naratriptan (Rx)

Brand and Other Names:Amerge
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 1mg
  • 2.5mg

Migraine

1-2.5 mg PO at onset; may repeat once after 4 hours

Not to exceed 5 mg/day

Renal Impairment

Mild-to-moderate: Not to exceed 2.5 mg/day

Severe (<15 mL/min); Do not administer

Safety and efficacy not established

Not recommended

Next:

Interactions

Interaction Checker

and naratriptan

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (14)

            • almotriptan

              almotriptan, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • bromocriptine

              bromocriptine, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Vasoconstrictive effects of triptans and bromocriptine may be additive. Drugs should not be used within 24h of one another.

            • cabergoline

              cabergoline, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • dihydroergotamine

              dihydroergotamine, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • dihydroergotamine intranasal

              dihydroergotamine intranasal, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • eletriptan

              eletriptan, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • ergoloid mesylates

              ergoloid mesylates, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • ergotamine

              ergotamine, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • frovatriptan

              frovatriptan, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • methylergonovine

              methylergonovine, naratriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • rizatriptan

              naratriptan, rizatriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • sumatriptan

              naratriptan, sumatriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • sumatriptan intranasal

              naratriptan, sumatriptan intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            • zolmitriptan

              naratriptan, zolmitriptan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Additive vasospasm. Sep. by 24h.

            Serious - Use Alternative (20)

            • citalopram

              citalopram, naratriptan. Mechanism: unknown. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome. If concomitant treatment with citalopram and a triptan is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.

            • cyclobenzaprine

              naratriptan and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

            • desvenlafaxine

              naratriptan and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

            • dolasetron

              dolasetron, naratriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • granisetron

              granisetron, naratriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • isocarboxazid

              naratriptan and isocarboxazid both increase serotonin levels. Avoid or Use Alternate Drug.

              isocarboxazid increases levels of naratriptan by decreasing metabolism. Contraindicated.

            • linezolid

              naratriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of naratriptan by decreasing metabolism. Contraindicated.

            • lorcaserin

              naratriptan and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

            • methylene blue

              naratriptan and methylene blue both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

            • netupitant/palonosetron

              netupitant/palonosetron, naratriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • ondansetron

              ondansetron, naratriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • ozanimod

              ozanimod increases toxicity of naratriptan by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

            • palonosetron

              palonosetron, naratriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • phenelzine

              naratriptan and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug.

              phenelzine increases levels of naratriptan by decreasing metabolism. Contraindicated.

            • procarbazine

              naratriptan and procarbazine both increase serotonin levels. Avoid or Use Alternate Drug.

            • rasagiline

              naratriptan and rasagiline both increase serotonin levels. Avoid or Use Alternate Drug. Avoid combination within 14 days of MAOI use

            • tedizolid

              tedizolid, naratriptan. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

            • tranylcypromine

              naratriptan and tranylcypromine both increase serotonin levels. Avoid or Use Alternate Drug.

              tranylcypromine increases levels of naratriptan by decreasing metabolism. Contraindicated.

            • vilazodone

              naratriptan, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

            • vortioxetine

              naratriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

            Monitor Closely (84)

            • 5-HTP

              naratriptan and 5-HTP both increase serotonin levels. Use Caution/Monitor.

            • almotriptan

              almotriptan and naratriptan both increase serotonin levels. Use Caution/Monitor.

            • amitriptyline

              naratriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • amoxapine

              naratriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • aripiprazole

              naratriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • asenapine

              naratriptan, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, naratriptan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • buspirone

              naratriptan and buspirone both increase serotonin levels. Modify Therapy/Monitor Closely.

            • cariprazine

              naratriptan, cariprazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • clomipramine

              naratriptan and clomipramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • clozapine

              naratriptan, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • cocaine

              naratriptan and cocaine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • cyproheptadine

              cyproheptadine decreases effects of naratriptan by pharmacodynamic antagonism. Use Caution/Monitor. Cyproheptadine may diminish the serotonergic effect of serotonin agonists.

