naratriptan
Naratriptan is a triptan that's used to treat migraines with or without aura in adults. While the brand name Amerge is no longer available, there's a generic version that you can get by prescription. Naratriptan is a tablet that's swallowed whole once, typically as a single dose. But you can take the medication again 4 hours later if the first dose didn't work to relieve your migraine. Side effects aren't common, but it might make you nauseous, sleepy, or dizzy.
What is Naratriptan?
What is Naratriptan used for?
- Treatment of migraine attacks with or without aura in adults
How Naratriptan works
Naratriptan is a triptan. It works on receptors in your brain and nervous system that respond to serotonin, a natural chemical in your body that's thought to play a role in migraines.
When it attaches to the serotonin receptors in the brain, naratriptan tightens the blood vessels in the brain and lessens blood vessel swelling that can cause migraine pain. The medication also stops the release of other pain signals through your nervous system. This helps relieve migraine pain.
Drug facts
Side effects of Naratriptan
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (up to 5%)
Less Common Side Effects
- Tiredness
- "Pins and needles" feeling in your hands, arms, legs, or feet
- Dizziness
- Sleepiness
- Pain or pressure in the throat or neck
Naratriptan serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart problems: heart attack, dangerously high blood pressure, severe headache, chest pain, trouble breathing, irregular heartbeat
- Stroke: sudden weakness on one side of your body, severe headache, changes in your speech or vision, confusion
- Narrowing of blood vessels in the body: bloody diarrhea; severe stomach pain; partial or permanent blindness; vision problems; tightness, weakness, numbness of legs or feet
- Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness or twitching, uncoordinated movement, hallucinations
The following Naratriptan side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Chest pain (severe)
heaviness, tightness, or pressure in the chest, throat, or neck
sensation of burning, warmth, heat, numbness, tightness, or tingling
Less common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
Less common or rare
Convulsions (seizures)
irregular heartbeat
slow heartbeat
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
bone pain
change in taste sensation
chills or fever
difficulty with sleeping
eye problems
fainting
general feeling of discomfort or illness
joint pain
muscle or joint stiffness, tightness, or rigidity
pounding heartbeat
stomach discomfort or pain
trembling or shaking of the hands or feet
unusual tiredness or weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Naratriptan
Pros
- One of the first-choice options for short-term treatment of migraines
- Might cause less side effects than sumatriptan (Imitrex)
- Available as a lower-cost, generic medication
Cons
- Only available as a tablet, so it might not be a good option for people who have trouble swallowing pills during migraine attacks
- Can take up to 4 hours to get the maximum benefit
- Hasn't been studied in children
- Can't use to prevent migraines
Pharmacist tips for Naratriptan
- Take naratriptan with a glass of water at the first sign of a migraine. You can take naratriptan with or without food.
- If your migraine comes back or if it doesn't completely go away after you take naratriptan, you can take a second dose at least 4 hours since your first dose. Taking another dose sooner than 4 hours from your previous dose might cause more side effects.
- If you feel that naratriptan hasn't helped with your migraine at all after you take the medication, call your primary care provider or neurologist. Don't take a second dose after the first dose of the day without talking to your care team. They can discuss with you whether there's a better treatment option for you.
- You might feel some tightness, pressure, or pain in the chest, throat, jaw, or neck after you take naratriptan. It typically doesn't last long and goes away. Keep in mind that these symptoms are very similar to those of a heart attack or heart problems. Get medical help right away if these symptoms worsen or if they don't go away.
- Naratriptan can make you feel very sleepy or dizzy. Don't drive or do anything that requires a lot of attention until you know how this medication affects you.
- Naratriptan isn't meant to be used to treat more than 4 migraines per month because it might not be safe to do so. Tell your primary care provider or neurologist if you have a lot of migraines in a month. They can consider other medication options to help with your symptoms. Or they might consider medications for migraine prevention.
