Naratriptan

Indications
Oral
Acute migraine attacks
Adult: Initially, 1-2.5 mg at the onset of headache. If there is no response, do not take a 2nd dose. If headache returns after an initial response, dose may be repeated every 4 hr. Max: 5 mg in 24 hr.
Renal impairment: Mild to moderate: Initiate at a lower dose. Max dose: 2.5 mg in 24 hr.
Hepatic impairment: Mild to moderate: Initiate at a lower dose. Max dose: 2.5 mg in 24 hr.

Special Populations: Mild to moderate hepatic or renal impairment: 1 mg. Max: 2.5 mg in 24 hrs.
Contraindications
Basilar/haemiplegic migraine, uncontrolled hypertension, ischaemic heart disease (angina, MI, silent ischaemia), coronary vasospasm, peripheral vascular disease, cerebrovascular syndromes (stroke, TIA), severe hepatic/renal impairment (CrCl <15 ml/min).
Warnings / Precautions
Use only if there is a clear diagnosis of migraine. Exclude unrecognised coronary artery or CV disease before use in postmenopausal women, men >40 yr and those with risk factors for ischaemic heart disease. Not to be used prophylactically. Mild or moderate hepatic/renal impairment. May impair ability to drive or operate machinery. Pregnancy and lactation. Hypersensitivity to sulfonamides. Not recommended in elderly patients.
Adverse Reactions
Dizziness, drowsiness, malaise/fatigue, nausea, vomiting, paraesthesia, pain or pressure in throat or neck, palpitation, hypertension, ECG changes, hypotension, heart murmurs, bradycardia, hyperlipidaemia, hypercholesterolaemia, hypothyroidism, hyperglycaemia, glycosuria, ketonuria, eye haemorrhage, abnormal LFTs, abnormal bilirubin tests, convulsions, allergic reaction, panic, hallucinations.
Potentially Fatal: Coronary artery vasospasm, transient myocardial ischaemia, MI, ventricular tachycardia, ventricular fibrillation.
Overdose Reactions
Symptoms: Marked hypertension, lightheadedness, tension in the neck, tiredness, loss of coordination. Management: Supportive and symptomatic; no specific antidote. Continue monitoring for at least 24 hr or while symptoms or signs persist.
Drug Interactions
Increased levels/effects with oral contraceptives.
Potentially Fatal: Increased risk of serotonin syndrome with serotonergic reuptake inhibitors (e.g. SSRIs/ serotonin noradrenaline reuptake inhibitors) and other serotonin agonists. Additive vasospastic effects with ergot-containing drugs.
See Below for More naratriptan Drug Interactions
Mechanism of Actions
Naratriptan is a selective serotonin agonist which acts at 5-HT1 receptors and produces vasoconstriction of cranial arteries.
Onset: 30 min.
Absorption: Bioavailability: 63% in men and 74% in women. Peak plasma concentrations after 2-3 hr (oral).
Distribution: Protein-binding: Approx 29%. Distributed into milk in rats.
Metabolism: Undergoes some hepatic metabolism by various cytochrome P450 isoenzymes.
Excretion: Primarily via urine (50% as unchanged drug, 30% as inactive metabolites). Elimination half-life: 6 hr; markedly prolonged in renal or hepatic impairment.
Administration
May be taken with or without food.
Storage Conditions
Oral: Store at 20-25°C (68-77°F).
ATC Classification
N02CC02 - naratriptan ; Belongs to the class of selective serotonin (5HT1) agonists preparations. Used to relieve migraine.
Storage
Oral: Store at 20-25°C (68-77°F).
Available As
  • Naratriptan 1 mg
  • Naratriptan 2.5 mg
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