Triptans for migraines: drugs, their use and cost

Migraine or headache

Migraines occur in more than 20% of the population. About 17% of women and 8% of men suffer from migraines. This condition has recognizable symptoms - with a migraine, only one part of the head hurts. It is also possible that an “aura”—a set of accompanying neurological symptoms—may appear. Patients often report nausea, photophobia, and aversion to loud noises. Some complain of confusion and blurred vision.

Aura may be absent during migraine. For some patients, the appearance of an “aura” indicates the onset of a migraine attack, which usually occurs several minutes after the onset of neurological symptoms.

It should be understood that migraine and headache are not the same thing . The causes of migraines are still not precisely understood, while headaches can be triggered by many different factors. This condition can be the result of severe stress, lack of sleep, or may indicate serious pathologies in the body, for example, instability in the cervical spine.

Before you start taking any medications, you should visit a neurologist. To determine the cause of pain, the following methods are used:

• dopplerography;
• encephalography;
• Magnetic resonance imaging.

Poor cerebral circulation can cause headaches. Dopplerography is prescribed for diagnosis. Encephalography is the most effective method for detecting brain disorders. In some cases, magnetic resonance imaging of the brain is indicated. With the help of such studies, you can identify any pathology that provoked the development of headaches.

Before you begin treating the problem, it is important to confirm the diagnosis. Drugs that successfully combat migraines are usually ineffective against headaches of other nature. At the same time, antispasmodics are good for headaches, but they will not help with a migraine attack.

Overdose

Exceeding the daily dose of this drug threatens the patient with the following consequences:

• Drowsiness;
• Nausea and vomiting;
• Cramps;
• Tachycardia;
• Decreased attention.

Did you know that the drug Mexidol is quite often prescribed by doctors for circulatory problems in the human brain. Indications, contraindications, as well as the price of Mexidol in ampoules of 2 ml.

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Triptans for headaches

The most effective headache medications today are triptans. The effectiveness of drugs is determined by their mechanism of action:

• migraine triptans act on the walls of blood vessels, narrowing those that are too dilated;
• acting on the vessels of the brain without affecting the peripheral and coronary vessels;
• block pain at the level of trigeminal nerve receptors;
• relieve associated symptoms.

The advantage of this group of drugs is their speed of action. So, relief comes quite quickly. In this case, the medicine has a complex effect.

Everyone knows the harbingers and companions of migraine - loss of energy, nausea and photosensitivity.

Triptans are also effective in relieving these symptoms. As a result, some time after taking the pill, pain and irritability disappear, and performance returns.

The effect of triptans - tablets for migraines

A person suffering from migraine is forced to stay in a dark and quiet room, isolating himself from any external stimuli. At the same time, he is recommended to rest in bed, since the attacks negatively affect the patient’s performance and social activity.

Often, patients with migraines prefer the wrong treatment, trying to stop the attack with analgesics. But the cause of migraines is vascular spasm in the brain and the analgesic in this case is absolutely useless, the patient will not receive the expected effect. But such treatment can really aggravate your condition.

Triptans are based on serotonin, which helps not only lower the hypersensitivity threshold, but also reduce pain.

The result is achieved due to the narrowing of cerebral vessels and the effect on the receptor apparatus.

The drug works selectively, only the vessels in the cerebral cortex are affected, and the rest of the vascular system is not involved.

With the help of triptans, the symptoms accompanying migraine are quickly eliminated: nausea subsides, the urge to vomit stops, irritability to light and sounds goes away, and the person can return to the usual rhythm of life.

What happens after taking it:

• Different from other drugs, triptans act more effectively on the migraine focus itself, while working in several directions at once.
• Vascular stimulation begins in the cerebral cortex, narrowing through the activation of 5HT1B/D type receptors located in these zones. Pulsation, which causes increased pain, is eliminated.
• The drug can act as an inhibitor of vasoactive and algogenic proteins secreted in the perivascular fibers of the trigeminal nerve. This helps stop the neurogenic inflammatory process and reduces pain.
• The drug reduces the threshold of pain sensitivity in the trigeminal nerve, while inhibiting the reactivity of receptors in the spinal nucleus of the same nerve.

The most popular drugs

Triptans for migraine appeared on the pharmaceutical market relatively recently. There is an extensive list of names of such drugs.

The first generation of drugs has the most studied mechanism of action. These medications, for example Sumatriptan, cause virtually no side effects.

The second generation of tablets is the drugs Almotriptan, Frovatriptan. They act faster and more effectively, unlike first-generation drugs, but can cause side effects.

Sumatriptan is the name of the active substance. A drug with the same name is produced; you can also find many analogues, the names of which need to be clarified at the pharmacy. Sumatriptan is the most studied drug in the triptan group and is practically safe. The drug Sumatriptan quickly stops a migraine attack; no more than half an hour passes from the moment of taking the pill to feeling better.

Sumatriptan is sold in a package of two tablets at an affordable price. Some pharmacies may require a doctor's prescription to dispense Sumatriptan.

The drug is not an anesthetic. It acts directly on the cause of migraine – dilated meningeal vessels.

The new generation drug Frovatriptan promises to become the most effective treatment for migraines. Frovatriptan underwent clinical trials this year and showed itself to be an effective and safe drug. Frovatriptan is not yet available in pharmacies in the CIS countries; it can be purchased in the countries of the European Union and the USA. It is impossible to say exactly when the drug Frovatriptan is expected to appear in domestic pharmacies.

