Naratriptan Bei Migräne Adgc (Naratriptan)

Naratriptan is indicated for the acute treatment of migraine, acting on the trigeminovascular system to abort attacks.

• Migraine (with aura): provides rapid relief of headache pain, photophobia, phonophobia and associated nausea within two hours of onset.
• Migraine (without aura): aborts the attack, reducing headache intensity, duration and associated symptoms such as vomiting and sensitivity to light.
• Menstrual migraine: helps alleviate attacks that occur in relation to the menstrual cycle, offering timely symptom control.

• Naratriptan selectively binds to serotonin 5‑HT1B and 5‑HT1D receptors on intracranial blood vessels and trigeminal nerve endings. Activation of 5‑HT1B receptors induces vasoconstriction of dilated cranial arteries, while stimulation of 5‑HT1D receptors inhibits release of pro‑inflammatory neuropeptides from trigeminal afferents. The combined vascular and neuronal effects interrupt the cascade that generates migraine pain, leading to rapid cessation of the headache.

Common side effects are generally mild and transient, whereas serious or rare reactions require immediate medical attention.

Common Side Effects

• Nausea
• Dizziness
• Dry mouth

Serious or Rare Side Effects

• Coronary vasospasm or myocardial ischemia
• Serotonin syndrome
• Severe allergic reaction (e.g., anaphylaxis)

Precautions should be observed before initiating therapy with Naratriptan.

• Cardiovascular disease: assess risk before prescribing, avoid in patients with uncontrolled angina or recent myocardial infarction.
• History of stroke or transient ischemic attack: contraindicated; do not use.
• Concomitant serotonergic drugs: monitor for serotonin syndrome when combined with SSRIs, SNRIs or MAO inhibitors.
• Pregnancy and lactation: use only if potential benefit justifies potential risk; consult healthcare provider.
• Elderly patients: start at lowest effective dose and monitor for adverse effects.
• Store at ambient temperature: keep below 25 °C in the original packaging, protect from moisture and light.

Naratriptan may interact with several medicines; some combinations should be avoided while others require monitoring.

Major Interactions (Avoid)

• MAO inhibitors: risk of severe hypertension and serotonin syndrome.
• Other triptans or ergot derivatives: additive vasoconstriction may cause coronary spasm.
• SSRIs, SNRIs, or other serotonergic agents: increased risk of serotonin syndrome.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: may enhance blood pressure‑lowering effect.
• Oral contraceptives: possible increase in migraine frequency.
• NSAIDs: combined use may raise risk of gastrointestinal irritation.
• CYP1A2 inhibitors (e.g., fluvoxamine): may increase naratriptan plasma levels.