Contraindicated in:
- Hypersensitivity
- Hemiplegic or basilar migraine
- Ischemic heart disease or Prinzmetal's angina
- Uncontrolled hypertension
- Wolff-Parkinson-White syndrome or other arrhythmias involving conduction pathways
- Stroke or transient ischemic attack
- Peripheral vascular disease
- Ischemic bowel disease
- Severe hepatic impairment
- Should not be used within 24 hr of other 5-HT1 agonists or ergot-type compounds (dihydroergotamine)
- Should not be used within 72 hr of potent CYP3A4 inhibitors including ketoconazole, itraconazole, nefazodone, clarithromycin, ritonavir, and nelfinavir.
Use Cautiously in:
- OB: Use only if potential benefits justify potential risk to fetus
- Lactation: Doses up to 80 mg daily not expected to cause adverse effects in breast-fed infants >2 mo
- Pedi: Safety and effectiveness not established
- Geri: ↑risk of ↑ BP.
Exercise Extreme Caution in:
- Cardiovascular risk factors (hypertension, hypercholesterolemia, cigarette smoking, obesity, diabetes, strong family history, menopausal women or men >40 yr); use only if cardiovascular status has been evaluated and determined to be safe and 1st dose is administered under supervision.
CNS: dizziness, drowsiness, weakness.
CV: MI, VENTRICULAR FIBRILLATION, VENTRICULAR TACHYCARDIA, angina, chest tightness/pressure, coronary vasospasm, ECG changes, transient hypertension.
GI: abdominal pain, dry mouth, dysphagia, nausea.
Neuro: paresthesia.
Misc: ANAPHYLAXIS.
Therapeutic Classification: vascular headache suppressants
Pharmacologic Classification: five ht1 agonists
Absorption: 50% absorbed after oral administration.
Distribution: Enters breast milk.
Metabolism/Excretion: Mostly metabolized by the liver via the CYP3A4 enzyme system.
Half-life: 4 hr.
(decreased migraine pain)
