Naratriptan


Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Acute migraine attacks
Adult: Initially, 1-2.5 mg, dose may be repeated after 4 hr if symptoms recur (2nd dose should not be taken for same attack). Max: 5 mg daily.
Renal Impairment
Mild to moderate: Initially, 1 mg. Max 2.5 mg daily.
CrCl (mL/min)  Dosage
 <15  Contraindicated.
Hepatic Impairment
Mild to moderate (Child-Pugh class A or B): Initially, 1 mg. Max 2.5 mg daily. Severe (Child-Pugh class C): Contraindicated.
Cách dùng
May be taken with or without food.
Chống chỉ định
Hypersensitivity. Coronary artery disease (e.g. angina pectoris, silent ischaemia, MI), coronary artery vasospasm, Prinzmetal’s angina, uncontrolled HTN, cerebrovascular syndromes (e.g. stroke, TIA), hemiplegic or basilar migraine, Wolff-Parkinson-White syndrome, peripheral vascular disease, ischemic bowel disease. Severe renal (CrCl <15 mL/min) and hepatic (Child-Pugh class C) impairment. Concomitant use w/ ergot derivatives and 5-HT1 receptor agonists.
Thận trọng
Patient w/ multiple CV risk factors. Not intended for cluster headache and for the prevention of migraine attacks. Mild to moderate renal and hepatic impairment. Pregnancy and lactation.
Phản ứng phụ
Significant: Chest pain/tightness, peripheral vascular ischaemia, GI vascular ischaemia/infarction, splenic infarction, Raynauld’s syndrome, transient and permanent blindness, partial loss of vision, recurrent/rebound headaches, withdrawal syndrome; hypertensive crisis, medication-overuse headache (MOH).
Nervous: Tingling sensation, paraesthesia, dizziness, somnolence, drowsiness, malaise, fatigue, heaviness sensation, hot/cold flushes, dizziness, vertigo, weakness.
CV: Bradycardia, palpitations.
GI: Nausea, vomiting, xerostomia.
Resp: Pharynx constriction.
Musculoskeletal: Neck pain, myalgia.
Ophthalmologic: Photophobia.
Potentially Fatal: Acute MI, coronary artery vasospasm, transient ischaemia, ventricular tachycardia/fibrillation, cerebral or subarachnoid haemorrhage, stroke, hypersensitivity reactions (e.g. angioedema).
Thông tin tư vấn bệnh nhân
This drug may cause dizziness, weakness, or drowsiness, if affected, do not drive or operate machinery.
MonitoringParameters
Assess clear diagnosis of migraine and neurological conditions prior to initiation of therapy. Perform periodic CV evaluation for patients w/ risk factors for coronary artery disease who are receiving intermittent long-term therapy. Monitor ECG, BP, signs and symptoms of withdrawal, serotonin syndrome, angina, hypersensitivity reactions, and headache severity.
Quá liều
Symptoms: Increase in BP, light-headedness, neck tension, tiredness, loss of coordination, ECG changes. Management: Supportive treatment. Monitor patient for at least 24 hr.
Tương tác
Potentially Fatal: May cause additive vasospastic reactions w/ ergot derivatives and 5-HT1 receptor agonists. Risk of serotonin syndrome w/ SSRIs or serotonin norepinephrine reuptake inhibitors (SNRIs).
Food Interaction
May cause undesirable adverse effects w/ St John’s wort.
Tác dụng
Description: Naratriptan is a selective serotonin (5-HT1B/1D) agonist in intracranial blood vessels, which causes vasoconstriction and reduction in oedema formation in the meninges thus alleviating migraine. It is also thought to inhibit trigeminal nerve activity.
Pharmacokinetics:
Absorption: Rapidly and well absorbed from the GI tract. Bioavailability: Approx 70%. Time to peak plasma concentration: 2-3 hr.
Distribution: Volume of distribution: 170 L. Plasma protein binding: Approx 29%.
Metabolism: Metabolised in the liver by CYP enzymes into inactive metabolites.
Excretion: Via urine (50% as unchanged drug, 30% as inactive metabolites). Elimination half-life: 6 hr.
Đặc tính

Chemical Structure Image
Naratriptan

Source: National Center for Biotechnology Information. PubChem Database. Naratriptan, CID=4440, https://pubchem.ncbi.nlm.nih.gov/compound/Naratriptan (accessed on Jan. 22, 2020)

Bảo quản
Store between 20-25°C.
Phân loại MIMS
Phân loại ATC
N02CC02 - naratriptan ; Belongs to the class of selective serotonin (5HT1) agonists preparations. Used to relieve migraine.
References
Amerge Tablet, Film Coated (GlaxoSmithKline LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 24/08/2017.

Anon. Naratriptan. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 24/08/2017.

Buckingham R (ed). Naratriptan Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/08/2017.

Joint Formulary Committee. Naratriptan. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/08/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Naratriptan Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 24/08/2017.

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