Frovatriptan

Oral
Acute migraine attacks

Severe: Contraindicated.

May be taken with or without food. Take on an empty stomach for fast relief.

Known or suspected ischaemic heart disease (e.g. angina pectoris, MI, silent ischaemia), coronary vasospasm (e.g. Prinzmetal variant angina), uncontrolled HTN, other serious underlying CV disease, cerebrovascular syndromes (e.g. stroke syndrome, TIA), peripheral vascular disease, or ischaemic bowel disease. Severe hepatic impairment. Concomitant admin w/ ergotamine, its derivatives or other 5-HT₁ receptor agonists.

Patients at risk of coronary artery disease (e.g. hypercholesterolaemia, heavy smokers, obesity, DM, family history of coronary artery disease, menopause, male >40 yr). Not indicated for the management of hemiplegic, basilar or ophthalmoplegic migraine. Mild to moderate hepatic impairment. Pregnancy and lactation.

Dizziness, fatigue, headache, paraesthesia, flushing, dry mouth, abdominal pain, sweating, visual disturbances, hot or cold sensation, skeletal pain, dyspepsia, chest pain, somnolence and nausea.
Potentially Fatal: Cardiac rhythm disturbances (e.g. ventricular tachycardia or fibrillation), acute MI, cerebral or subarachnoid haemorrhage and stroke, serotonin syndrome.

PO: C

This drug may cause somnolence, if affected, do not drive or operate machinery.

Periodic CV evaluation for patients w/ risk factors for coronary artery disease who are receiving intermittent long-term therapy.

Potential risk of serotonin syndrome or HTN w/ MAOIs, TCAs, serotonin and norepinephrine reuptake inhibitors (SNRIs) or SSRIs. Increased blood concentrations by fluvoxamine, a potent CYP1A2 inhibitor.
Potentially Fatal: Additive vasospastic effects when used concomitantly w/ ergot alkaloids (e.g. ergotamine, dihydroergotamine, methysergide) and other 5-HT₁ receptor agonists.

Food may delay time to peak plasma concentrations by approx 1 hr. Increased risk of serotonin syndrome w/ St John's wort.

Description: Frovatriptan is a selective agonist for serotonin (5-HT_1B and 5-HT_1D receptors) in cranial arteries. It causes vasoconstriction and reduces sterile inflammation associated w/ antidromic neuronal transmission correlating w/ relief of migraine.
Pharmacokinetics:
Absorption: Food may delay time to peak plasma concentrations. Bioavailability: Approx 20% (male); 30% (female). Time to peak plasma concentration: 2-4 hr.
Distribution: Distributed into cellular fraction of blood, principally erythrocytes (approx. 60%, reversibly bound). Plasma protein binding: 15%.
Metabolism: Undergoes hepatic metabolism mainly by CYP1A2 isoenzyme.
Excretion: Via faeces (62%) and urine (approx. 32%). Plasma elimination half-life: Approx 26 hr.

Source: National Center for Biotechnology Information. PubChem Database. Frovatriptan, CID=77992, https://pubchem.ncbi.nlm.nih.gov/compound/Frovatriptan (accessed on Jan. 21, 2020)

Store at 25°C. Protect from moisture.

Antimigraine Preparations

N02CC07 - frovatriptan ; Belongs to the class of selective serotonin (5HT1) agonists preparations. Used to relieve migraine.

Anon. Frovatriptan. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/03/2016.

Buckingham R (ed). Frovatriptan. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/03/2016.

Joint Formulary Committee. Frovatriptan. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/03/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Frovatriptan Succinate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 14/03/2016.