Frovatriptan

Following administration, triptans can be associated with transient symptoms including chest pain and tightness, which may be intense and involve the throat. Where such symptoms are thought in indicate ischaemic heart disease, no further dose should be taken and patients referred to their GP for appropriate evaluation. It should be noted that migraineurs may be at risk of certain cerebrovascular events (eg. CVA or TIA). Triptans have been associated with coronary vasospasm. In rare cases, myocardial ischemia or infarction have been reported. Where such symptoms are thought to indicate ischaemic heart disease, no further dose should be taken and patients referred to their GP for appropriate evaluation. Triptans may cause mild, transient increases in blood pressure. This may be more pronounced in older patients. Prolonged use of any painkiller for headache can lead to medication overuse headaches. The diagnosis of medication overuse headache should be suspected in patients who have frequent or daily headaches despite (or because of) the regular use of headache medications. If headache has developed or worsened whilst taking the following for 3 months or more then medication overuse headache should be suspected:

• Triptans, opioids, ergots or combination analgesic medications on 10 days per month or more
• Paracetamol, aspirin or NSAIDs (alone or in combination) on 15 days per month or more Patients should be referred to their GP for appropriate management of withdrawal of painkillers.

The initial dose should be taken as early as possible after the onset of migraine. A second dose may be taken if the symptoms reappear within 24 hours AND a response was seen to the first dose. If a second dose is required, it should not be taken within 2 hours of the previous dose. If there is no response to the first dose a second dose should not be taken. The attack may still be treated with simple analgesics such as paracetamol, aspirin or ibuprofen.

Any drug may produce unwanted or unexpected adverse reactions. Detection and recording of these is of vital importance. Patients should be actively encouraged to report any suspected adverse reaction, particularly to black triangle medicine. All side effect information is taken from relevant product SPCs as referenced in this PGD. Different 5HT1-receptor agonists have a different incidence of side effects. Frovatriptan Common side effects:

• Dizziness, tingling, numbness or abnormal sensation, somnolence, visual disturbance, flushing, throat tightness, nausea, dry mouth, dyspepsia and abdominal pain, hyperhidrosis, fatigue, chest discomfort

  Uncommon and rare side effects can be found in the SPC. Patients should be advised to read the patient information leaflet before taking the medication. Healthcare professionals are asked to report any suspected adverse reactions via the Medicines and Healthcare products Regulatory Agency (MHRA), Yellow Card Scheme at https://yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store.