Frovatriptan (Oral)

Overview

Belonging to the class of drugs known as triptans, frovatriptan is one of the most effective medications for the treatment of migraine headaches and the symptoms associated with them. It acts on the substance in the body called serotonin, which can narrow blood vessels in the brain and elsewhere, thus triggering a migraine headache. By relaxing this narrowing of the blood vessels, frovatriptan can relieve many of the associated side effects triggered by a migraine headache.

While it has no effect on the frequency or likelihood of future headaches, frovatriptan can provide significant relief from those in progress, provided it is used soon after the onset of an attack. It is an oral medication which should be ingested at the very first sign of a migraine headache, either with food or without, although some evidence suggests that it may be more effective on an empty stomach.

If symptoms of your migraine headache are not fully relieved after taking frovatriptan, it is allowable to take another dose of the medication within two hours. However, no more than three dosages should be taken within a single 24-hour period, for the safety and health of the patient. Many doctors will require that your initial dosage of this medication be administered in the office setting, so that you can be monitored by medical personnel, to determine your reaction to the medication, and what your body's tolerance will be to the specific dosage administered.

Condition treated

  • Symptoms of migraine headaches

Type Of Medicine

  • Triptan

Side Effects

Along with the beneficial effects delivered by frovatriptan, there may also be some undesirable side effects imparted to patients using the medication. While not all patients will experience these side effects, some users of the medication can be expected to have one or more of these side effects to a greater or lesser degree. If you should experience any of the side effects listed in the groupings below to a level which makes you uncomfortable, you should alert your doctor at the earliest opportunity, and seek medical attention if necessary.

One of the first reactions you should be aware of is an allergic reaction to frovatriptan, this can be very important because the side effects of an allergic reaction can become so severe that they actually develop into a life-threatening situation. If that should happen to you, you should seek emergency medical care immediately, to avoid a worst-case scenario. Things to look for in an allergic reaction are as follows:

  • Extreme itchiness at various sites around the body
  • Hives and/or rashes appearing on the skin
  • Lightheadedness or dizziness
  • Swelling or puffiness in the facial area, particularly in the eyelids, throat, lips, or tongue
  • Difficulty with breathing, often accompanied by the sensation of tightness in the chest.

Some of the less commonly experienced side effects are included in this group:

  • Blurry vision, or other vision changes
  • Fast or irregular heartbeat
  • Profuse sweating
  • Pain in the chest area
  • Abdominal cramping or pains
  • Stomach cramping or pains
  • Paleness of the skin
  • A feeling of coldness or numbness in the toes and fingertips
  • Sudden loss of coordination
  • Overactive reflexes
  • Large swellings that look like hives on the legs, sex organs, face, throat or feet
  • Headaches which can come on quickly and severely, and then persist for hours
  • Fevers
  • Dizziness or fainting
  • Persistent diarrhea
  • Strong urge toward coughing
  • Bloody diarrhea
  • Agitation or nervousness
  • Difficulty with swallowing
  • Extreme restlessness
  • Trembling or shivering
  • Over-agitated talking
  • Tendency toward twitching
  • Unexplained weakness in the legs or arms
  • Uncharacteristic fatigue or persistent tiredness.

Some side effects which you may experience, come and go quickly, as your body adapts itself to the medication. For the most part, these side effects do not require medical attention, unless you experience them to a degree which makes you extremely uncomfortable.

  • Upset stomach
  • Runny or stuffy nose
  • Redness on the neck, face, arms or upper chest
  • Sensation of hot or cold on the skin
  • Indigestion
  • Heartburn
  • Hearing loss or other hearing changes
  • Acid or sour stomach
  • Pain in the bones and joints
  • A ringing or buzzing which comes and goes in the ears
  • An unexplained feeling of warmth
  • Belching
  • Seizures or convulsions.

Dosage

Frovatriptan is a medication which is generally taken as needed and should be administered as soon as you recognize the symptoms of a migraine headache coming on. As such, there is no regular dosing schedule that must be established and adhered to, but there are still some dosage considerations which should be observed for safety's sake.

In many cases, your doctor will want to administer your first dosage of frovatriptan right in the office setting, so that your reaction to the medication can be monitored and treated on the spot if necessary. When you do take frovatriptan at home, it's important that you follow all instructions on the label, and that you do not take more or less than what is recommended, either by your doctor or what has been printed on the label. This is especially important when you feel that a more severe migraine headache is coming on because the temptation will be to take more medication in the expectation that greater relief will be provided. That's not how the medication works though, so taking more frovatriptan than is called for by the instructions will not provide any greater relief.

