Pharmacologic class: Serotonin 5-hydroxytryptamine (5-HT)1-receptor agonist
Therapeutic class: Antimigraine agent
Pregnancy risk category C
Binds selectively to serotonin receptors on cranial arteries, causing vasoconstriction and decreased blood flow
Tablets: 2.5 mg
Indications and dosages
➣ Acute migraine
Adults: 2.5 mg P.O. as a single dose at first symptom of migraine. If migraine returns, may repeat after 2 hours. Maximum of three doses in 24 hours (7.5 mg/day).
• Hypersensitivity to drug or its components
• Cerebrovascular disorders
• Ischemic heart disease or history of myocardial infarction
• Uncontrolled hypertension
• Peripheral vascular disease
• Hemiplegic or basilar migraine
• Within 24 hours of another 5-HT1-receptor agonist or ergotamine-containing or ergot-type drug
Use cautiously in:
• patients receiving selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)
• pregnant or breastfeeding patients
• children (safety and efficacy not established).
• Give one tablet with plenty of fluids at first symptom of migraine.
• If headache returns, administer another tablet after 2 hours.
• Don't exceed three tablets in 24-hour period.
• Give first dose under close supervision if patient has coronary artery disease or other risk factors.
• Don't give within 24 hours of another 5-HT1-receptor agonist or ergotamine-containing or ergot-type drug.
CNS: dizziness, headache, anxiety, malaise, fatigue, weakness, drowsiness, paresthesia, sensation loss
CV: palpitations, tightness in chest, myocardial infarction (MI)
EENT: abnormal vision, tinnitus, rhinitis
GI: nausea, diarrhea, dyspepsia, abdominal pain
Musculoskeletal: skeletal or muscle pain
Skin: flushing, diaphoresis, photosensitivity
Other: altered taste, hot or cold sensations
Drug-drug. Ergot alkaloids, other serotonin 5-HT1-receptor agonists: prolonged vasoactive reactions
Hormonal contraceptives, propranolol: increased frovatriptan bioavailability
SSRIs, SNRIs: serotonin syndrome (including mental status changes, hyperreflexia, nausea, vomiting)
Drug-behaviors. Sun exposure: increased risk of photosensitivity
• Assess for cardiovascular reactions, especially signs and symptoms of MI.
• Monitor neurologic status, particularly for indications of cerebrovascular accident.
• Check for rash and itching.
• Instruct patient to take one tablet with plenty of fluids at first symptom of migraine.
• Tell patient he may take second tablet 2 hours after first if migraine returns.
☞ Advise patient to immediately report chest pain.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.