Naratriptan belongs to a class of medications known as 5-hydroxytryptamine agonists. It is used to treat migraine attacks with or without aura (warning signs that occur prior to the onset of a migraine). It is not to be used for the prevention of migraine.

Migraine headaches are thought to be caused by a widening of the blood vessels in the head. Naratriptan relieves migraine headaches by narrowing these vessels.

For most people, naratriptan eliminates or reduces the symptoms of migraine including headache, nausea, vomiting, and sensitivity to light and sound.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult single dose of naratriptan ranges from 1 mg to 2.5 mg. The maximum recommended single dose is 2.5 mg.

Naratriptan should be taken as early as possible after the onset of a migraine headache, but is effective if taken at a later stage. A second tablet may be taken if the headache returns, but not sooner than 4 hours after the first tablet was taken. You should not take any more than 5 mg of naratriptan in any 24-hour period (i.e., 2 of the 2.5 mg strength or 5 of the 1 mg strength).

If you do not get relief from the first dose of naratriptan, a second dose should not be taken for the same attack unless you talk with your doctor first, as it is unlikely to be of benefit.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

The tablets should be swallowed whole with fluids.

It is important to take this medication exactly as prescribed. The safety of treating more than 4 migraines with naratriptan in a 1-month period of time is not known. If you are experiencing more than 4 migraines in a month, contact your doctor.

Store this medication at room temperature, protect it from light and keep it out of the reach of children.

1 mg
Each light gray, D-shaped, film-coated tablet, engraved with "93" on one side and "8522" on the other side, contains 1 mg of naratriptan. Nonmedicinal ingredients: croscarmellose sodium, FD&C Blue No. 1, hydroxypropyl methylcellulose, iron oxide black, iron oxide yellow, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, and titanium dioxide.

2.5 mg
Each green, D-shaped, film-coated tablet, engraved with "93" on one side and "8523" on the other side, contains 2.5 mg of naratriptan. Nonmedicinal ingredients: croscarmellose sodium, FD&C Blue No. 1, hydroxypropyl methylcellulose, iron oxide black, iron oxide yellow, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, and titanium dioxide.

Do not take naratriptan if you:

• are allergic to naratriptan or any ingredients of the medication
• have angina (chest pain), including Prinzmetal angina (coronary vasospasm)
• have blood vessel disease (e.g., ischemic bowel disease, Raynaud's syndrome, stroke, transient ischemic attacks [TIAs])
• have had a heart attack
• have heart disease (e.g., heart valve disease, ischemic heart disease, abnormal heart rhythms, congenital heart disease)
• have high blood pressure that is severe or not under control
• have taken another 5-hydroxytryptamine agonist (i.e., rizatriptan, sumatriptan, zolmitriptan) in the previous 24 hours
• have taken ergotamine-containing or ergot-type medications (such as dihydroergotamine, ergotamine, or methysergide) in the previous 24 hours
• have certain types of migraine headaches (including hemiplegic, basilar or ophthalmoplegic migraine)
• have severely reduced kidney function
• have severely reduced liver function
• do not have a clear diagnosis of migraine

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• changed sense of taste
• constipation
• diarrhea
• dizziness
• drowsiness
• dry mouth
• ear, nose, or throat infections
• feeling full or bloated
• feeling unwell
• flushing
• headache
• increased sensitivity to sun
• itching skin
• lack of energy
• lightheadedness
• muscle cramps
• muscle or joint pain
• nasal congestion
• nausea
• skin rash
• stomach discomfort or pain
• sweating
• thirst
• trouble sleeping
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• anxiety
• decreased coordination
• eye problems (e.g., dry eyes, blurred vision)
• increased blood pressure
• increased sensitivity to touch
• irregular heartbeat (e.g., fast or slow heart rate, pounding heartbeat)
• numbness and tingling of head and face
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• symptoms of low blood pressure (e.g., fainting, dizziness, lightheadedness, blurred vision, increased thirst, nausea)
• symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)
• trembling or shaking of hands or feet
• trouble thinking clearly

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• sensation of cold, numbness, or purplish discolouration in hands or feet
• severe, sudden abdominal pain
• severe chest pain
• signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating, tightness, heaviness or pressure in the arm, chest, jaw, or neck)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a stroke (e.g., sudden vision change, dizziness, difficulty speaking or moving, rapid onset of severe headache)

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: If you are allergic to sulfonamides, you may experience an allergic reaction to naratriptan. Reactions range from skin allergy to serious allergic reaction. Rarely, anaphylactic reactions to naratriptan may occur. Because of the possibility of allergic reactions, people who are allergic to any of the other drugs of this class (5-hydroxytryptamine agonists) should not use naratriptan.

Blood pressure: Naratriptan may cause increases in blood pressure. If you have mild to moderately increased blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

People with severe or uncontrolled high blood pressure should not take naratriptan.

Drowsiness/reduced alertness: This medication may cause drowsiness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.

Headache type: Naratriptan should only be used where there is a clear diagnosis of migraine headache.

Heart disease: There have been rare reports of heart attack and stroke occurring with people who have appeared to be otherwise healthy. If you have risk factors for heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Risk factors for heart disease include high blood pressure, high cholesterol levels, smoking, obesity, diabetes, a family history of heart disease, being male over 40 years old, or being a post-menopausal woman.

If you have heart disease you should not use naratriptan.

Kidney function: For people with reduced kidney function, it takes longer for naratriptan to leave the body, which may result in an increase in side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you have severely reduced kidney function you should not use naratriptan.

Liver function: For people with reduced liver function, it takes longer for naratriptan to leave the body, which may result in an increase in side effects. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you have severely reduced liver function you should not use naratriptan.

Medication overuse headache: As with other medications for treating headaches, the overuse of naratriptan may create a situation where the headache returns as the medication wears off, prompting the use of more medication. Do not take more naratriptan than recommended by your doctor. If you require more than 5 mg of naratriptan in a 24-hour period, or need to treat more than four headaches over 30 days, contact your doctor.

Medications containing ergotamine: After taking any ergotamine-containing preparation, wait at least 24 hours before taking naratriptan. Likewise, ergotamine-containing preparations should not be taken for at least 24 hours following naratriptan administration.

Seizures: There have been rare reports of seizures occurring with naratriptan. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Serotonin syndrome: Severe reactions are possible when naratriptan is combined with other medications that act on serotonin such as tricyclic antidepressants and serotonin reuptake inhibitors, medications used to treat depression. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible.

If you are taking antidepressants, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if naratriptan passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children, and its use by this age group is not recommended.

Seniors: There may be a higher risk of side effects such as high blood pressure and heart problems associated with the use of naratriptan by people over the age of 65 years. The use of naratriptan by people in this age group is not recommended.

There may be an interaction between naratriptan and any of the following:

• bromocriptine
• doxepin
• ergot-containing medications (e.g., dihydroergotamine, ergotamine, or methysergide) if taken at the same time or within the previous 24 hours
• linezolid
• lithium
• methylene blue
• mirtazapine
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine) if taken at the same time or within 14 days of naratriptan
• narcotic pain relievers (e.g., codeine, fentanyl, hydrocodone, oxycodone, tapentadol, tramadol)
• other 5-hydroxytryptamine agonists (e.g., rizatriptan, sumatriptan, zolmitriptan)
• selective norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
• selective serotonin receptor agonists (SSRIs; e.g., fluoxetine, fluvoxamine, paroxetine, sertraline)
• St. John's wort
• trazodone
• tricyclic antidepressant drugs (e.g., amitriptyline, imipramine)
• tryptophan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.