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    DEA Class; Rx

    Common Brand Names; Amerge

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

    Oral serotonin agonist
    Used for treatment of acute migraine; has been used off-label for menstrual migraine prophylaxis
    Similar to sumatriptan but with a longer half life/duration of action

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

    For menstrual migraine prophylaxis.

    Hypersensitivity, including angioedema and anaphylaxis

    Severe hepatic or renal impairment

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

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

    History of stroke or TIA, or history of hemiplegic or basilar migraine because such patients are at a higher risk of stroke

    Peripheral vascular disease

    Ischemic bowel disease

    Uncontrolled hypertension

    Within 24 hours of another 5-HT 1 agonist, ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide)

    • Dizziness
    • Drowsiness
    • Fatigue
    • Paresthesias
    • Pain/pressure sensation
    • Nausea (1-5%)
    • Throat/neck symptoms
    • Myocardial infarction
    • Coronary artery vasospasm in pts with CAD risk factors

    Decrease dose with mild-moderate renal impairment

    Anaphylaxis/anaphylactoid and hypersensitivity reactions, including angioedema reported (see Contraindications)

    May cause dizziness, weakness, or drowsiness (infrequent)

    Life-threatening disturbances of cardiac rhythm, including ventricular tachycardia and ventricular fibrillation leading to death, reported within a few hours following the administration of 5-HT1 agonists; discontinue therapy if these disturbances occur

    Sensations of tightness, pain, and pressure in the chest, throat, neck, and jaw commonly occur after treatment and are usually non-cardiac in origin; however, perform a cardiac evaluation if these patients are at high cardiac risk

    Therapy may cause non-coronary vasospastic reactions, such as peripheral vascular ischemia, gastrointestinal vascular ischemia and infarction (presenting with abdominal pain and bloody diarrhea), splenic infarction, and Raynaud’s syndrome; in patients who experience symptoms or signs suggestive of non-coronary vasospasm reaction following the use of any 5-HT1 agonist, rule out a vasospastic reaction before receiving additional doses

    Reports of transient and permanent blindness and significant partial vision loss reported with the use of 5-HT1 agonists; since visual disorders may be part of a migraine attack, a causal relationship between these events and the use of 5-HT1 agonists have not been clearly established

    Pregnancy: There are no adequate data on the developmental risk associated with use of naratriptan in pregnant women; several studies have suggested that women with migraine may be at increased risk of preeclampsia during pregnancy

    Lactation: There are no data on presence of naratriptan in human milk, effects of naratriptan on the breastfed infant, or effects of naratriptan on milk production; naratriptan is present in rat milk; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for naratriptan and any potential adverse effects on the breastfed infant from naratriptan or from the underlying maternal condition


    5 mg/day PO or per 24 hour period. The safety of treating more than 4 headaches in a 30-day period is unknown.


    5 mg/day PO or per 24 hour period. The safety of treating more than 4 headaches in a 30-day period is unknown.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.

    Naratriptan hydrochloride


    • 1mg
    • 2.5mg