Reyvow for Migraines: Efficacy, Side Effects, and More
Key takeaways:
Reyvow (lasmiditan) is a migraine medication. It’s taken orally as a single dose after a migraine attack begins. It’s currently only available as a brand-name medication.
Reyvow can help relieve migraine pain within 2 hours of taking it. It’s usually prescribed if triptan medications, such as sumatriptan (Imitrex), aren’t an option.
Reyvow has a few side effects to keep in mind, including dizziness, drowsiness, and a tingling feeling in your body.
Table of contents
It’s estimated that over 1 billion people worldwide experience migraines — and that number may actually be even higher. Many people likely live with migraines without being evaluated, diagnosed, or treated.
Migraines tend to disrupt work, school, and life in general. When needed, medications are available to help prevent migraines from happening in the first place. Other medications treat migraine symptoms after they’ve already started.
Reyvow (lasmiditan) is one prescription medication used to treat migraines once symptoms are underway. It works in a unique way to alleviate pain and discomfort, but it has a few risks and side effects to keep in mind. Here, we’ll cover what you need to know about taking Reyvow for migraines — from dosing recommendations to side effects and more.
What is Reyvow?
Reyvow is an oral medication that’s FDA approved to treat migraine headaches in adults. It’s able to treat migraines with or without aura. Auras are sensory or visual changes — such as bright spots, blurry vision, or numbness — that can happen before or during a migraine.
Reyvow is only meant for occasional use, and it’s not intended to prevent migraines from happening. It also shouldn’t be used by people younger than 18 years old.
How does Reyvow work?
The exact way Reyvow works isn’t fully understood. But we do have some idea as to how it exerts its effects.
Reyvow activates certain binding sites (receptors) in your brain called serotonin receptors. As a result, Reyvow blocks the release of certain chemicals called calcitonin gene-related peptide (CGRP) and glutamate. These chemicals contribute to the pain and inflammation associated with migraines. Blocking these chemicals is likely how Reyvow reduces migraine symptoms.
It’s important to note that serotonin, a chemical well-known for its role in mood, has also been a target for migraine medications. It was previously thought that low serotonin levels contribute to migraines. But more recent evidence questions whether this is true. So although Reyvow impacts serotonin receptors, experts don’t believe that serotonin is involved in how Reyvow treats migraines.
Is Reyvow a triptan?
No, triptans are a group of migraine medications that are distinct from Reyvow.
Reyvow side effects: Check out these common Reyvow side effects and find out how to manage them.
Reyvow vs. Imitrex: These two medications both relieve migraines, but which one is right for you?
Prescription migraine treatments: Learn about what other prescription medications help prevent and treat migraines.
Reyvow and triptans both stimulate serotonin receptors but they act on different types. They both affect chemicals like CGRP.
They also have some different side effects. For example, triptans are more known for increasing blood pressure than Reyvow. This can be dangerous if you have a heart condition or if you’re at risk of a stroke.
However, Reyvow and triptans can cause some similar side effects too, such as dizziness or a paresthesia (a tingling sensation often in the hands and feet).
We’ll talk more below about whether triptans or Reyvow are first-choice for migraine treatment.
How effective is Reyvow?
Most of what we know about Reyvow’s effectiveness comes from its initial clinical trials.
In one key study, when people with moderate to severe migraines took Reyvow, up to 30% of people saw pain relief within 2 hours. And many also had relief from other migraine-related symptoms, such as nausea and sensitivity to light or sound.
How does Reyvow compare to other migraine medications?
Reyvow isn’t considered a first-choice migraine treatment for most people. But if triptans aren’t an option for you, your prescriber may suggest it.
In general, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), are recommended to treat mild-to-moderate migraine symptoms. Excedrin Migraine (acetaminophen / aspirin / caffeine) is another first-choice option too. If these medications don’t work, or if you’re having moderate-to-severe migraines, triptans may be recommended next.
Research has found that triptans are generally better at reducing pain than Reyvow. The evidence is less clear about how Reyvow stacks up to NSAIDs or Excedrin. However, NSAIDs and Excedrin are available OTC, so they may be easier to access and more affordable.
If these preferred options don’t work, cause intolerable side effects, or aren’t safe for you to use, then Reyvow may be an option.
What is a typical Reyvow dosage?
Reyvow is an oral tablet that should only be taken when needed. It’s not considered a routine maintenance medication.
The starting dose is usually 50 mg or 100 mg as a single dose. You can take a dose right when you first feel a migraine attack. If needed, your prescriber may increase your dose up to 200 mg. You shouldn’t take more than one dose in a 24-hour period.
Reyvow can be taken with or without food. And it should always be swallowed whole. You shouldn’t crush, split, or chew the tablets.
What are the side effects of Reyvow?
