Home Drug Guide Frovatriptan Succinate

Drug Guide

Generic Name

Frovatriptan Succinate

Brand Names Frova

Classification

Therapeutic: Antimigraine agent

Pharmacological: Serotonin receptor agonist (Triptan)

FDA Approved Indications

  • Acute treatment of migraine headaches with or without aura

Mechanism of Action

Frovatriptan is a selective 5-HT1B/1D receptor agonist. It causes vasoconstriction of intracranial blood vessels and inhibits the release of pro-inflammatory neuropeptides, thereby alleviating migraine symptoms.

Dosage and Administration

Adult: Initially 2.5 mg taken orally once. Dose may be repeated after 2 hours if needed, but not exceeding 7.5 mg in 24 hours.

Pediatric: Not approved for use in pediatric patients.

Geriatric: Use with caution; start at lower end of dosing range due to potential increased sensitivity.

Renal Impairment: Use with caution; may require dose adjustment based on severity.

Hepatic Impairment: Use with caution, especially in severe hepatic impairment.

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma concentration in approximately 2-3 hours.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Primarily via hepatic CYP1A2 metabolism.

Excretion: Excreted mainly in urine, including metabolites.

Half Life: Frovatriptan has a half-life of approximately 26 hours, contributing to its comparatively long duration of action.

Contraindications

  • History of coronary artery disease, uncontrolled hypertension, cerebrovascular disease, peripheral vascular disease.
  • Use with monoamine oxidase inhibitors (MAOIs) or ergot alkaloids within 24 hours.
  • Hypersensitivity to Frovatriptan or other triptans.

Precautions

  • Risk of coronary vasospasm especially in patients with risk factors for cardiovascular disease.
  • Use cautiously in patients with risk factors for stroke or cerebrovascular disease.
  • Patients should be advised to seek emergency care if they experience chest pain or symptoms suggestive of myocardial ischemia.

Adverse Reactions - Common

  • Dizziness (Less common)
  • Fatigue (Less common)
  • Nausea (Less common)
  • Sensations of pressure or tightness in the chest or throat (Common)

Adverse Reactions - Serious

  • Serious cardiovascular events (myocardial infarction, arrhythmia) (Rare)
  • Serotonin syndrome (especially with concomitant serotonergic drugs) (Rare)

Drug-Drug Interactions

  • Other serotonergic drugs (SSRIs, SNRIs, MAOIs), ergot alkaloids, other triptans
  • Caution with CYP1A2 inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor migraine characteristics and response. Assess for cardiovascular risk factors.

Diagnoses:

  • Risk for ineffective tissue perfusion related to vasospasm.
  • Acute pain related to migraine.

Implementation: Administer at onset of migraine symptoms. Ensure patient understands dosing limits.

Evaluation: Evaluate relief of migraine symptoms and any adverse effects.

Patient/Family Teaching

  • Instruct patient to take the medication at first sign of migraine.
  • Do not exceed recommended dose within 24 hours.
  • Seek immediate medical attention if chest pain, jaw pain, or symptoms of cardiovascular ischemia occur.

Special Considerations

Black Box Warnings:

  • Coronary vasospasm, myocardial infarction, and other ischemic events have been reported with triptan use.
  • Use only if a clear diagnosis of migraine has been established.
  • Not recommended for patients with ischemic cardiac or cerebrovascular disease.

Genetic Factors: Pharmacogenomic variations in CYP1A2 may affect metabolism, but routine testing is not standard.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Serious cardiovascular symptoms, CNS effects such as hallucinations or agitation.

Treatment: Supportive care, manage symptoms, and consider ICU admission for significant toxicity.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable for the duration of the expiration date on the package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.