            • desipramine

              naratriptan and desipramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dexfenfluramine

              naratriptan and dexfenfluramine both increase serotonin levels. Use Caution/Monitor.

            • dextroamphetamine

              naratriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • dextromethorphan

              naratriptan and dextromethorphan both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dihydroergotamine

              naratriptan and dihydroergotamine both increase serotonin levels. Use Caution/Monitor.

            • dihydroergotamine intranasal

              naratriptan and dihydroergotamine intranasal both increase serotonin levels. Use Caution/Monitor.

            • dosulepin

              naratriptan and dosulepin both increase serotonin levels. Modify Therapy/Monitor Closely.

            • doxepin

              naratriptan and doxepin both increase serotonin levels. Modify Therapy/Monitor Closely.

            • droxidopa

              naratriptan and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension

            • duloxetine

              naratriptan and duloxetine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • eletriptan

              eletriptan and naratriptan both increase serotonin levels. Use Caution/Monitor.

            • ergotamine

              naratriptan and ergotamine both increase serotonin levels. Use Caution/Monitor.

            • escitalopram

              naratriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • fenfluramine

              naratriptan and fenfluramine both increase serotonin levels. Use Caution/Monitor.

              fenfluramine, naratriptan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

            • fluoxetine

              naratriptan and fluoxetine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • fluphenazine

              naratriptan, fluphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • fluvoxamine

              fluvoxamine and naratriptan both increase serotonin levels. Modify Therapy/Monitor Closely.

            • frovatriptan

              frovatriptan and naratriptan both increase serotonin levels. Use Caution/Monitor.

            • haloperidol

              naratriptan, haloperidol. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • hydrocodone

              hydrocodone, naratriptan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • iloperidone

              naratriptan, iloperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • imipramine

              naratriptan and imipramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • isoniazid

              naratriptan and isoniazid both increase serotonin levels. Use Caution/Monitor.

            • L-tryptophan

              naratriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.

            • levomilnacipran

              naratriptan and levomilnacipran both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lisdexamfetamine

              naratriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

            • lithium

              naratriptan and lithium both increase serotonin levels. Use Caution/Monitor.

            • lofepramine

              naratriptan and lofepramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • loxapine

              naratriptan, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • loxapine inhaled

              naratriptan, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • lsd

              naratriptan and lsd both increase serotonin levels. Use Caution/Monitor.

            • lurasidone

              naratriptan, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • maprotiline

              naratriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • meperidine

              naratriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • milnacipran

              naratriptan and milnacipran both increase serotonin levels. Modify Therapy/Monitor Closely.

            • mirtazapine

              naratriptan and mirtazapine both increase serotonin levels. Use Caution/Monitor.

            • molindone

              naratriptan, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • morphine

              naratriptan and morphine both increase serotonin levels. Use Caution/Monitor.

            • nefazodone

              naratriptan and nefazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

            • nortriptyline

              naratriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • olanzapine

              naratriptan, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • oliceridine

              naratriptan, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

            • paliperidone

              naratriptan, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • paroxetine

              naratriptan and paroxetine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • pentazocine

              naratriptan and pentazocine both increase serotonin levels. Use Caution/Monitor.

            • perphenazine

              naratriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • pimavanserin

              naratriptan, pimavanserin. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • pimozide

              naratriptan, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • procarbazine

              procarbazine increases levels of naratriptan by serotonin levels. Modify Therapy/Monitor Closely. Closely monitor for signs and symptoms of serotonin toxicity/serotonin syndrome during such therapy.

            • protriptyline

              naratriptan and protriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • quetiapine

              naratriptan, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • remifentanil

              remifentanil increases toxicity of naratriptan by serotonin levels. Modify Therapy/Monitor Closely. Increases risk of serotonin syndrome.

            • risperidone

              naratriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • rizatriptan

              naratriptan and rizatriptan both increase serotonin levels. Use Caution/Monitor.