Reyvow has a few possible side effects to keep in mind. Some of the most common ones include:
Dizziness
Feeling tired or sleepy
Paresthesia (numbness or tingling sensations)
Lack of energy
Nausea and vomiting
Muscle weakness
More rarely, Reyvow can cause a slightly lower heart rate or increased blood pressure.
What are the serious side effects of Reyvow?
While not common, Reyvow also has more serious risks. These include:
Rebound headaches
Extreme drowsiness and dizziness
Due to its risk for dependence and misuse, Reyvow is categorized as a controlled substance. Taking Reyvow exactly as prescribed can help minimize the risk of misuse. It can also help minimize your risk for rebound headaches, as taking Reyvow for more than 10 days in a month can cause headaches as a rebound effect.
Additionally, Reyvow can impair your ability to complete activities that require alertness, such as driving. That’s why you should wait at least 8 hours after taking Reyvow before driving or doing other activities that require focus.
Does Reyvow interact with other medications?
Reyvow can interact with a few medications. Most Reyvow interactions occur with other medications and substances that have similar side effects, such as drowsiness or dizziness. But Reyvow may also block the breakdown (metabolism) of other medications, causing their side effects to be more severe. Some common interactions are listed in the table below.
Medications that can make you sleepy | Alcohol • Insomnia treatments, such as zolpidem (Ambien) • Benzodiazepines, such as alprazolam (Xanax) • Opioid pain medications, such as Percocet (oxycodone / acetaminophen) • Phenobarbital • Cannabis | Taking Reyvow with any of these substances or medications could cause extreme dizziness or sleepiness. |
Medications that boost the effect of serotonin | • Antidepressants, such as sertraline (Zoloft) • OTC cough medications, such as dextromethorphan (Delsym) • Herbal supplements, such as St. John’s wort | Taking Reyvow with any of these medications could cause a buildup of serotonin in your brain. This could lead to a potentially serious condition called serotonin syndrome. |
Medications that lower heart rate | • Beta blockers, like propranolol • Calcium channel blockers, like verapamil | Taking Reyvow with medications that lower your heart rate could cause your heart rate to be too slow (also called bradycardia). This may cause dizziness, lightheadedness, or fatigue. |
This isn’t a complete list of Reyvow interactions. That’s why it’s important to give your prescriber an updated list of all the medications that you take. This should include OTC medications, supplements, and herbal products, too.
How to save
Currently, Reyvow is only available as a brand-name medication. If you have commercial insurance, you may be able to get Reyvow at no cost with a savings card from the manufacturer.
The bottom line
Reyvow (lasmiditan) is a medication that treats migraines. It's a brand name-only, controlled substance medication. You can take it as needed at the first sign of a migraine. But you shouldn’t take more than one dose in 24 hours.
Reyvow usually isn’t a first-choice migraine medication. It’s typically only prescribed if triptans, such as sumatriptan (Imitrex), don’t work or can’t be used. But for some people, Reyvow may be a viable first-choice option.
Common Reyvow side effects include dizziness, paresthesias (a tingling sensation in the hands and feet), and fatigue. You shouldn’t drive for at least 8 hours after taking a dose of Reyvow.
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References
Aggarwal, M., et al. (2012). Serotonin and CGRP in migraine. Annals of Neurosciences.
Ailani, J., et al. (2021). The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache.
Amiri, P., et al. (2022). Migraine: A review on its history, global epidemiology, risk factors, and comorbidities. Frontiers in Neurology.
Ashina, M., et al. (2021). Randomized, controlled trial of lasmiditan over four migraine attacks: Findings from the CENTURION study. Cephalalgia.
Berger, A. A., et al. (2020). Lasmiditan for the treatment of migraines with or without aura in adults. Psychopharmacology Bulletin.
Clemow, D. B., et al. (2020). Lasmiditan mechanism of action – review of a selective 5-HT1F agonist. The Journal of Headache and Pain.
Deen, M., et al. (2018). High brain serotonin levels in migraine between attacks: A 5-HT4 receptor binding PET study. Neuroimage: Clinical.
Eli Lilly and Company. (2022). Reyvow - lasmiditan tablet [package insert].
Hoffmann, J., et al. (2018). Glutamate and its receptors as therapeutic targets for migraine. Neurotherapeutics.
Karlsson, W. K., et al. (2024). Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. The British Medical Journal.
Wattiez, A. S., et al. (2021). Calcitonin gene-related peptide (CGRP): Role in migraine pathophysiology and therapeutic targeting. Expert Opinion on Therapeutic Targets.
Yang, C. P., et al. (2021). Comparison of new pharmacologic agents with triptans for treatment of migraine: A systematic review and meta-analysis. Journal of the American Medical Association Network Open.
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