Frovatriptan
(Frova) |
| Preparation: 2.5 mg tab, may take a second dose in 2
hours, not to exceed 3 tab in a 24 hour period |
| Half life: has the longest half-life of all the
triptans (>20 hours) |
|
Sumatriptan
(Imitrex) |
| Tab: 25, 50, 100 mg tab. 9 tablet/box
| Dose: 1 tab, may repeat in 2 hr (Max single oral dose 100 mg, Max
200
mg /day) |
|
| Nasal Spray : 20mg /spray, also 5 mg/ spray.
6 spray / box
| Dose: 1 spray, may repeat once in 2 hr (Max 40 mg/day) |
|
| Injection: 6 mg /0.5 ml. 2 per package |
| Dose: Injection SC, may repeat in 1 hr (Max: 12
mg/day, 2 shots) |
|
Zolmitriptan (Zomig)
|
| Tab: 2.5, 5 mg. 2.5 mg ZMT orally disintegrating
tablets in Orange flavor |
| Dose: start with 2.5 mg, may repeat in 2 hr, max 10 mg/day |
| 5 mg Nasal spray |
|
| Naratriptan (Amerge) |
| Tab: 1, 2.5 mg |
| Dose: 2.5 mg, may repeat in 4 hr, max 5 mg/24 hour |
| Longer 1/2 life, not contraindicated with MAO |
|
Rizatriptan
(Maxalt) |
| Tab: 5, 10 mg |
| Maxalt-MLT: orally disintegrating tablets |
| dose: 5 to 10 mg, may repeat in 2 hours, Max 30 mg/24 hr |
|
Almotriptan
(Axert) |
| Tab: 6.25 mg, 12.5, package of 6/box |
| Dose: 12.5 to 25 mg / 24 hour period |
| Less chance of chest tightness. |
| About $11 pre tab. |
|
|
|
|