            • SAMe

              naratriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

            • selegiline

              naratriptan and selegiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • selegiline transdermal

              naratriptan and selegiline transdermal both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sertraline

              naratriptan and sertraline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • St John's Wort

              naratriptan and St John's Wort both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sufentanil SL

              sufentanil SL, naratriptan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • sumatriptan

              naratriptan and sumatriptan both increase serotonin levels. Use Caution/Monitor.

            • sumatriptan intranasal

              naratriptan and sumatriptan intranasal both increase serotonin levels. Use Caution/Monitor.

            • tapentadol

              naratriptan and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • thiothixene

              naratriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • tramadol

              naratriptan and tramadol both increase serotonin levels. Use Caution/Monitor.

            • trazodone

              naratriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

            • trifluoperazine

              naratriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • trimipramine

              naratriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • venlafaxine

              naratriptan and venlafaxine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • ziprasidone

              naratriptan, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • zolmitriptan

              naratriptan and zolmitriptan both increase serotonin levels. Use Caution/Monitor.

            Minor (11)

            • duloxetine

              duloxetine, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • escitalopram

              escitalopram, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • ethinylestradiol

              ethinylestradiol increases effects of naratriptan by unspecified interaction mechanism. Minor/Significance Unknown. The clinical implication of these interactions is unknown.

            • fluoxetine

              fluoxetine, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • mestranol

              mestranol increases effects of naratriptan by unspecified interaction mechanism. Minor/Significance Unknown.

            • milnacipran

              milnacipran, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • nefazodone

              nefazodone, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • paroxetine

              paroxetine, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • sertraline

              sertraline, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • trazodone

              trazodone, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • venlafaxine

              venlafaxine, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            Previous
            Next:

            Adverse Effects

            1-10%

            Dizziness

            Drowsiness

            Fatigue

            Paresthesias

            Pain/pressure sensation

            Nausea (1-5%)

            Throat/neck symptoms

            <1%

            Myocardial infarction

            Coronary artery vasospasm in pts with CAD risk factors

            Previous
            Next:

            Warnings

            Contraindications

            Hypersensitivity, including angioedema and anaphylaxis

            Severe hepatic or renal impairment

            Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders

            Ischemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal’s angina)

            History of stroke or TIA, or history of hemiplegic or basilar migraine because such patients are at a higher risk of stroke

            Peripheral vascular disease

            Ischemic bowel disease

            Uncontrolled hypertension

            Within 24 hours of another 5-HT 1 agonist, ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide)

            Cautions

            Decrease dose with mild-moderate renal impairment

            Anaphylaxis/anaphylactoid and hypersensitivity reactions, including angioedema reported (see Contraindications)

            May cause dizziness, weakness, or drowsiness (infrequent)

            Life-threatening disturbances of cardiac rhythm, including ventricular tachycardia and ventricular fibrillation leading to death, reported within a few hours following the administration of 5-HT1 agonists; discontinue therapy if these disturbances occur

            Sensations of tightness, pain, and pressure in the chest, throat, neck, and jaw commonly occur after treatment and are usually non-cardiac in origin; however, perform a cardiac evaluation if these patients are at high cardiac risk

            Therapy may cause non-coronary vasospastic reactions, such as peripheral vascular ischemia, gastrointestinal vascular ischemia and infarction (presenting with abdominal pain and bloody diarrhea), splenic infarction, and Raynaud’s syndrome; in patients who experience symptoms or signs suggestive of non-coronary vasospasm reaction following the use of any 5-HT1 agonist, rule out a vasospastic reaction before receiving additional doses

            Reports of transient and permanent blindness and significant partial vision loss reported with the use of 5-HT1 agonists; since visual disorders may be part of a migraine attack, a causal relationship between these events and the use of 5-HT1 agonists have not been clearly established

