Migraine and headache:
Indications for AMERGE:
Acute treatment of migraine. Limitations of use: not for prophylaxis of migraine attacks or treatment of cluster headaches.
≥18yrs: 1mg or 2.5mg with fluids; may repeat once after 4hrs; max 5mg/24hrs. The safety of treating, on average, more than 4 headaches in a 30-day period has not been established. Mild-to-moderate renal or hepatic impairment: initially 1mg; max 2.5mg/24hrs.
<18yrs: not recommended.
Ischemic coronary artery disease or vasospasm, including Prinzmetal's angina. Wolff-Parkinson-White syndrome. Arrhythmias associated with other cardiac accessory conduction pathway disorders. History of stroke, TIA, or basilar or hemiplegic migraine. Peripheral vascular disease. Ischemic bowel disease. Uncontrolled hypertension. Severe renal or hepatic impairment. Within 24hrs of other 5-HT1 agonists or ergot-type drugs.
Confirm diagnosis. Exclude underlying cardiovascular disease, supervise 1st dose, and consider monitoring ECG in patients with likelihood of unrecognized coronary disease (eg, increased age, hypertension, obesity, diabetes, smokers, strong family history). Monitor cardiovascular function in long-term intermittent use. Discontinue if arrhythmias, cerebrovascular events, or serotonin syndrome occur. Possible peripheral or GI vascular ischemia, splenic infarction, or Raynaud's syndrome following use of 5-HT1 agonists. Monitor BP during treatment. Hepatic or renal dysfunction. Elderly (monitor). Pregnancy. Nursing mothers.
Selective 5-HT1B/1D receptor agonist.
Methysergide, other ergotamines, or other 5-HT1 agonists: see Contraindications. Serotonin syndrome with SSRIs, SNRIs, TCAs, or MAOIs.
Paresthesias, nausea, dizziness, drowsiness, malaise/fatigue, throat/neck symptoms (pain, pressure, tightness), drug overuse headache (discontinue if occurs); rare: serious cardiac events, anaphylactoid reactions.
Register pregnant patients exposed to naratriptan by calling (800) 336-2176.