Classifications: adrenergic antagonist; 5-ht1 serotonin agonist; Therapeutic: antimigraine; 5-ht1 serotonin agonist
Pregnancy Category: C
1 mg, 2.5 mg tablets
Binds to the serotonin receptors (5-HT1D and 5-HT1B) on intracranial blood vessels, resulting in selective vasoconstriction of dilated vessels in the carotid circulation.
It also inhibits the release of proinflammatory neuropeptides associated with a migraine attack.
Inhibits vasoconstriction of dilated vessels selectively. This results in the relief of acute migraine headache attacks.
Acute migraine headaches with or without aura.
Severe renal impairment (creatinine clearance <15 mL/min); severe hepatic impairment; history of ischemic heart disease
(i.e., angina pectoris, MI), arteriosclerosis, cardiac arrhythmias; cardiac disease, CAD, older adults, peripheral vascular
disease; cerebrovascular syndromes (i.e., strokes or TIA); uncontrolled hypertension; patients with hemiplegic or basilar
migraine; hypersensitivity to naratriptan; older adults, pregnancy (category C).
Cardiovascular disease; renal or hepatic insufficiency; lactation. Safety and efficacy in children <18 y are not established.
Route & Dosage
Adult: PO 12.5 mg; may repeat in 4 h if necessary (max: 5 mg/24 h); patients with mild or moderate renal or hepatic impairment
should not exceed 2.5 mg/24 h
- Give any time after symptoms of migraine appear. If the first tablet was effective but symptoms return, a second tablet
may be given, but no sooner than 4 h after the first. Do not exceed 5 mg in 24 h.
- If there is no response to the first tablet, contact physician before administering a second tablet.
- Do not give within 24 h of an ergot-containing drug or other 5-HT1 agonist.
- Store at 2°25° C (36°77° F); protect from light.
Adverse Effects (≥1%)Body as a Whole:
, malaise, pain, pressure sensation, paresthesias, throat pressure, warm/cold sensations, hot flushes. CNS:
Somnolence, dizziness, drowsiness, headache, hypesthesia, decreased mental acuity, euphoria, tremor. CV:
Coronary artery vasospasm, transient myocardial ischemia, MI,
ventricular tachycardia, ventricular fibrillation, chest pain/tightness/heaviness, palpitations. GI:
Dry mouth, nausea, vomiting, diarrhea. Respiratory:
InteractionsDrug: Dihydroergotamine, methysergide,
and other 5-ht1 agonists
may cause prolonged vasospastic reactions; ssri
s have rarely caused weakness, hyperreflexia, and incoordination; maoi
s should not be used with 5-ht1 agonists
. Herbal: Gingko, ginseng, echinacea, St. John's wort
may increase triptan toxicity.
Rapidly absorbed, 70% bioavailability. Peak:
24 h. Distribution:
2831% protein bound. Metabolism:
In liver. Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Monitor carefully cardiovascular status following first dose in patients at risk for CAD (e.g., postmenopausal women, men
over 40 y, persons with known CAD risk factors) or coronary artery vasospasms.
- Be aware that ECG is recommended following first administration of naratriptan to someone with known CAD risk factors and
periodically with long-term use.
- Report immediately to the physician: chest pain, nausea, or tightness in chest or throat that is severe or does not quickly
- Obtain periodic cardiovascular evaluation with continued use.
Patient & Family Education
- Carefully review patient information leaflet and guidelines for administration.
- Contact physician immediately for any of the following: symptoms of angina (e.g., severe and/or persistent pain or tightness
in chest or throat, severe nausea); hypersensitivity (e.g., wheezing, facial swelling, skin rash, or hives); or abdominal
- Report any other adverse effects (e.g., tingling, flushing, dizziness) at next physician visit.