Active Ingredients: Gabapentin
Cardio- and cerebrovascular severe adverse events myocardial infarction, ictus, without an established cause—effect relationship, were rarely reported. ECG modifications are also rarely reported.
Dystonic crises, akathisia, euphoria, can also rarely occur. Warnings Pregnancy and breastfeeding From findings obtained by pregnancy registries, a greater number of preterm newborns or newborns with low birth-weight due to the use of sumatriptan during pregnancy have been described.
Information on the safety of triptans during breastfeeding is limited but reassuring, because the minimal quantities secreted with milk are insufficient to induce adverse events to the child.
They can be used only with a therapeutic plan approved by an Ethical Committee and with informed consent. SSRI antidepressants A serotoninergic syndrome can occur in the case of contemporary use of triptans and consists in motor incoordination, marked asthenia and hyperreflexia.
Propranolol increases the concentration of rizatriptan. The clinical relevance of these observations needs to be clarified.
NSAIDs and analgesics Indications They are indicated for the treatment of mild or moderate attacks or when triptans are contraindicated or ineffective.
Efficacy The most consistent evidence of efficacy is available for paracetamol, acetylsalicylic acid ASA, lysine acetylsalicylate, naproxen sodium, ibuprofen, diclofenac sodium and potassium, metamizole and ketorolac, whereas the evidence of efficacy for other NSAIDs is more limited.
Few studies have evaluated the efficacy of analgesics and NSAIDs on associated symptoms and functional disability. There is evidence only for ASA, salicylates, ibuprofen and diclofenac sodium.
Observations ASA is recommended in patients with cardio- and cerebrovascular comorbidities.
Paracetamol is first-choice drug for migraine attacks during pregnancy. There is evidence of the use of ketorolac i.
In the same setting, ketorolac has been demonstrated to be more effective than sumatriptan nasal spray. Metamizole, both by oral and intravenous route, has been demonstrated to be effective in the treatment of migraine attacks, but the risk of agranulocytosis and hypotension as relevant side effects should be considered.
Side effects consist mainly in gastrointestinal adverse events from gastric pain to gastric or duodenal ulcer. The percentage of adverse events found in clinical trials concerning the use of NSAIDs for migraine attack are lower than those detected in studies regarding their daily use.
These adverse events, occasional in migraine patients using sometimes NSAIDs, can occur with higher frequency in the case of daily or almost daily use by chronic migraine patients.