- Let your healthcare team and pharmacist know about all the medications and over-the-counter products you're taking or planning to take. This is especially important if you take antidepressants or other medications for mental health because naratriptan can interact with them and raise the risk for side effects. Your healthcare team can check that your medications are safe to take together. They might make dose adjustments and possibly consider switching you to a different migraine medication to avoid harmful drug interactions.
More on Naratriptan tips
Common questions about Naratriptan
For some people, naratriptan can start to relieve migraine symptoms within 1 hour. But it can take up to 4 hours to get the maximum effect. Speak with your primary care provider or neurologist if you're concerned with how well naratriptan is working for you.
It can take about 30 hours for naratriptan to leave your body after a dose of medication. This time frame is estimated based on the half-life of naratriptan in people with normal kidney and liver function. Since the kidneys and liver helps remove the medication from the body, naratriptan might stay longer in the body for people who have kidney or liver problems. Discuss with your primary care provider or neurologist if you have questions about how long the medication stays in your body.
If your migraine doesn't completely go away or comes back after you take a dose of naratriptan, you can take one more dose 4 hours later. Only take naratriptan for up to 4 migraines in a 30-day period because it's not known how safe it is to take the medication too many times. Speak with your primary care provider or neurologist if your migraine doesn't go away even after two doses of naratriptan in a day or if you've already used the medication for 4 migraines in a month. Also talk to your care team if a dose of naratriptan doesn't help your migraine at all. In general, using migraine medications for 10 or more days per month might make your headaches come back and possibly be worse (rebound or medication-overuse headaches). Your care team can discuss other treatment options, if needed.
No. Naratriptan isn't an opioid pain medication; it's a triptan.
Yes, it's possible for naratriptan to make you sleepy, but it's not common. Only about 1% to 2% of people who took naratriptan reported feeling tired or fatigued as a side effect of the medication in clinical studies. Wait and see how naratriptan affects you before driving or performing activities where you need to be alert.
It's generally considered safe to take naratriptan with acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin). Naratriptan, acetaminophen (Tylenol), and NSAIDs work completely differently to relieve migraine pain and they don't appear to interact with each other. Taking naratriptan with these pain relievers can potentially work even better to ease migraine symptoms than taking any of these medications alone. But keep in mind that acetaminophen (Tylenol) and NSAIDs also have their own risks (e.g., liver risks, heart risks, kidney problems). Before you use other pain medications with naratriptan, speak with your primary care provider to make sure it's safe for you to do so.
Besides taking migraine medications like naratriptan, you can try other alternative or supportive therapies to help treat or prevent migraines. Examples include acupuncture, relaxation techniques, and cognitive-behavioral therapy (CBT). Also, try avoiding certain foods and beverages, alcohol, and caffeine that might trigger migraines. In addition, keeping track of your migraine patterns and avoiding triggers can help prevent these painful episodes from happening. Speak with your primary care provider or neurologist about other ways to prevent and relieve migraines.
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Risks and warnings for Naratriptan
Naratriptan can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart problems and high blood pressure
- Risk factors: History of heart problems | Age older than 65 | Diabetes | People who are considered obese | High blood pressure | Smoking tobacco
Although rare, some people have reported serious heart problems, such as heart attack and heart rhythm problems, within a few hours after taking naratriptan. In addition, naratriptan might raise your blood pressure to dangerously high levels.
If you have a history of heart or blood circulation problems, talk to your cardiologist or primary care provider first to make sure naratriptan is as safe for you as possible. And make sure to periodically check your blood pressure while you're taking naratriptan. Let your healthcare team know if it's higher than usual. Get emergency help right away if you experience a heart attack, severe headache, chest pain, or irregular heartbeat.
Stroke or other brain injury
Some people who've taken triptans like naratriptan have had life-threatening strokes or bleeding in the brain. For this reason, you won't be able to take this medication if you've had a stroke in the past. Let your primary care provider or neurologist know about your medical history.
