Naratriptan

The recommended adult single dose of naratriptan ranges from 1 mg to 2.5 mg. The maximum recommended single dose is 2.5 mg.

Naratriptan should be taken as early as possible after the onset of a migraine headache, but is effective if taken at a later stage. A second tablet may be taken if the headache returns, but not sooner than 4 hours after the first tablet was taken. You should not take any more than 5 mg of naratriptan in any 24-hour period (i.e., 2 of the 2.5 mg strength or 5 of the 1 mg strength).

If you do not get relief from the first dose of naratriptan, a second dose should not be taken for the same attack unless you talk with your doctor first, as it is unlikely to be of benefit.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

The tablets should be swallowed whole with fluids.

It is important to take Naratriptan exactly as prescribed. The safety of treating more than 4 migraines with naratriptan in a 1-month period of time is not known. If you are experiencing more than 4 migraines in a month, contact your doctor.

Store Naratriptan at room temperature, protect it from light and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may cause nausea or, rarely, vomiting; it may cause stiffness of the neck and jaw. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each green-coloured, D-shaped, film-coated tablet, with "SZ" debossed on one side and "248" on the other side, contains 2.5 mg of naratriptan (as naratriptan hydrochloride). Nonmedicinal ingredients: FD&C Blue No. 2 Aluminum Lake, cellulose microcrystalline, croscarmellose sodium, hypromellose, iron oxide yellow, lactose anhydrous, lactose monohydrate, magnesium stearate, titanium dioxide, and triacetin.

Do not take naratriptan if you:

• are allergic to naratriptan or any ingredients of the medication
• have Angina (chest pain), including Prinzmetal angina (coronary vasospasm)
• have blood vessel disease (e.g., ischemic bowel disease, Raynaud's syndrome, Stroke, transient ischemic attacks [TIAs])
• have had a Heart Attack
• have heart disease (e.g., heart valve disease, ischemic heart disease, abnormal heart rhythms, congenital heart disease)
• have high blood pressure that is severe or not under control
• have taken another 5-hydroxytryptamine agonist (i.e., Rizatriptan, Sumatriptan, Zolmitriptan) in the previous 24 hours
• have taken ergotamine-containing or ergot-type medications (such as Dihydroergotamine, ergotamine, or methysergide) in the previous 24 hours
• have certain types of migraine headaches (including hemiplegic, basilar or ophthalmoplegic migraine)
• have severely reduced kidney function
• have severely reduced liver function
• do not have a clear diagnosis of migraine

There may be an interaction between naratriptan and any of the following:

• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antipsychotics (e.g., Chlorpromazine, Fluphenazine, Haloperidol, Pimozide, Quetiapine, Risperidone)
• Bromocriptine
• Buspirone
• Cabergoline
• Dextromethorphan
• ergot-containing medications (e.g., dihydroergotamine, ergotamine, or methysergide) if taken at the same time or within the previous 24 hours
• lithium
• Meperidine
• Metoclopramide
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, Selegiline, Tranylcypromine) if taken at the same time or within 14 days of naratriptan

• nefazodone
• other 5-hydroxytryptamine agonists (e.g., rizatriptan, sumatriptan, zolmitriptan)
• SAMe
• selective norepinephrine reuptake inhibitors (SNRIs; e.g., Venlafaxine)
• selective serotonin receptor agonists (SSRIs; e.g., Fluoxetine, Fluvoxamine, Paroxetine, Sertraline)
• St. John's wort
• Tapentadol
• Tramadol
• Trazodone
• tricyclic antidepressant drugs (e.g., Amitriptyline, Imipramine)
• Tryptophan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Naratriptan. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Naratriptan.

Allergic reactions: If you are allergic to sulfonamides you may experience an allergic reaction to naratriptan. Reactions range from skin allergy to serious allergic reaction. Rarely, anaphylactic reactions to naratriptan may occur. Because of the possibility of allergic reactions, people who are allergic to any of the other drugs of this class (5-hydroxytryptamine agonists) should not use naratriptan.

Blood pressure: Naratriptan may cause increases in blood pressure. If you have mild to moderately increased blood pressure, discuss with your doctor how Naratriptan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Naratriptan, and whether any special monitoring is needed.

People with severe or uncontrolled high blood pressure should not take naratriptan.

Drowsiness/reduced alertness: Naratriptan may cause drowsiness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how Naratriptan affects you.

Headache type: Naratriptan should only be used where there is a clear diagnosis of migraine headache.

Heart disease: There have been rare reports of heart attack and stroke occurring with people who have appeared to be otherwise healthy. If you have risk factors for heart disease, discuss with your doctor how Naratriptan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Naratriptan, and whether any special monitoring is needed.

Risk factors for heart disease include high blood pressure, High Cholesterol levels, smoking, Obesity, Diabetes, a family history of heart disease, being male over 40 years old, or being a post-menopausal woman.

If you have heart disease you should not use naratriptan.

Kidney function: For people with reduced kidney function, it takes longer for naratriptan to leave the body, which may result in an increase in side effects. If you have reduced kidney function or Kidney Disease, discuss with your doctor how Naratriptan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Naratriptan, and whether any special monitoring is needed.

If you have severely reduced kidney function you should not use naratriptan.

Liver function: For people with reduced liver function, it takes longer for naratriptan to leave the body, which may result in an increase in side effects. If you have reduced liver function or liver disease, discuss with your doctor how Naratriptan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Naratriptan, and whether any special monitoring is needed.

If you have severely reduced liver function you should not use naratriptan.

Medication overuse headache: As with other medications for treating headaches, the overuse of naratriptan may create a situation where the headache returns as the medication wears off, prompting the use of more medication. Do not take more naratriptan than recommended by your doctor. If you require more than 5 mg of naratriptan in a 24 hour period, or need to treat more than four headaches over 30 days, contact your doctor.

Medications containing ergotamine: After taking any ergotamine-containing preparation, wait at least 24 hours before taking naratriptan. Likewise, ergotamine-containing preparations should not be taken for at least 24 hours following naratriptan administration.

Seizures: There have been rare reports of seizures occurring with naratriptan. If you have a history of Epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how Naratriptan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Naratriptan, and whether any special monitoring is needed.

Serotonin syndrome: Severe reactions are possible when naratriptan is combined with other medications that act on serotonin such as tricyclic antidepressants and serotonin reuptake inhibitors, medications used to treat Depression. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible.

If you are taking antidepressants, discuss with your doctor how Naratriptan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Naratriptan, and whether any special monitoring is needed.

Pregnancy: Naratriptan should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Naratriptan, contact your doctor immediately.

Breast-feeding: It is not known if naratriptan passes into breast milk. If you are a breast-feeding mother and are taking Naratriptan, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Naratriptan have not been established for children, and its use by this age group is not recommended.

Seniors: There may be a higher risk of side effects such as high blood pressure and heart problems associated with the use of naratriptan by people over the age of 65 years. The use of naratriptan by people in this age group is not recommended.

For greater effectiveness and faster relief, use this product at the first sign of a migraine. Generally, this medication is used only as needed. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. This medication may be taken with or without food.