            Serotonin syndrome

            • Serotonin syndrome may occur, particularly during coadministration with selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase (MAO) inhibitors
            • Serotonin syndrome symptoms may include mental status changes (eg, agitation, hallucinations, coma), autonomic instability (eg, tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (eg, hyperreflexia, incoordination), and/or gastrointestinal symptoms (eg, nausea, vomiting, diarrhea)
            • The onset of symptoms usually occurs within minutes to hours of receiving a new or a greater dose of a serotonergic medication; discontinue therapy if serotonin syndrome is suspected
            • Significant elevation in blood pressure, including hypertensive crisis with acute impairment of organ systems, reported on rare occasions in patients treated with 5-HT1 agonists, including patients without a history of hypertension; monitor blood pressure in patients receiving therapy; drug is contraindicated in patients with uncontrolled hypertension

            Medication overuse

            • Overuse of acute migraine drugs (eg, ergotamine, triptans, opioids, or combination of these drugs for ≥10 days/month) may lead to exacerbation of headache (medication overuse headache)
            • Medication overuse headache may present as migraine-like daily headaches or as a
            • marked increase in frequency of migraine attacks; detoxification of patients, including withdrawal of overused drugs, and treatment of withdrawal symptoms (which often includes a transient worsening of headache) may be necessary

            Cerebrovascular events

            • Cerebral hemorrhage, subarachnoid hemorrhage, and stroke have occurred in patients treated with 5-HT1 agonists, and some have resulted in fatalities
            • In a number of cases, it appears possible that the cerebrovascular events were primary, the 5-HT1 agonist having been administered in the incorrect belief that the symptoms experienced were a consequence of migraine when they were not
            • Also, patients with migraine may be at increased risk of certain cerebrovascular events (eg, stroke, hemorrhage, TIA)
            • Discontinue drug if a cerebrovascular event occurs; before treating headaches in patients not previously diagnosed as migraineurs, and in migraineurs who present with symptoms atypical for migraine, exclude other potentially serious neurological conditions

            Myocardial ischemia, infarction, and Prinzmetal’s angina

            • Serious cardiac adverse reactions, including acute myocardial infarction, occurring within a few hours following administration of therapy reported; some of these reactions occurred in patients without known CAD; therapy may cause coronary artery vasospasm (Prinzmetal’s angina) even in patients without a history of CAD
            • Perform a cardiovascular evaluation in triptan-naive patients who have multiple cardiovascular risk factors (eg, increased age, diabetes, hypertension, smoking, obesity, strong family history of CAD) prior to receiving therapy; if there is evidence of CAD or coronary artery vasospasm, AMERGE is contraindicated
            • For patients with multiple cardiovascular risk factors who have a negative cardiovascular evaluation, consider administering the first dose in a medically supervised setting and performing an electrocardiogram (ECG) immediately following administration of; for such patients, consider periodic cardiovascular evaluation in intermittent long-term treatments
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy: There are no adequate data on the developmental risk associated with use of naratriptan in pregnant women; several studies have suggested that women with migraine may be at increased risk of preeclampsia during pregnancy

            Lactation: There are no data on presence of naratriptan in human milk, effects of naratriptan on the breastfed infant, or effects of naratriptan on milk production; naratriptan is present in rat milk; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for naratriptan and any potential adverse effects on the breastfed infant from naratriptan or from the underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Selective 5-HT1 receptor agonist in cranial arteries

            Causes vasoconstriction and reduces inflammation associated with antidronic neuronal transmission associated with relief of migraine

            Absorption

            Bioavailability: 70%

            Peak Plasma Time: 3-4 hr

            Peak Plasma Concentration: 50-1,000 ng/ml; 50% higher in women

            Distribution

            Protein Bound: 28-31%

            Vd: 170 L

            Metabolism

            Via hepatic CYP450 enzymes

            Elimination

            Half-Life: 6 hr

            Excretion: Urine 50%

            Previous
            Next:

            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Amerge oral
            -
            2.5 mg tablet
            Amerge oral
            -
            1 mg tablet
            naratriptan oral
            -
            2.5 mg tablet
            naratriptan oral
            -
            1 mg tablet
            naratriptan oral
            -
            2.5 mg tablet
            naratriptan oral
            -
            2.5 mg tablet
            naratriptan oral
            -
            1 mg tablet
            naratriptan oral
            -
            2.5 mg tablet

            Copyright © 2010 First DataBank, Inc.

