Naratriptan 2.5mg tablets

Around 91% of migraine patients use over-the-counter medicines to treat attacks, often without further treatment or medical consultation. This therapeutic principle is established in most countries, regardless of how the healthcare system is otherwise structured or financed. Using Germany as an example, the basis for an expansion of attack therapy with rizatriptan as an over-the-counter triptan is described. To achieve the best possible tolerability and safety in the context of self-medication, the lowest possible dose should be selected to provide the most favourable tolerability and safety profile in the context of self-medication through low dosages. The lowest approved dose of rizatriptan is 5 mg. This was investigated in three randomized controlled trials with 752 patients. The results show that rizatriptan at a dose of 5 mg is more effective than the triptans naratriptan 2.5 mg, almotriptan 12.5 mg and sumatriptan 50 mg, which were previously available for self-medication in Germany. There was no significant difference in the frequency of adverse events with rizatriptan 5 mg compared to placebo. Rizatriptan 5 mg does not have a higher side effect potential than sumatriptan 50 mg, which is already exempt from the prescription requirement. The reasons given show that rizatriptan in a dose of 5 mg for the treatment of acute migraine attacks fulfils the requirements for a transfer from prescription to pharmacy-only status at least as well as sumatriptan 50 mg, naratriptan 2.5 mg and almotriptan 12.5 mg. From a clinical care perspective, it is desirable for affected patients to have other options available for self-medication. Non-responders to other substances also have a further treatment option with rizatriptan 5 mg, with the same or even better risk-benefit profile, to treat migraine attacks safely, effectively and in a tolerable manner as part of self-medication.

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Tinnitus, a distressing condition that can significantly impair quality of life, has been associated with several medications, including triptans. This study aimed to explore the relationship between tinnitus and specific migraine treatments, focusing on triptans and calcitonin gene-related peptide (CGRP) inhibitors. Data from the FDA Adverse Event Reporting System (FAERS) through the third quarter of 2023 were analyzed to calculate proportional reporting ratios (PRR) and reporting odds ratios (ROR) for migraine treatments, specifically triptans and CGRP inhibitors. Positive tinnitus signals were identified when PRRs or RORs were greater than 2.0, the lower bound of the 95% confidence interval exceeded 1.0, and at least three cases were reported. Intra- and inter-class analyses were conducted to compare tinnitus reports among individual drugs and drug classes. Among 47,615 tinnitus-related adverse events, 345 were associated with CGRP inhibitors and 183 with triptans. Positive tinnitus signals were observed for several CGRP inhibitors, except eptinezumab and atogepant, and for all triptans except sumatriptan. Inter-class analysis revealed no significant differences between triptans and CGRP inhibitors. However, intra-class analysis identified naratriptan, almotriptan, and frovatriptan as having notable tinnitus signals among triptans, while CGRP inhibitors did not exhibit strong signals for any specific drug. Using real-world data from FAERS and pharmacovigilance methods, this study identified tinnitus signals related to migraine treatments, particularly among certain triptans. These findings provide preliminary evidence for further investigation into the relationship between migraine medications and tinnitus.

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Background: Understanding all factors that affect a patient's acute migraine treatment care is crucial. We sought to determine the impact of headache specialist density and the introduction of the gepants and lasmiditan on the prescription of acute treatments for migraine. Methods: We analyzed three scenarios: first, we performed linear regression analysis with the percentage of patients with migraine prescribed an acute medication in 2023, obtained via Epic Cosmos, and the density of headache specialists at the state level. Second, we conducted interrupted time-series analysis examining the change in patients prescribed the triptans before (2016-2019) and after (2020-2023) the introduction of the gepants and lasmiditan. Finally, we used regression analysis to look at the association of one pharmaceutical company, Pfizer, payments to physicians with prescriptions for that company's gepant, rimegepant. Results: We included 6,559,854 patients with migraine and found that increased headache specialist density was associated with increased eletriptan, almotriptan, and naratriptan; there was no association with the other queried acute medications. In our interrupted time-series analysis, the introduction of the gepants and lasmiditan was linked to decreases in triptan utilization, except for eletriptan which remained stable, and rizatriptan which rose at a slower rate. Finally, increased Pfizer payments to physicians were associated with a higher percentage of patients prescribed rimegepant. Conclusion: Our study suggests increased headache provider availability is associated with more prescriptions for naratriptan, eletriptan, and almotriptan. Additionally, the introduction of the gepants and lasmiditan broadly decreased the utilization of triptans. Critically, there was a strong association between a pharmaceutical company's, Pfizer, payments to physicians and utilization of their medication, rimegepant.

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Spinal and bulbar muscular atrophy (SBMA) is a neuromuscular disorder caused by CAG trinucleotide expansion in the androgen receptor (AR) gene. To improve the quality of in vitro cell-based assays for the evaluation of potential drug candidates for SBMA, we developed a morphology-based phenotypic analysis for a muscle cell model of SBMA that involves multiparametric morphological profiling to quantitatively assess the therapeutic effects of drugs on muscle cell phenotype. The analysis was validated using dihydrotestosterone and pioglitazone, which have been shown to exacerbate and ameliorate the pathophysiology of SBMA, respectively. Gene expression analysis revealed activation of the JNK pathway in the SBMA cells compared to the control cells. Phenotypic analysis revealed the effect of naratriptan, a JNK inhibitor, on the phenotypic changes of SBMA cells, and the results were confirmed by LDH assays. We then trained a predictive machine learning model to classify the drug responses, and it successfully discriminated between pioglitazone-type and naratriptan-type morphological profiles based on their morphological characteristics. Our morphology-based phenotypic analysis provides a noninvasive and efficient screening method to accelerate the development of therapeutics for SBMA.