Symptoms of stroke or other brain injuries include sudden weakness on one side of the body, severe headaches, drooping face, trouble breathing, or changes in your speech or vision. These symptoms can be similar to migraine symptoms, so strokes can be mistaken for a migraine. Stop taking naratriptan and get medical help as soon as possible if you notice symptoms of a stroke, especially if you haven't had a migraine before.
Extreme narrowing of blood vessels
Naratriptan can cause extreme narrowing of your blood vessels in different parts of your body. Depending on the location, this can lead to serious stomach problems (e.g., stomach pain, bloody diarrhea), vision problems, and changes in sensation in your hands and feet. Sometimes, it can cause symptoms similar to Raynaud's phenomenon, which can look like color changes in your hands and feet (can turn pale or more reddish depending on how much blood is flowing through). Don't take any more naratriptan until you see a member of your healthcare team if you notice these symptoms after you take the medication. They can check out what's going on.
Worsened headaches if naratriptan is taken too often
Taking more than the recommended dose of migraine medications, including naratriptan, or taking them too often can cause them to not work as well. This can lead to more migraine-like headaches or more migraine attacks. Let your primary care provider or neurologist know if you're taking multiple migraine medications and if you need to take them for more than 9 days per month. Also, let them know if you have more than 4 migraine headaches a month while you're taking naratriptan. Your primary care provider or neurologist can talk with you about better options to help with migraines.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels
Some people who take naratriptan have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens when there's too much serotonin in the brain.
Let your primary care provider or neurologist know about all the medications you take before you start naratriptan, as well as any medications you plan to take. Your risk for serotonin syndrome can be higher if you use naratriptan with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, and migraine medications.
Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.
Naratriptan dosage
Interactions between Naratriptan and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Almotriptan
- Bromocriptine
- Dihydroergotamine
- Eletriptan
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Frovatriptan
- Linezolid
- Methylergonovine
- Methysergide
- Rizatriptan
- Sumatriptan
- Tranylcypromine
- Zolmitriptan
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Buprenorphine
- Butorphanol
- Citalopram
- Clomipramine
- Codeine
- Desipramine
- Desvenlafaxine
- Dextroamphetamine
- Dibenzepin
- Dihydrocodeine
- Dolasetron
- Doxepin
- Duloxetine
- Escitalopram
- Fenfluramine
- Fentanyl
- Fluoxetine
- Fluvoxamine
- Furazolidone
- Granisetron
- Hydrocodone
- Hydromorphone
- Imipramine
- Iproniazid
- Isocarboxazid
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lorcaserin
- Melitracen
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Methylene Blue
- Milnacipran
- Mirtazapine
- Moclobemide
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nefazodone
- Nortriptyline
- Ondansetron
- Opipramol
- Oxycodone
- Oxymorphone
- Palonosetron
- Paroxetine
- Pentazocine
- Phenelzine
- Procarbazine
- Protriptyline
- Rasagiline
- Reboxetine
- Remifentanil
- Selegiline
- Sertraline
- Sibutramine
- St John's Wort
- Sufentanil
- Tapentadol
- Tianeptine
- Tramadol
- Trazodone
- Trimipramine
- Tryptophan
- Venlafaxine
- Vilazodone
- Vortioxetine
- Ziprasidone
How much does Naratriptan cost?
Naratriptan contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Naratriptan will not be safe for you to take.
- Coronary artery disease
- Coronary artery vasospasm, such as Prinzmetal's angina
- Certain conditions that cause an irregular heart rhythm (arrhythmias), such as Wolff-Parkinson-White syndrome
- History of stroke or transient ischemic attack ("mini-stroke")
- Uncontrolled high blood pressure
- Peripheral vascular disease
- Ischemic bowel disease
- Use of ergot-containing or ergot-type medications like dihydroergotamine (Migranal) or other triptans in the last 24 hours
- Currently take or have taken a monoamine oxidase inhibitor (MAOI), such as selegiline, in the last 14 days
- Severe kidney or liver problems
What are alternatives to Naratriptan?
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