Home Drug Guide Naratriptan Hydrochloride

Drug Guide

Generic Name

Naratriptan Hydrochloride

Brand Names Amerge, Naratriptan

Classification

Therapeutic: Antimigraine agent

Pharmacological: Selective serotonin receptor agonist (5-HT1B/1D receptor agonist)

FDA Approved Indications

  • Migraine headache with or without aura

Mechanism of Action

Naratriptan selectively binds to 5-HT1B/1D receptors on intracranial blood vessels and sensory nerves, leading to vasoconstriction and inhibition of neuropeptide release, which alleviates migraine symptoms.

Dosage and Administration

Adult: Initial dose typically 2.5 mg orally, may repeat after 4 hours if needed, maximum 5 mg in 24 hours.

Pediatric: Safety and efficacy not established, generally not recommended for children.

Geriatric: Use with caution, no specific dose adjustment, monitor for adverse effects.

Renal Impairment: Adjust dose based on severity; consultation recommended.

Hepatic Impairment: Use with caution; no specific dose adjustment established.

Pharmacokinetics

Absorption: Rapid absorption, bioavailability approximately 70%.

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

Metabolism: Primarily metabolized in the liver via CYP1A2.

Excretion: Excreted mainly in urine as metabolites.

Half Life: Approximately 3 to 6 hours.

Contraindications

  • History of ischemic heart disease, uncontrolled hypertension, or risk factors for cardiovascular disease.
  • Use in patients with concurrent MAO inhibitor therapy.
  • History of hypersensitivity to triptans.

Precautions

  • Use with caution in patients with cerebrovascular disease, uncontrolled hypertension, or at risk for coronary artery disease.
  • Assess cardiovascular status before administration, especially in patients over 40 or with risk factors.

Adverse Reactions - Common

  • Dizziness (Common)
  • Nausea (Common)
  • Somnolence (Common)

Adverse Reactions - Serious

  • Myocardial ischemia, infarction (Rare)
  • Serotonin syndrome (with concomitant serotonergic drugs) (Rare)
  • Allergic reactions (rash, edema, hypotension) (Rare)

Drug-Drug Interactions

  • Other serotonergic drugs (SSRIs, SNRIs, MAOIs)
  • Ergot alkaloids

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for cardiovascular symptoms, including chest pain, dizziness, and hypertension.

Diagnoses:

  • Risk for cardiac ischemia
  • Ineffective tissue perfusion

Implementation: Administer orally, assess symptom resolution, monitor for adverse effects.

Evaluation: Evaluate reduction in migraine intensity and duration, monitor for adverse effects, especially cardiovascular.

Patient/Family Teaching

  • Instruct to report chest pain, chest tightness, or unusual symptoms immediately.
  • Advise to take medication as soon as migraine symptoms begin.
  • Warn against concurrent use with other serotonergic drugs or ergot alkaloids.

Special Considerations

Black Box Warnings:

  • Use only where clearly indicated due to risk of coronary vasospasm and serious cardiovascular events.

Genetic Factors: None specific.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Severe vasospasm, chest pain, hypertension, dizziness.

Treatment: Supportive care; cardiac monitoring; vasodilators may be used if vasospasm occurs.

Storage and Handling

Storage: Store at room temperature, 15-30°C (59-86°F).

Stability: Stable; protect from moisture and light.

🛡️ 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.