What is the most important information I should know about naratriptan?

Naratriptan can cause serious side effects on the heart, including heart attack or stroke. Although these side effects are rare, do not use this medication if you have a history of heart disease, angina (chest pain), blood circulation problems, ischemic bowel disease, severe or uncontrolled high blood pressure, or history of a heart attack or stroke.

Before using naratriptan, tell your doctor if you have coronary artery disease, or risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

Do not use naratriptan within 24 hours after taking almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), or ergot medicine such as methysergide (Sansert), ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), methylergonovine (Methergine).

Before taking naratriptan, tell your doctor if you are also taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Naratriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

If your headache does not go away after taking a naratriptan tablet, or if the headache goes away and then comes back, call your doctor before taking a second tablet. You must wait at least four (4) hours after you have taken the first tablet before you take the second tablet. Do not take more than two (2) naratriptan tablets in 24 hours.

If your symptoms have not improved after taking 2 tablets in 24 hours, contact your doctor before taking any more tablets.

What is naratriptan?

Naratriptan is a headache medicine. It is believed to work by narrowing the blood vessels around the brain. Naratriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Naratriptan is used to treat migraine headaches.

Naratriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Naratriptan may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using naratriptan?

Do not use this medication if you are allergic to naratriptan, or if you have:

• a history of heart disease, angina (chest pain), blood circulation problems, or history of a heart attack or stroke;
• severe kidney disease;
• severe liver disease;
• ischemic bowel disease;
• severe or uncontrolled high blood pressure; or
• a headache that is not like other headaches you have had.

Do not use naratriptan within 24 hours after taking any of the following medicines:

• almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
• ergot medicine such as methysergide (Sansert), ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), methylergonovine (Methergine).

Before using naratriptan, tell your doctor if you have:

• high blood pressure;
• liver disease;
• kidney disease; or
• coronary artery disease (or risk factors that include diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take naratriptan.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Your name may need to be listed on a naratriptan pregnancy registry when you start using this medication.

Naratriptan can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

This medicine should not be given to anyone under 18 or over 65 years of age.

How should I use naratriptan?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Take naratriptan as soon as you notice headache symptoms, or after an attack has already begun.

Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to see if you have any serious side effects.

Take one naratriptan tablet whole with a full glass of water.

After taking a tablet: If your headache does not go away completely, or if the headache goes away and then comes back, call your doctor before taking a second tablet. You must wait at least four (4) hours after you have taken the first tablet before you take the second tablet. Do not take more than two (2) naratriptan tablets in 24 hours.

If your symptoms have not improved after taking 2 tablets in 24 hours, contact your doctor before taking any more tablets.

Contact your doctor if you have more than four headaches in one month (30 days).

Store naratriptan at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Since naratriptan is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using naratriptan.

After taking a naratriptan tablet, you must wait four (4) hours before taking a second tablet. Do not take more than two (2) naratriptan tablets in 24 hours.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure (convulsions), neck stiffness, tiredness, lack of coordination, feeling light-headed, or fainting.

What should I avoid while using naratriptan?

Naratriptan can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of naratriptan?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using naratriptan and call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• fast heart rate, agitation, muscle stiffness, hallucinations, lack of coordination, with nausea, vomiting, or diarrhea;
• sudden and severe stomach pain and bloody diarrhea;
• numbness or tingling and a pale or blue-colored appearance in your fingers or toes; or
• sore throat, ear pain, fever, cold symptoms.

Less serious side effects may include:

• upset stomach, drooling;
• feeling too warm or too cold;
• feeling of pain or pressure in your neck and throat;
• dizziness, sleepiness; or
• sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect naratriptan?

Before using naratriptan, tell your doctor if you are using any of the following drugs:

• an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor);
• another migraine medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and there may be other drugs that can interact with naratriptan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about naratriptan.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 4.04. Revision date: 04/16/2008.