Naratriptán

Naratriptán is a selective serotonin 5-HT1B/1D receptor agonist used for the acute treatment of migraine with or without aura in adults. It is part of the triptan class and works by constricting dilated intracranial blood vessels and inhibiting the release of inflammatory neuropeptides, contributing to relief of migraine pain and associated symptoms.

Pharmacokinetically, naratriptán is administered orally as a tablet. The typical dose is 2.5 mg per attack, which may be repeated after at least four hours if needed, with a maximum of 5 mg in a 24-hour period. The onset of relief is usually within 1 to 3 hours, and the drug has a relatively long half-life, which can help reduce early headache recurrence compared with some other triptans.

Common adverse effects include dizziness, drowsiness, nausea, and chest or neck pressure. Serious cardiovascular events such as myocardial ischemia or stroke are rare but have been reported, particularly in patients with cardiovascular risk factors. Naratriptán is contraindicated in individuals with ischemic heart disease, history of myocardial infarction or stroke, and in those with uncontrolled hypertension or certain types of migraine (for example, basilar or hemiplegic migraine). It should not be used with ergot-containing medications or with MAO inhibitors because of the risk of severe vasoconstriction or serotonergic interactions. While data on pregnancy are limited, naratriptán is generally used with caution during pregnancy and lactation.

Naratriptán is metabolized in the liver and should be used with caution in hepatic impairment. Drug interactions with other serotonergic agents or vasoconstrictors can increase the risk of adverse effects. Brand names include Amerge, among others, and the medication is marketed in many countries.