Naratriptan

Naratriptan is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound or light). Naratriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels around the brain, stopping pain signals from being sent to the brain, and stopping the release of certain natural substances that cause pain, nausea, and other symptoms of migraine. Naratriptan does not prevent migraine attacks or reduce the number of headaches you have.

Naratriptan comes as a tablet to take by mouth. It is usually taken at the first sign of a migraine headache. If your symptoms improve after you take naratriptan but return after 4 hours or longer, you may take a second tablet. However, if your symptoms do not improve after you take naratriptan, do not take a second tablet before calling your doctor. Your doctor will tell you the maximum number of tablets you may take in a 24-hour period. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take naratriptan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

You may take your first dose of naratriptan in a doctor's office or other medical facility where you can be monitored for serious reactions.

Call your doctor if your headaches do not get better or occur more frequently after taking naratriptan.

If you take naratriptan more often or for longer than the recommended period of time, your headaches may get worse or may occur more frequently. You should not take naratriptan or any other headache medication for more than 10 days per month. Call your doctor if you need to take naratriptan to treat more than four headaches in a 1-month period.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking naratriptan,

• tell your doctor and pharmacist if you are allergic to naratriptan any other medications, or any of the ingredients in naratriptan tablets. Ask your pharmacist for a list of the ingredients.
• do not take naratriptan if you have taken any of the following medications in the past 24 hours: other selective serotonin receptor agonists such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), or zolmitriptan (Zomig); or ergot-type medications such as bromocriptine (Parlodel), cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), ergotamine (Cafergot, Ergomar), methylergonovine (Methergine), methysergide (Sansert), and pergolide (Permax).
• some medications should not be taken with naratriptan. Other medications may cause dosing changes or extra monitoring when taken with naratriptan. Make sure you have discussed any medications you are currently taking or plan to take before starting naratriptan with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking naratriptan, please get the advice of your doctor or pharmacist.
• tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate).
• the following nonprescription products may interact with naratriptan: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); acetaminophen (Tylenol). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking naratriptan. Do not start any of these medications while taking naratriptan without discussing with your healthcare provider.
• tell your doctor if you have or have ever had heart disease; a heart attack; angina (chest pain); irregular heartbeats; stroke or 'mini-stroke'; circulation problems such as varicose veins, blood clots in the legs, Raynaud's disease (problems with blood flow to the fingers, toes, ears, and nose), or ischemic bowel disease (bloody diarrhea and stomach pain caused by decreased blood flow to the intestines); Your doctor may tell you not to take naratriptan.
• tell your doctor if you smoke or are overweight; if you have or have ever had high blood pressure, diabetes, high cholesterol, or kidney or liver disease; if you have gone through menopause (change of life); or if any family members have or have ever had heart disease or stroke.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you plan to be sexually active while you are taking this medication, talk to your doctor about effective methods of birth control. If you become pregnant while taking naratriptan, call your doctor.
• you should know that naratriptan may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• talk to your doctor about your headache symptoms to make sure they are caused by migraine. Naratriptan should not be used to treat certain types of migraine headaches (hemiplegic or basilar migraines) or other types of headaches (such as cluster headaches).

Naratriptan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• weakness
• tiredness
• upset stomach
• nausea
• dizziness
• feeling warm or cold

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• tightness, pain, pressure, or heaviness in the chest, throat, neck, or jaw
• rapid, pounding, or irregular heartbeat
• shortness of breath
• breaking out in a cold sweat
• lightheadedness
• weakness or numbness or an arm or leg
• slow or difficult speech
• difficulty breathing or swallowing
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• hives
• rash
• itching
• sudden or severe stomach pain
• bloody diarrhea
• constipation
• vomiting
• paleness or blue color of fingers or toes
• pain, burning, or tingling in the hands or feet

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• lightheadedness
• neck pain
• tiredness
• loss of coordination
• chest pain

Keep all appointments with your doctor. Your blood pressure should be checked regularly.

You should keep a headache diary by writing down when you have headaches and when you take naratriptan.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Amerge^®