triptans

=Triptans=

How they work
Helps to constrict the dilated blood vessels in your head that are causing the pain associated with migraines //Constrict cranial vessels by acting selectively at 5HT1B/1D receptors; also thought to inhibit the abnormal activation of trigeminal nociceptors.//

Questions to Ask
What medications? - medical conditions? (vasoconstriction) //history of MI, ischaemic heart disease, coronary vasospasm//, //uncontrolled hypertension, History of cerebrovascular accident or TIA//, //PVD// - allergies?

How to take
2.5 mg as soon as possible after onset of headache. Dose may be repeated after at least 4 hours if migraine recurs. Maximum daily dose 5 mg. //Renal or hepatic impairment// Maximum daily dose 2.5 mg in mild-to-moderate renal or hepatic impairment.
 * Naratriptan:**

2.5 mg as soon as possible after onset of headache. Dose may be repeated after at least 2 hours if migraine recurs; 5 mg may be given at onset if lower dose tolerated but ineffective in previous attack. Maximum daily dose 10 mg. //Severe hepatic impairment// Maximum daily dose 5 mg.
 * Zolmitriptan:**

Use as soon as possible after onset of headache. //Oral//, 50–100 mg. Dose may be repeated after at least 2 hours if migraine recurs. Maximum daily dose 300 mg. //SC//, 6 mg. Dose may be repeated after at least 1 hour if migraine recurs. Maximum daily dose 12 mg. //Intranasal//, 10–20 mg into 1 nostril. Dose may be repeated after at least 2 hours if migraine recurs. Maximum daily dose 40 mg.
 * Sumatriptan:**

Side effects
- sensations of tingling, heat, pain, heaviness or tightness in any part of the body including chest and throat, flushing, dizziness, feeling of weakness, drowsiness, fatigue, nausea, vomiting, dry mouth, transient increase in BP

Dependence may occur with overuse resulting in recurrent and/or rebound headaches and withdrawal syndrome.

Other advice?
With the exception of naratriptan, the oral triptans provide headache relief within 30–60 minutes. //Naratriptan// has a slower onset of action and is less effective in improving headache than sumatriptan, but has a lower relapse rate and fewer adverse effects. //Zolmitriptan// has similar efficacy and adverse effects to sumatriptan. //Sumatriptan// is also available as an injection and as a nasal spray; may be useful in people with nausea and vomiting.

CMI
Naratriptan: [|AMH] [|Naramig] Zolmitriptan: [|AMH] [|Zomig] Sumatriptan: [|AMH] [|Imigran] [|Sumatab]