Serotonin 5-HT- Receptor Agonists

Type of Drug:

Agent for treating migraine headaches.

How the Drug Works:

Serotonin 5-HT 1 receptor antagonists constrict blood vessels in the brain and reduce transmission of trigeminal pain pathways, thus providing relief from migraine headaches.

Uses:

For the acute management of migraine with or without aura in adults. Not intended for the prevention of migraine or for use in the management of hemiplegic or basilar migraine.

Sumatriptan succinate injection: For the acute treatment of cluster headache episodes.

Precautions;

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if 5-HT agonists appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established. Not recommended in patients younger than 18 years of age.

Lab Tests: Lab tests may be required prior to or during therapy. Tests include cardiovascular system evaluations.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements while taking these drugs. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs or drug classes interact with these drugs:

• Another 5-HT agonist cimetidine (eg, Tagamet)

• Contraceptives, oral (eg, OrthoNovum) (frovatriptan only)

• Ergot-containing drugs (eg, methysergide)

• Erythromycin (eg, E-Mycin)

• Ketoconazole (eg, Nizoral)

• MAGis (eg, phenelzine)

• Propranolol (eg, Inderal)

• Rtonavir (Norvir)

• Sibutramine (Meridia)

• Itraconazole (Sporanox)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Stomach pain; nausea; dry mouth; vomiting.

Nervous System: Drowsiness; headache; abnormal skin sensations (eg, feeling of warmth, heat, numbness, tingling); dizziness; unusual drowsiness or weakness.

Circulatory System: Increased blood pressure; chest pain, tightness, heaviness, or pressure; abnormal heart rhythm; fainting; flushing.

Other: Light sensitivity; neck, throat, or jaw pain or tightness; fatigue.

Guidelines for Use:

• 5-HT agonists are only used to treat migraine headaches. They should not be used to prevent a migraine.

• Review patient information leaflet before use.

• Your doctor may want you to take the first dose in the office if you have any risk factors for coronary artery disease.

• Dosage is individualized. Take exactly as prescribed.

• Do not stop taking or change the dose, unless instructed by your doctor.

• If the headache returns after the first dose, you may take a second dose 2 hours or more after the first dose. If pain continues after the first dose, do not take a second dose without first checking with your doctor.

• Orally-disintegrating tablets - Make sure your hands are dry before removing the tablet from the package. Remove tablet and immediately place it on the tongue. The tablet dissolves within seconds and is swallowed with the saliva. You do not need to drink water or other liquids to swallow the tablets.

• Nasal spray _ Clear nasal passages before using. May irritate the nose (eg, burning, soreness, discharge).

• Tablets may be taken without regard to food.

• May cause drowsiness or dizziness, Use caution while driving or per­forming other tasks requiring alertness, coordination, or physical dexterity.

• Notify your doctor immediately if you experience tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw.

• The safety of treating more than 4 headaches in a 30-day period is unknown.

• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.

• Lab tests may be required prior to or during therapy. Be sure to keep appointments. Long-term users who have or develop risk factors for coronary artery disease will need periodic heart tests.

• Store at controlled room temperature (59° to 86°F). Do not store orally­disintegrating tablets in the bathroom or other damp places. Heat or moisture will destroy the medicine.