Section 02 · Monograph
Naratriptan
Reviewed Nov 2026FDA label
AmergeTriptan
- Forms
- Tab: 1, 2.5mg
- Dose
- 1-2.5mg PRN (max 5mg/day)
- MOA
- 5-HT1B/1D agonist
Indications
- Acute treatment of migraine with or without aura in adultsFDA-labeled
Mechanism of Action
- Selective agonist at 5-HT1B/1D receptors causing cranial vasoconstriction and inhibition of trigeminal neuropeptide release
- Longer elimination half-life (~6 hours) than most other triptans, associated with slower onset but more sustained effect
Full Dosing
Adult / usual
- Adults: 1mg or 2.5mg single dose; may repeat once after ≥4 hours if headache recurs
- Maximum: 5mg in any 24-hour period
- Slower onset of action than most other oral triptans, consistent with its longer half-life
Renal
- Mild-moderate renal or hepatic impairment: maximum 2.5mg in 24 hours; start with the 1mg dose
Contraindications
- Ischemic or vasospastic coronary artery disease
- 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
- Severe renal impairment (creatinine clearance <15 mL/min)
- Severe hepatic impairment (Child-Pugh C)
- Known hypersensitivity to naratriptan
Drug Interactions
- MAO-A inhibitors: increase exposure — contraindicated
- SSRIs/SNRIs: increased risk of serotonin syndrome
- Other triptans or ergot-containing drugs within 24 hours: additive vasospastic risk — contraindicated
- Minimal hepatic (CYP) metabolism relative to other triptans — comparatively low potential for hepatic enzyme-mediated interactions, though renal excretion is a major elimination pathway requiring dose adjustment in renal impairment
Adverse Effects
- Common: paresthesia, nausea, dizziness, drowsiness, malaise/fatigue, throat/neck discomfort
- Generally milder and less frequent adverse effect profile than shorter-acting, faster-onset triptans, at the tradeoff of slower symptom relief
- Serious (rare, class-wide): myocardial ischemia/infarction, arrhythmia, coronary vasospasm, cerebrovascular events, serotonin syndrome, medication-overuse headache
Monitoring Parameters
- Cardiovascular risk assessment before first dose in at-risk patients
- Renal and hepatic function — dose adjustment needed with impairment; avoid in severe impairment
- Frequency of use — limit to avoid medication-overuse headache
Pregnancy & Lactation
- Animal studies showed developmental toxicity at clinically relevant exposures; human pregnancy registry data insufficient for definitive conclusions
- Use during pregnancy only if potential benefit justifies potential fetal risk
- Present in animal milk; limited human lactation data — caution advised with breastfeeding