The cost of original drugs is quite high. Russian and Ukrainian analogues are much cheaper. You should ask the pharmacy directly about their availability.

List of drugs containing triptans

Features of the action

Triptans are effective only for the treatment of migraines. Tablets will not cure headaches of any other nature, since they are not a pain reliever.

The medicine should be taken when the attack is already in full swing. When initial symptoms or aura appear, the drug often does not help relieve the attack. Triptans are most effective when a throbbing pain appears in one part of the head.

These drugs are effective in six out of ten cases. Some patients note that certain groups of triptans do not help them, while drugs from the same group of medications, but with a different substance in their composition, effectively and quickly relieve an attack.

Even a qualified doctor cannot select the necessary medicine that will definitely help a particular patient, so the choice of triptans is carried out by trial and error.

Side effects

Triptans have a number of side effects

As a rule, drugs from the triptan group are well tolerated by the body, but sometimes the following side effects are possible:

• increased heart rate, tachycardia, and in the most difficult cases – myocardial infarction;
• muscle spasms and pain;
• feeling hot or cold;
• change in taste sensations;
• increased urination;
• dizziness, decreased sensitivity, drowsiness, dizziness, asthenia;
• dry mouth, dyspeptic disorders;
• allergic manifestations.

How to take the pills

For migraines, triptans are available in the form of tablets, sprays and suppositories. This is a whole group of drugs, and the list of names is quite extensive. The tablets are packaged in cardboard boxes, with instructions for use included inside.

You should consult your doctor about dosage. It is also very important to read the instructions. For migraines, you should take only one tablet, and for moderate pain, half a tablet. As a rule, relief occurs within half an hour after administration. If the tablet does not work, the medication should be taken again no earlier than three hours after the previous dose.

The tablets can be taken continuously to treat migraine attacks, but not more than three times a week. The dosage should not exceed the permissible dosage given in the instructions or recommended by the doctor.

The use of drugs together with other medications should be careful; they should not be taken with antidepressants, antibacterial drugs and anti-inflammatory drugs.

Mode of application

The tablets should be taken orally. The triptan dosage is 2.5 mg. If the pain returns, you can repeat taking the drug, but not earlier than 2 hours after taking the previous tablet.

The spray is sprayed into the nasal cavity, which ensures better absorption.

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Contraindications

Triptans are quite strong drugs, so they can only be taken as prescribed by a doctor, or after consultation with a specialist.

Contraindications to treatment with drugs of this group:

• cardiac ischemia;
• impaired blood supply to the brain;
• renal failure;
• liver diseases;
• period of bearing a child;
• allergic reaction to the components of the drug.

Since the drug constricts blood vessels, it should not be taken for atherosclerosis and other diseases of the cardiovascular system. Before starting treatment with triptans, you should consult your doctor.

The drugs are not prescribed to children and adolescents, as well as people over 65 years of age.

What triptans are there for migraines?

Triptans are the main active ingredient of the following medications: “Amigrenin”, “Relpacasa”, “Zomiga”, “Imigran”, “Trimigren”, “Sumamigren”, “Sumatriptan”, “Narmiga”, “Almotriptan”, “Eletreptana”, “ Frovatriptan", "Naratriptan", "Rizotriptan", "Zolmitriptan".

In each particular case, the drugs will have an unequal effect. To be able to verify the effectiveness of such treatment, the remedy must be tested on at least three attacks.

Kinds

In the pharmacological classification, there are two groups of triptans: the first generation (sumatriptan) and the second (naratriptan, zolmitriptan, eletriptan).

Sumatriptan has several routes of administration: subcutaneously, in tablets or as an intranasal spray. The method of drug delivery determines the speed at which the active substance enters the bloodstream. When administered subcutaneously, within 10 minutes a drug concentration of 96% is achieved in the blood. Doctors point out that the drug in any form should be taken as quickly as possible after the onset of a headache attack in order to prevent the occurrence of all stages of the pathogenetic mechanism. The maximum daily dose is 300 mg. Some people do not recommend taking sumatriptan due to its purely peripheral mode of action or its higher potential for side effects than other triptans. However, for many patients this is the drug of choice, about which there is a fairly large number of positive reviews. The reason for this opinion is its low price compared to other groups of drugs.

Second-generation triptans are also very popular because they can pass through the blood-brain barrier and have not only peripheral, but also central effects.

Compared to sumatriptan, the effect of naratriptan occurs somewhat later, but the phenomenon of “return of headache” is observed in a smaller percentage of patients. The therapeutic dose is 1 to 2.5 mg. The incidence of side effects for drugs in this group is the lowest.

Zolmitriptan has a relatively low bioavailability (40%), but its effectiveness does not depend on the time at which the drug was taken. It can also be taken with caution, but can be taken during pregnancy and breastfeeding. Reviews about taking this drug are generally positive.

The correct method for relieving migraine attacks

While the patient is waiting for the medicine to take effect, he is advised to take all available measures to alleviate his condition. It is best to sit in a room with dim lighting, take a warm shower every hour, and drink decoctions of medicinal herbs that have a sedative effect.

To make it less painful, menthol balms or the usual “Star” are rubbed into the temples. If possible, do acupressure, using the areas responsible for the activity of the cerebral cortex.