This medication should be taken with a full glass of water, and if your migraine symptoms do not subside or if they come back, it is allowable to take a second tablet after waiting two hours. Under no circumstances should you take more than three frovatriptan tablets within a 24-hour period. If you have taken three tablets on the same day and your migraine headache symptoms have not been relieved, you should call your doctor and ask for instructions, rather than taking any more medication.

You should also call your doctor if you have taken at least one frovatriptan tablet and there has been no relief at all in the symptoms of your headache. It is possible that the symptoms of your migraines can become even worse if you over-medicate and take more tablets than your instructions call for.

If you should experience more than four migraine headaches in one calendar month, you should discuss this with your doctor at the very earliest opportunity, because there may be some other medical condition triggering the migraines.

If you are a person suffering from regular migraine headaches, and you notice that over a period of weeks or months that the effectiveness of frovatriptan seems to be diminishing, and your symptoms are going unrelieved, this should prompt another discussion with your doctor about other possible alternatives.

Since there is a potential for frovatriptan to increase your blood pressure significantly, you may need to monitor your blood pressure at home fairly often to make sure that it does not reach dangerous levels. This is especially important if you are a long-term user of frovatriptan. It's also possible that your doctor may want to have your heart checked using an electrocardiograph, to make sure that your heart function is not being impacted by the medication.

Interactions

When taking frovatriptan or any other medication, there's a possibility that the drug will interact with other drugs you may be taking. When this happens, it can cause adverse side effects to occur, and some of these may be severe enough that you need to seek medical attention. Another possibility with drug interactions is that one or the other of the two may diminish the effectiveness of the other drug, and in an extreme case, might even render it completely ineffective.

In order to avoid these kinds of scenarios, it is highly advisable that you prepare a complete list of all medications which are currently taking, including vitamins, herbal supplements, over-the-counter drugs, and other prescription medications, as well as all of the dosages of each of these. This list can be reviewed by your doctor, and if necessary, alternative medications can be used if any of those on your list conflict with frovatriptan. It's also possible that dosage modifications might achieve the same effect and avoid interactions of the drugs you are taking.

You can also use this list of your medications if there's ever a need for you to visit an emergency room or healthcare clinic where your primary care doctor is not in residence. Any doctor at one of these facilities can review your medication list and safely prescribe a program of treatment for whatever medical condition brought you to the emergency room.

Some of the medications which are most commonly checked by doctors for potential interaction with frovatriptan are the following:

  • Bupropion
  • Ondansetron
  • Cetirizine
  • Amphetamine
  • Dextroamphetamine
  • Zolpidem
  • Lorazepam
  • Mirtazapine
  • Elatriptan
  • Rizatriptan
  • Duloxetine
  • Acetaminophen
  • Omega-3 polyunsaturated fatty acids
  • Cholecalciferol
  • Codeine
  • Ketorolac
  • Topiramate
  • Quetiapine
  • Pregabalin
  • Escitalopram
  • Zolpidem.

In addition to interaction with other medications, there is a potential for frovatriptan to impact patients who have specific medical conditions besides their migraine headaches which can be affected by the drug. Those diseases or medical conditions include the following:

  • Liver disease
  • Cardiovascular disease
  • CAD risk factors.

You should not take frovatriptan within 24 hours of using any other migraine headache medication, including sumatriptan injection, eletriptan, naratriptan, zolmitriptan, ergotomine, dihydroergotamine, ergonovine or methylergonovine.

It is also inadvisable to take frovatriptan when you're using types of medications which promote high levels of serotonin in the body (a condition commonly referred to as serotonin syndrome) because this can result in a life-threatening situation developing. For this reason, you need to avoid concurrently taking medications which treat depression, psychiatric disorders, narcotics or any medications used in the prevention of nausea and vomiting.

Warnings

When using frovatriptan in the treatment of migraine headaches, there are some precautions which should be observed by patients, in order to avoid developing an undesirable medical condition or exacerbating an existing one. It's important for you to keep all appointments with your doctor so that he/she can monitor the effectiveness of the medication, and make a decision whether or not it's worthwhile to continue using it.

