Section 02 · Monograph
Frovatriptan
Reviewed Nov 2026FDA label
FrovaTriptan
- Forms
- Tab: 2.5mg
- Dose
- 2.5mg PRN (max 7.5mg/day)
- MOA
- 5-HT1B/1D agonist
Indications
- Acute treatment of migraine with or without aura in adultsFDA-labeled
Off-Label Uses
- Short-term perimenstrual prophylaxis of menstrual migraine (given as a scheduled regimen around the menstrual period)Off-label
Mechanism of Action
- Selective agonist at 5-HT1B/1D receptors causing cranial vasoconstriction and inhibition of trigeminal neuropeptide release
- Longest elimination half-life of the triptan class (~26 hours), giving sustained receptor occupancy that underlies its slower onset and its use for short-term migraine prevention
Full Dosing
Adult / usual
- Adults: 2.5mg single dose; may repeat once after ≥2 hours if headache recurs
- Maximum: 3 tablets (7.5mg) in 24 hours
- Slow onset of action relative to other triptans, consistent with its long half-life — not ideal as a first-line agent when rapid relief is the priority
- Off-label menstrual migraine prevention regimen (as reported in the literature): typically 2.5mg once or twice daily, started 1-2 days before expected menses and continued for a total of ~6 days
Renal
- No dose adjustment required for mild-moderate hepatic or renal impairment; not studied in severe impairment
Contraindications
- Ischemic or vasospastic coronary artery disease (e.g., Prinzmetal's angina)
- History of stroke, TIA, or peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Hemiplegic or basilar migraine
- Use of another 5-HT1 agonist or ergot-type medication within 24 hours
- Use of an MAO-A inhibitor within the preceding 2 weeks
- Known hypersensitivity to frovatriptan
Drug Interactions
- MAO-A inhibitors: labeled interaction data limited but caution advised — avoid per class warning
- SSRIs/SNRIs: increased risk of serotonin syndrome
- Other triptans or ergot-containing drugs within 24 hours: additive vasospastic risk — contraindicated
- Oral contraceptives: modestly increase frovatriptan exposure; not considered clinically significant
- Minimal CYP450-mediated metabolism — low potential for hepatic enzyme-mediated drug interactions
Adverse Effects
- Common: dizziness, fatigue, headache, paresthesia, dry mouth, flushing, chest pain/tightness
- Generally mild adverse effect profile consistent with slow, sustained receptor binding
- Serious (rare, class-wide): myocardial infarction, coronary vasospasm, arrhythmia, cerebrovascular events, serotonin syndrome, medication-overuse headache
Monitoring Parameters
- Cardiovascular risk assessment before first dose in at-risk patients
- Frequency of use — limit to avoid medication-overuse headache, particularly relevant given its long half-life and use in scheduled preventive regimens
Pregnancy & Lactation
- Animal studies showed fetal renal effects at high doses
- Use during pregnancy only if potential benefit justifies potential fetal risk
- Limited data on presence in human milk; caution advised with breastfeeding