What is Naratriptan used for?
Naratriptan is used to treat migraines. It helps to relieve headaches, pain and other symptoms of migraines, including sensitivity to light/sound, nausea, and vomiting. Prompt treatment allows you to get back to your normal routine and may decrease your need for other pain medications. Naratriptan does not prevent future migraines or reduce how often you may get a headache.
Naratriptan belongs to a group of drugs called triptans. It affects a certain natural chemical (serotonin) that constricts blood vessels in the brain. It may also block other pain pathways in the brain.
How should I take Naratriptan?
Take one tablet by mouth with or without food, at the first sign of a migraine, or as directed by your doctor. Do not take naratriptan to prevent a migraine. If there is no improvement in your symptoms, do not take any more doses of this medication before talking to your doctor. If your symptoms are only partly relieved, or if your headache comes back, you may take a second dose after 4 hours or as directed by your doctor. Do not take more than 5 milligrams in a 24-hour period.
If you have never taken this medication before and you have risk factors for heart disease (see Precautions), you may be advised to take your first dose in your doctor’s office in order to monitor for rare but serious heart problems (e.g., heart attack).
Your dosage is based on your medical condition and response to therapy. Tell your doctor if your condition does not improve or if it worsens.
If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Tell your doctor if you need to use this medication more often, or if the medication is not working as well, or if your headaches get worse.
How do I store Naratriptan?
Naratriptan is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Naratriptan in the bathroom or the freezer. There may be different brands of Naratriptan that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush Naratriptan down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Precautions & warnings
What should I know before using Naratriptan?
Before taking naratriptan, tell your doctor or pharmacist if you are allergic to it; or to other triptan migraine drugs; or it you have other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (e.g., chest pain, heart attack, irregular heartbeat), decreased blood flow in the brain (e.g., stroke, transient ischemic attack), blood circulation disease (e.g., ischemic bowel disease, Raynaud’s disease), certain types of headaches (hemiplegic or basilar migraine), kidney disease, liver disease.
Tell your doctor if you have the following risk factors for heart disease: diabetes, family history of heart disease, high blood pressure, high cholesterol, overweight, smoker, female after menopause, male over age 40.
If you are at high risk for heart disease, your doctor may want to check your heart before prescribing naratriptan.
This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.
The risk of heart disease and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.
This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.
Is it safe during pregnancy or breast-feeding?
There are no adequate studies in women for determining risk when using this Naratriptan during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Naratriptan. Naratriptan is pregnancy risk category C according to the US Food and Drug Administration (FDA).
FDA pregnancy risk category reference below:
- A=No risk,
- B=No risk in some studies,
- C=There may be some risk,
- D=Positive evidence of risk,
What side effects can occur from Naratriptan?
Flushing, sensations of tingling/numbness/prickling/heat, weakness, drowsiness, or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.
Tell your doctor right away if you have any serious side effects, including: blue fingers/toes/nails, cold sensation of hands/feet, hearing changes, mental/mood changes.
Naratriptan can commonly cause chest/jaw/neck tightness, pain, or pressure that is usually not serious. However, these side effects are like symptoms of a heart attack, which may include chest/jaw/left arm pain, shortness of breath, or unusual sweating. Get medical help right away if these or other seriousfast/irregular heartbeat, fainting, severe stomach/abdominal pain, bloody diarrhea, signs of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes, confusion).
This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
What drugs may interact with Naratriptan?
If you also take any ergotamine medication (e.g., dihydroergotamine) or any other “triptan” drugs (e.g., zolmitriptan, rizatriptan), you will need to separate your naratriptan dose from your dose of these other medications in order to lessen the chance of serious side effects. Ask you doctor how long you should wait between your doses of these drugs.
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,”St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Naratriptan may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.
Does food or alcohol interact with Naratriptan?
Naratriptan may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with Naratriptan?
Naratriptan may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Naratriptan.
What is the dose of Naratriptan for an adult?
Usual Adult Dose for Migraine
Use only after a clear diagnosis of migraine has been established
Initial dose: 1 mg or 2.5 mg orally, once
-Provided there has been some response to first dose, a second dose may be administered at least 4 hours later if migraine returns or symptoms recur.
Maximum dose: 5 mg in a 24-hour period
-This drug should not be used to treat basilar or hemiplegic migraines because these patients are at a greater risk of stroke.
-The safety of treating an average of 4 or more migraine attacks in a 30-day period has not been established.
Use: For the acute treatment of migraine with or without aura.
Renal Dose Adjustments
Severe renal impairment (CrCl less than 15 mL/min): Use is contraindicated
Mild to moderate renal impairment:
-Initial dose: 1 mg orally, once
-Maximum dose: 2.5 mg in a 24 hour period
Liver Dose Adjustments
Severe hepatic impairment (Child-Pugh grade C): Use is contraindicated
Mild to moderate hepatic impairment (Child-Pugh grade A or B):
-Initial dose: 1 mg orally, once
-Maximum dose: 2.5 mg in a 24 hour period
Elderly: Dose selection should be cautious, consider starting at the lower end of the dosing range.
-Take orally with water or other liquids
-A second dose should be taken no sooner than 4 hours after the first dose
-This drug should be used only where a clear diagnosis of migraine has been established; if a patient does not respond, the diagnosis of migraine should be reconsidered before treating subsequent attacks.
-This drug is not intended to treat cluster headaches, hemiplegic, or basilar migraines or for the prophylactic treatment of migraines.
-For patients with coronary artery disease (CAD) risk factors, a cardiovascular evaluation should be performed prior to initiating therapy; for patients who have satisfactorily completed a cardiovascular evaluation, consider administering first dose in a medically supervised setting and performing an ECG immediately following administration.
-Medication overuse headaches may present as migraine-like headaches or as a marked increase in migraine frequency; for patients using acute migraine medications (e.g. ergotamine, triptans, opioids) for 10 or more days per month consider withdrawal of the overused drugs and treatment of withdrawal symptoms.
-ECG monitoring should be considered in the interval following the first dose in patients with risk factors for coronary artery disease (CAD) who have satisfactorily completed a cardiovascular evaluation, consider periodic cardiovascular evaluation in intermittent long-term users with cardiovascular risk factors.
-Monitor blood pressure
-Monitor for serotonin syndrome if concomitant use of selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs) are necessary, particularly when starting therapy or with a new or increased dose of a serotonergic medication.
-Patients should be advised to talk with their doctor or pharmacist before taking any new medications or supplements.
-Patients should be aware of the risk of serious cardiovascular side effects and the importance of seeking medical advice promptly if they occur.
-Patients experiencing no relief from a first dose of this medication should be instructed not to take a second dose without first talking to their healthcare provider.
-Patients should be informed of the possibility of developing medication overuse headaches.
-This drug may impair judgment, thinking, or motor skills; have patient avoid driving or operating machinery until adverse effects are determined.
-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.
What is the dose of Naratriptan for a child?
The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.
How is Naratriptan available?
Naratriptan is available in the following dosage forms and strengths:
- Oral tablet
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.
What should I do if I miss a dose?
If you miss a dose of Naratriptan, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
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