You should not use frovatriptan within 24 hours of having used any other ergot-based medication or any other triptan medication. You should be alert to the potential for this medication to trigger a serious allergic reaction, including anaphylaxis, which can be life-threatening, and which will require immediate emergency medical attention.

If you have started using frovatriptan and your migraine symptoms either get worse or are occurring more frequently, you should discontinue use of the drug and contact your doctor immediately.

There is a potential for this medication to increase your risk of having irregular heart rhythms, heart attacks, angina, or even stroke. This is more likely in families which have a history of heart problems, and with patients who have diabetes, high blood pressure or who smoke and drink excessive alcohol.

If you experience any kind of symptoms suggestive of a heart issue, e.g. shortness of breath, sweating, chest pains or discomforts, elevated heart rate, nausea and vomiting, pain and discomfort in the arms, jaw, back, shoulders, or neck - all these are potential signs of an impending heart problem, and you should seek immediate medical attention.

In a similar vein, there are number of symptoms which can be precursors to a stroke, and you should take the same kind of precautions if any of these become apparent confusion or disorientation, difficulty speaking, sudden inability to move facial muscles, arms, or legs, headaches, double vision or blurry vision, and slurred speech.

You should also notify your doctor immediately if you should experience chest discomfort, tightness in the neck or jaw, bloody diarrhea, stomach cramps or pains, and abdominal cramps or pains after taking frovatriptan.

You should be aware that using frovatriptan as a standalone medication or in combination with any other migraine medicine for at least 10 days in a given month may cause a worsening of your headache symptoms. For this reason, it is recommended that you maintain a headache diary so that you can monitor any worsening of the effects of your headache medications.

Drinking any kind of alcoholic beverages can worsen the effects of headaches, or can lead to the onset of new migraines. Any person who is experiencing regular migraine headaches should completely avoid the intake of alcohol if possible, and at the very least, should never take alcohol while a headache is in progress.

There is a potential for frovatriptan to make a patient feel drowsy or dizzy afterward, and that means it will be unsafe for you to operate a motor vehicle or any other machinery in the immediate aftermath of the dosage.

Women who are pregnant or thinking of becoming pregnant should consult with a doctor if you are currently taking frovatriptan. Animal studies which have been conducted which indicate some adverse effects in the offspring, although this was only in cases where a much higher dosage level was given to the animal that is recommended for humans.

The same holds true for women who intend to breastfeed their infants, e.g. there is potential for adverse side effects, but only when much higher dosage levels have been administered than humans are typically prescribed. Talk to your doctor in order to have a full understanding of the risks associated with becoming pregnant, and with breastfeeding while concurrently taking frovatriptan.

Storage

Frovatriptan should be stored at room temperature, and away from excessive heat or cold. Humidity is also to be avoided, as it can degrade the effectiveness of the medication. Be sure to keep this medication out of the reach of pets and small children, so that accidental ingestion does not occur.

When it is necessary to dispose of expired frovatriptan, follow proper disposal methods and do not simply flush the tablets down a sink or toilet. If you are not aware of what proper disposal methods are for this medication, you can ask your doctor or pharmacist. You can also consult a website maintained by the FDA which provides information on the safe disposal of medicines.

Summary

Frovatriptan is one of the most effective medications prescribed for patients who suffer from migraine headaches. It works by relieving the narrowing of blood vessels which commonly cause such headaches, and helps to restore a state of clear-mindedness. It is only taken as needed but should be taken at the very first sign of a migraine in order to be as effective as possible.

There are several side effects and precautions which should be observed by patients taking frovatriptan, notably that your doctor will probably want to monitor your medical condition often while you are taking the drug. This is to ensure that the medication is being effective in treating your symptoms and that it is not triggering high blood pressure or any kind of heart issues which may be possible.

It's extremely important for patients using this drug to not over-use it in an attempt to alleviate severe symptoms of a bothersome headache because overuse of frovatriptan can cause the opposite effect to occur, and make the symptoms even worse. There is always a possibility that this medication will not be effective in treating your migraine symptoms, or that its effectiveness will diminish over time, so all patients who engage in long-term usage of this medication must be alert to that potential, and should discuss the situation with a family doctor if it happens.

Many doctors advise their migraine patients to maintain a migraine diary' so that the frequency of headaches can be monitored, as well as the severity of any symptoms, and the effectiveness of whatever medication was used in treatment.