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BACKGROUND: Triptans selectively agoniste 5-Hydroxytryptamine(5-HT) receptors and are widely used in the treatment of migraine. Nevertheless, there is a dearth of comprehensive real-world clinical research on the safety of triptans. In light of the growing prevalence of migraine, it is imperative to gain a deeper understanding of the true extent of adverse events (AEs) associated with triptans in the clinical management of migraine. METHODS: A database query of AEs reported to the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database for triptans was performed using the online platform Open Vigil 2.1. The query spanned the period from 1 January 2018 to 31 December 2023 and extracted all AEs for 'sumatriptan', 'zolmitriptan', 'rizatriptan', and 'naratriptan' from the 15-49 years old population and retrospective quantitative analyses. A proportional reporting ratio (PRR), reporting odds ratio (ROR), and Bayesian Confidence Propagation Neural Network (BCPNN) methodology were utilized to contrast AEs across the four triptans. RESULTS: A total of 1.272 AEs reports for sumatriptan, 114 for zolmitriptan, 162 for rizatriptan, and 15 for naratriptan were identified. The ratio of females to males was approximately three times higher in all cases, with the highest number of reports originating from the Americas. A review of the FAERS database revealed that nervous system disorders were the primary SOC category for four drugs, with all four drugs exhibiting the AE indicative of reversible cerebral vasoconstriction syndrome, also classified as Nervous system disorders. The most frequently reported AE signal for sumatriptan was dyspnea, which is classified as respiratory, thoracic and mediastinal disorders. The most frequently reported AEs signals for the remaining three drugs were nausea, vomiting and terminal ileitis, all of which are classified as gastrointestinal disorders. CONCLUSION: Analyses have demonstrated that AEs are present in a range of systems, including cardiac, nervous, gastrointestinal, and musculoskeletal disorders. It should be noted, however, that the incidence and signal intensity of these AEs vary depending on the specific drug in question. In clinical practice, the selection of an appropriate drug and the monitoring of AEs should be tailored to the individual patient's and specific characteristics.

Abstract licence: CC BY-NC-ND

Abstract Aim Headache is one of the most frequent somatic complaints in psychiatric practice and is often attributed to underlying mental disorders. However, primary headache disorders—particularly migraine and tension‐type headache (TTH)—commonly coexist with psychiatric conditions. Evidence from psychiatric outpatient settings remains limited. Methods We conducted a retrospective chart review of all psychiatric outpatients who visited our 600‐bed regional general hospital between April 1, 2023, and March 31, 2024. Among 2525 patients, we identified 360 individuals with headache‐related insurance diagnoses and extracted data on headache labels, treating departments, and prescribed medications. For calcitonin gene–related peptide (CGRP)‐targeted monoclonal antibodies, we extended the observation period to March 31, 2025, to describe an exploratory case series including additional prescriptions. Results Of 2525 psychiatric outpatients, 360 (14.3%) carried a headache‐related insurance diagnosis. The most frequent labels were “headache” (203/360, 56.4%), migraine (92/360, 25.6%), and TTH (46/360, 12.8%); cluster headache and medication‐overuse headache (MOH) were each recorded in 1/360 (0.3%). Headache care was most often delivered within psychiatry (153/360, 42.5%), followed by neurology (42/360, 11.7%), neurosurgery (40/360, 11.1%), general internal medicine (28/360, 7.8%), and rheumatology/collagen‐vascular disease (15/360, 4.2%). Commonly documented agents included nonsteroidal anti‐inflammatory drug (NSAIDs) (40/360, 11.1%), acetaminophen (38/360, 10.6%), triptans (23/360, 6.4%), Japanese Kampo formulas (16/360, 4.4%), and CGRP monoclonal antibodies (6/360, 1.7%). At the agent level, acetaminophen ( n = 38), loxoprofen ( n = 33), zolmitriptan ( n = 14), goreisan ( n = 8), sumatriptan ( n = 6), kakkonto ( n = 6), diclofenac ( n = 4), valproic acid ( n = 4), and naratriptan ( n = 3) were among the most frequently listed. In the exploratory CGRP analysis (total seven patients through March 31, 2025), six were women; the mean age was 48.4 ± 9.2 years. Psychiatric comorbidities were heterogeneous, including eating disorder, bipolar disorder, post‐traumatic stress disorder, dysthymia with social anxiety disorder, schizophrenia, autism spectrum disorder, and neurotic depression. All cases experienced headache improvement; two required switching to another CGRP agent for recurrent attacks yet maintained benefit. One patient temporarily discontinued due to a rash before resuming a different CGRP agent. In contrast, medium‐term changes in mood/anxiety were limited. Conclusion In a psychiatric outpatient cohort, primary headaches were common and frequently managed within psychiatry. CGRP‐targeted therapy yielded headache relief even under psychiatric comorbidity, while psychiatric symptoms did not uniformly improve, underscoring the need for parallel mental‐health interventions alongside headache‐specific care. Strengthening cross‐specialty pathways and early headache evaluation within psychiatry are warranted.

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