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The triptan drug class includes 1st generation sumatriptan (which has poor bioavailability), and second generation zolmitriptan. [2] Due to their safety, efficacy and selectivity, triptans are considered first line agents for abortion of migraines. [2]
Excessive use may result in medication overuse headaches. [3] Use is not recommended during pregnancy and breastfeeding is not recommended within 24 hours after taking a dose. [4] Rizatriptan is in the triptan class and is believed to work by activating the 5-HT 1 receptor. [3] Rizatriptan was patented in 1991 and came into medical use in 1998.
Triptans are a mid-line treatment suitable for many migraineurs with typical attacks. They may not work for atypical or unusually severe migraine attacks, transformed migraine, or status migrainosus (continuous migraine). Triptans are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70–80% of patients. [6]
Medication overuse headache is a recognized ICHD (International Classification of Headache Disorders) classification. [4] Over the years different sets of diagnostic criteria have been proposed and revised by the major experts of headache disorders. The term MOH first appeared in the ICHD 2nd edition in 2004.
Rescue treatment involves acute symptomatic control with medication. [4] Recommendations for rescue therapy of migraine include: (1) migraine-specific agents such as triptans, CGRP antagonists, or ditans for patients with severe headaches or for headaches that respond poorly to analgesics, (2) non-oral (typically nasal or injection) route of administration for patients with vomiting, (3) avoid ...
In 1991, Glaxo received approval for sumatriptan, which was the first available triptan. In July 2009, the US FDA approved a single-use jet injector formulation of sumatriptan. The device delivers a subcutaneous injection of sumatriptan, without the use of a needle. Autoinjectors with needles have been previously available in Europe and North ...
As with other triptans, almotriptan should not be used in patients with a history, symptoms or signs of ischaemic heart disease (myocardial infarction, angina pectoris, documented silent ischaemia, Prinzmetal's angina) or severe hypertension and uncontrolled mild or moderate hypertension.
Eletriptan, sold under the brand name Relpax and used in the form of eletriptan hydrobromide, is a second-generation triptan medication intended for treatment of migraine headaches. [3] [4] It is used as an abortive medication, blocking a migraine attack which is already in progress. Eletriptan is marketed and manufactured by Pfizer Inc.