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Title: About triptans Post by Svenn on Apr 13th, 2004, 5:03am The World Headache Alliance: -------------------------------------------------------------------------------- | Print This Page | | Close Window | -------------------------------------------------------------------------------- 'More information about triptans' -------------------------------------------------------------------------------- Triptans are not a “miracle cure” for migraines but do have the best evidence for efficacy of any drug designed specifically to treat migraine. Triptans can be prescribed from the beginning, as first-line therapy to patients with moderate to severe migraine who do not have contraindications for their use. They can also be given to patients who have failed on simple and combination therapy with painkillers. Patients who should not take triptans include those: With evidence of existing cardiovascular disease Uncontrolled hypertension Severe renal and hepatic involvement The patient should be fully evaluated before receiving triptans if they: Have risk factors for cardiovascular disease, e.g. history of smoking or men over 40 years of age. How do triptans work? Triptans act on dilated blood vessels and return them to normal size, as well as reducing neuronal firing and the release of inflammatory factors on the trigeminal nerves (the nerve that delivers sensory stimuli to the brain from the face, teeth and tongue). Both of these mechanisms result in a reduced stimulation of the trigeminal nerve and improvement of all migraine symptoms. What triptans are available? There are seven triptans now available or have been approved in at least some countries: 1. Sumatriptan (Imigran, Imitrex in the U.S. and some other countries) is available in oral, nasal spray, injection, and in a few countries in suppository formulations. 2. Naratriptan (Naramig, Amerge in the U.S.) is available in an oral formulation. 3. Zolmitriptan (Zomig) is available in an oral (conventional and one that dissolves and can be taken without water) and has been submitted for regulatory approval as a nasal spray. 4. Rizatriptan (Maxalt) is available in oral (conventional and dissolving) formulations. 5. Almotriptan (Almogram, Axert in the U.S.) is available as an oral formulation. 6. Eletriptan (Relpax) is available as an oral formulation. 7. Frovatriptan (Elan) was recently approved by the U.S. FDA as an oral (conventional) formulation. More triptans are in clinical development and are likely to be introduced over the next several years. What are the common side effects with triptans? They are generally well tolerated, with adverse effects being short-lived, mild to moderate in intensity. They can include: Unpleasant but short-lived feelings of pain, heaviness or tightness in any part of the body, including areas such as the chest and neck Nausea Drowsiness and fatigue Dizziness Patients should be sure to tell their doctor about other drugs they are taking because certain drugs are contraindicated for use with triptans. Source: Dowson AJ. Your questions answered: Migraine and other headaches. London: Churchill Livingstone 2003. More Information: For information comparing the efficacy of triptans please click HERE. You will be asked for a username and password. The site is free to use and has a lot of interesting information on headaches and migraines. Neuroland - Neurology information for physicians & health professionals -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Disclaimer - Please Read When reading an article containing information on a specific therapy remember that it's only one of many that will appear in the medical literature. Its findings need to be understood within the context of all the data available to the scientific and medical communities. A study's conclusions and recommendations are limited by its design and no single study is designed to answer all clinical questions or to compare a new treatment or therapy with all currently available treatments or therapies. With the health and safety of their patients as their primary concern, the medical community rarely changes well-established treatment and diagnostic approaches on the basis of a single study. New treatment strategies arise when new findings have been confirmed and validated by other research studies. This takes time. Before adopting any change that will affect your own healthcare or that of your family you should consult your primary healthcare physician. |
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Title: Re: About triptans Post by Edna on Apr 13th, 2004, 8:41am Thank you Svenn, I see you're still as smart as you always were. And still got the goodness in you to help out with whatever way you can. Very informative article. AND......btw It's GREAT to see you posting here again........glad you got the rest you needed............and did you know "we missed you while you were gone" ??????? :o hugs to you friend, EDNA |
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Title: Re: About triptans Post by Mark C on Apr 13th, 2004, 8:50am Thanks Svenn, I love Triptans, the first thing to really work however there are many side effects and it is a powerful med. I am lucky I can take it and even more lucky I don't need it right now. Another undesriable side effect is the Triptans build up the the tissues of the eye over time. It seems best taken as little as needed. "Corneal Opacities: Dogs receiving oral sumatriptan developed corneal opacities and defects in the corneal epithelium. Corneal opacities were seen at the lowest dosage tested, 2 mg/kg/day, and were present after 1 month of treatment. Defects in the corneal epithelium were noted in a 60-week study. Earlier examinations for these toxicities were not conducted and no-effect doses were not established; however, the relative exposure at the lowest dose tested was approximately 5 times the human exposure after a 100-mg oral dose or 3 times the human exposure after a 6-mg subcutaneous dose. Melanin Binding: In rats with a single subcutaneous dose (0.5 mg/kg) of radiolabeled sumatriptan, the elimination half-life of radioactivity from the eye was 15 days, suggesting that sumatriptan and its metabolites bind to the melanin of the eye. The clinical significance of this binding is unknown." |
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