Reyvow
Reyvow, the brand name for lasmiditan, is a serotonin agonist. It's used to treat migraine with or without aura in adults. It comes as a tablet that's taken by mouth when you have a migraine. Many people feel pain relief within 2 hours. Common side effects include dizziness, sleepiness, and a "pins-and-needles" feeling. Reyvow (lasmiditan) is a controlled substance because of the risk of misuse. Currently, Reyvow (lasmiditan) is a brand-name medication only; there's no generic yet.
What is Reyvow (lasmiditan)?
What is Reyvow (lasmiditan) used for?
Treatment of migraine attacks with or without aura in adults
How Reyvow (lasmiditan) works
Reyvow (lasmiditan) is a serotonin agonist. It's not exactly clear how the medication works. But it's thought to attach to certain serotonin receptors in the brain. This blocks certain chemicals from getting released in the brain. These include calcitonin gene-related peptide (CGRP) and glutamate. Blocking these chemicals help lower inflammation in the brain and pain signaling. This helps relieve migraine.
Drug Facts
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What are the risks and warnings for Reyvow (lasmiditan)?
Reyvow (lasmiditan) 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.
Dizziness and sleepiness
Risk factors: Drinking alcohol while taking Reyvow (lasmiditan) | Taking other medications that cause sleepiness
Reyvow (lasmiditan) can make you feel dizzy and sleepy. If you drink alcohol or take other medications that make you sleepy, like opioids or benzodiazepines, you might feel even more dizzy and sleepy.
These side effects can make driving or using machinery dangerous. Don't drive or use heavy machinery for at least 8 hours after taking Reyvow (lasmiditan). If you think this won't work for you, talk to your prescriber about other treatment options.
Tell your prescriber if you feel very sleepy during the daytime or if you fall asleep when you need to stay awake while taking Reyvow (lasmiditan).
Serotonin syndrome
Risk factors: Taking other medications that raise serotonin levels in your brain
Some people who take Reyvow (lasmiditan) have had a rare but serious condition called serotonin syndrome. This happens when there's too much serotonin in the brain.
The risk is higher if you take Reyvow (lasmiditan) with other medications that can raise serotonin levels. These can include certain antidepressants, mental health medications, and migraine medications. Be sure to tell your healthcare team about all the medications you take so they can check your risk.
If serotonin syndrome happens, symptoms usually start within minutes to hours after you begin taking these medications or take a higher dose. Get medical help right away if you have a fast heart rate, stiff or twitching muscles, fever, or feel confused. These can be signs of serotonin syndrome.
Medication-overuse headache
Taking too much of your migraine medications, including Reyvow (lasmiditan), or taking them too often can make them work less well. It can cause more migraine-like headaches or make migraine happen more often.
Let your primary care provider know if you take more than 1 migraine medication. Also tell them if you need to take migraine medications for more than 9 days a month. Your primary care provider can help you find better options to manage your migraines.
What are the side effects of Reyvow (lasmiditan)?
Common Side Effects
- Dizziness (up to 17%)
- Numbness or tingling feeling (up to 9%)
- Sleepiness (up to 7%)
- Tiredness (up to 6%)
Other Side Effects
- Nausea or vomiting
- Muscle weakness
- Vertigo
- Changes in vision
- Heart palpitations
- Slower heart rate
- Rise in blood pressure
- Sleep disturbances
Serious Side Effects
- Serotonin syndrome: fast heart rate, fever, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness or twitching, uncoordinated movement, hallucinations
- Serious allergic reaction: rash; getting sunburns more easily; swelling of the face, lips, or tongue
Source: DailyMed
More on Reyvow (lasmiditan) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Burning or tingling sensation in the hands or feet
- Dizziness
- Drowsiness
- Fatigue
Pros and cons of Reyvow (lasmiditan)
Pros
Starts to work to relieve migraine pain within 2 hours
Can take with or without food
Available in 3 different strengths
Cons
Might not work as well as triptans
Need to wait at least 8 hours before driving or operating machinery after taking the medication because it affects how well you can stay alert
Not used to prevent migraines
Pharmacist tips for Reyvow (lasmiditan)
Take Reyvow (lasmiditan) when you feel a migraine coming. But don't take Reyvow (lasmiditan) more than once during the day. Also don't take Reyvow (lasmiditan) to treat an average of more than 4 migraines a month. It isn't clear if it's safe or if it works well to take the medication more often. Ask your prescriber about your options if Reyvow (lasmiditan) isn't enough to help with your migraines.
Swallow the Reyvow (lasmiditan) tablet whole with or without food. Don't cut, crush, or chew the tablet. Talk to your prescriber if you're having trouble swallowing the tablets whole. There might be a different option for you that's easier to take.
Reyvow (lasmiditan) can make it hard to focus because it can make you sleepy and dizzy. Don't drive or do anything that needs your full attention for at least 8 hours after taking the medication. If you can't avoid these activities for 8 hours, don't take Reyvow (lasmiditan). Talk to your prescriber if this doesn't work with your daily routine.
Avoid drinking alcohol while you're taking Reyvow (lasmiditan). Alcohol can make side effects like dizziness, sleepiness, nausea, and vomiting more intense. Talk to your prescriber if it isn't possible for you to avoid alcohol. They can recommend ways to quit.
Reyvow (lasmiditan) might sometimes lower your heart rate and raise your blood pressure, but this isn't common. Ask your prescriber if this medication is safe for you if you have heart problems. Let them know if your heart rate is consistently lower than usual or if your blood pressure stays higher than normal while taking Reyvow (lasmiditan).
Tell your healthcare team about all the medications you take. They can make sure it's safe to take them with Reyvow (lasmiditan). Some medications can raise your risk of side effects like sleepiness and serotonin syndrome. These medications can include antidepressants, other migraine medications, and sedatives.
Keep track of how many days you need to take migraine medication, like Reyvow (lasmiditan), each month. Taking migraine medication too often (more than 9 days a month) can make your headaches worse. Talk to your prescriber to see if there are other treatments that can help manage your migraines better. They might also consider medications that help prevent migraines.
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Reyvow (lasmiditan) dosage forms
Typical dosing for Reyvow (lasmiditan)
The typical dose is 50 mg, 100 mg, or 200 mg by mouth once as needed when you have a migraine. Don't take more than 1 dose in a 24-hour period.
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How much does Reyvow (lasmiditan) cost?
What are alternatives to Reyvow (lasmiditan)?
Treatment of migraine attacks with or without aura in adults
Treatment of migraine attacks with or without aura in adults
Treatment of migraines with or without aura in adults
Prevention of migraines with or without aura in adults
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References
Best studies we foundClemow, D. B., et al. (2020). Lasmiditan mechanism of action - review of a selective 5-HT1F agonist. The Journal of Headache and Pain.
Drugs and Lactation Database (LactMed®). Lasmiditan. National Institute of Child Health and Human Development.
Eli Lilly and Company. (2024). Reyvow- lasmiditan tablet [package insert]. DailyMed.
Goadsby, P. J., et al. (2019). Phase 3 randomized, placebo-controlled, double-blind study of lasmiditan for acute treatment of migraine. Brain.
MedlinePlus. (2023). Prescription drug misuse.
Preuss, C. V., et al. (2023). Prescription of controlled substances: Benefits and risks. StatPearls.
U.S. Food and Drug Administration. (2019). FDA approves new treatment for patients with migraine.
Wattiez, A. S., et al. (2020). Calcitonin gene-related peptide (CGRP): Role in migraine pathophysiology and therapeutic targeting. Expert Opinion on Therapeutic Targets.
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