            Previous
            Next:

            Patient Handout

            Patient Education
            naratriptan oral

            NARATRIPTAN - ORAL

            (nair-uh-TRIP-tan)

            COMMON BRAND NAME(S): Amerge

            USES: This medication is used to treat migraines. It helps to relieve headaches, pain and other symptoms of migraines, including sensitivity to light/sound, nausea, and vomiting. Prompt treatment allows you to get back to your normal routine and may decrease your need for other pain medications. Naratriptan does not prevent future migraines or reduce how often you may get a headache.Naratriptan belongs to a group of drugs called triptans. It affects a certain natural chemical (serotonin) that constricts blood vessels in the brain. It may also block other pain pathways in the brain.

            HOW TO USE: Read the Patient Information Leaflet available from your pharmacist before you start using naratriptan and each time you get a refill. Ask your doctor or pharmacist if you have any questions.Take one tablet by mouth with or without food, at the first sign of a migraine, or as directed by your doctor. Do not take naratriptan to prevent a migraine. If there is no improvement in your symptoms, do not take any more doses of this medication before talking to your doctor. If your symptoms are only partly relieved, or if your headache comes back, you may take a second dose after 4 hours or as directed by your doctor. Do not take more than 5 milligrams in a 24-hour period.If you have never taken this medication before and you have risk factors for heart disease (see Precautions), you may be advised to take your first dose in your doctor's office in order to monitor for rare but serious heart problems (e.g., heart attack).Your dosage is based on your medical condition and response to therapy. Tell your doctor if your condition does not improve or if it worsens.If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Tell your doctor if you need to use this medication more often, or if the medication is not working as well, or if your headaches get worse.

            SIDE EFFECTS: Flushing, sensations of tingling/numbness/prickling/heat, weakness, drowsiness, or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: blue fingers/toes/nails, cold sensation of hands/feet, hearing changes, mental/mood changes.Naratriptan can commonly cause chest/jaw/neck tightness, pain, or pressure that is usually not serious. However, these side effects are like symptoms of a heart attack, which may include chest/jaw/left arm pain, shortness of breath, or unusual sweating. Get medical help right away if these or other serious side effects occur, including: fast/irregular heartbeat, fainting, severe stomach/abdominal pain, bloody diarrhea, signs of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes, confusion).This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking naratriptan, tell your doctor or pharmacist if you are allergic to it; or to other triptan migraine drugs; or it you have other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (e.g., chest pain, heart attack, irregular heartbeat), decreased blood flow in the brain (e.g., stroke, transient ischemic attack), blood circulation disease (e.g., ischemic bowel disease, Raynaud's disease), certain types of headaches (hemiplegic or basilar migraine), kidney disease, liver disease.Tell your doctor if you have the following risk factors for heart disease: diabetes, family history of heart disease, high blood pressure, high cholesterol, overweight, smoker, female after menopause, male over age 40.If you are at high risk for heart disease, your doctor may want to check your heart before prescribing naratriptan.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).The risk of heart disease and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.If you also take any ergotamine medication (e.g., dihydroergotamine) or any other "triptan" drugs (e.g., zolmitriptan, rizatriptan), you will need to separate your naratriptan dose from your dose of these other medications in order to lessen the chance of serious side effects. Ask you doctor how long you should wait between your doses of these drugs.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy,"St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Take this medication only as needed when a migraine occurs, as directed by your doctor. This medication should not be taken on a regular schedule. Never increase your dose of this medication or take it more often than prescribed by your doctor.Certain foods/beverages or food additives (e.g., red wine, cheese, chocolate, monosodium glutamate) as well as some lifestyle patterns (e.g., irregular eating/sleeping habits, stress) may bring about a migraine headache. Avoiding these "triggers" may help decrease the frequency of migraine headaches. Consult your doctor for more details.Laboratory and/or medical tests (such as blood pressure) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

            MISSED DOSE: Not applicable.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised October 2018. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.