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Frovatriptan

    DEA Class; Rx

    Common Brand Names; Frova, Migard

    • Serotonin 5-HT-Receptor Agonists; 
    • Antimigraine Agents

    Oral serotonin agonist
    For acute migraine treatment; may be used off-label for menstrual migraine prophylaxis
    Longer half-life and lower headache recurrence rate than other serotonin agonists

    Indicated for the acute treatment of migraine with or without aura.

    Indicated for acute treatment of migraine headache

    For menstrual migraine prophylaxis.

    Ischemic coronary artery disease (CAD) (eg., angina pectoris, history of myocardial infarction, or documented silent ischemia), or coronary artery vasospasm, including Prinzmetal’s angina

    Wolff-Parkinson-White Syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders

    History of stroke, transient ischemic attack (TIA), or history of hemiplegic or basilar migraine because these patients are at higher risk of stroke

    Peripheral vascular disease

    Ischemic bowel disease

    Uncontrolled hypertension

    Recent use (ie, within 24 hr) of another 5-HT1 agonist, an ergotamine containing or ergot-type medication such as dihydroergotamine (DHE) or methysergide

    Hypersensitivity to frovatriptan succinate (angioedema and anaphylaxis seen)

    • Chest pain (>2%)
    • Dizziness
    • Fatigue
    • Flushing
    • Headache
    • Hot or cold sensation
    • Paresthesia
    • Somnolence
    • Dyspepsia
    • Nausea
    • Xerostomia
    • Skeletal pain
    • Myocardial infarction and coronary artery vasospasm in patients with CAD risk factors (extremely rare)

    Clear diagnosis of migraine headache must be established

    Chest discomfort and jaw or neck tightness reported infrequently following intranasal administration (relatively common following SC injection)

    Sensations of pain, tightness, pressure, and heaviness reported in chest, throat, neck, and jaw after treatment and are usually non-cardiac in origin; however, perform a cardiac evaluation if these patients are at high cardiac risk; contraindicated in patients with CAD and those with Prinzmetal’s angina

    Overuse of acute migraine drugs (eg, ergotamine, triptans, opioids, or combination of these drugs for 10 or more days per month) may lead to exacerbation of headache (medication overuse headache); medication overuse headache may present as migraine-like daily headaches or as a marked increase in frequency of migraine attacks; detoxification of patients, including withdrawal of the overused drugs, and treatment of withdrawal symptoms (which often includes a transient worsening of headache) may be necessary

    Significant elevation in blood pressure, including hypertensive crisis with acute impairment of organ systems, reported on rare occasions in patients treated with 5-HT1 agonists, including patients without a history of hypertension; monitor blood pressure in patients receiving therapy; contraindicated in patients with uncontrolled hypertension

    There have been reports of reactions, including anaphylaxis and angioedema, in patients receiving therapy; such reactions can be life threatening or fatal; in general, anaphylactic reactions to drugs are more likely to occur in individuals with a history of sensitivity to multiple allergens; therapy is contraindicated in patients with a history of hypersensitivity reaction to drug

    There are no adequate data on developmental risk associated with use in pregnant women

    There are no data on presence of frovatriptan in human milk, effects of frovatriptan on breastfed infant, or effects of on milk production

    Adults

    7.5 mg/day PO for acute migraine treatment.

    Geriatric

    7.5 mg/day PO for acute migraine treatment.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Frovatriptan succinate

    tablet

    • 2.5mg