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Frovatriptan Disease Interactions

There are 3 disease interactions with frovatriptan:

Major

5-HT1 agonists (Includes frovatriptan) ↔ CAD risk factors

Major Potential Hazard, High plausibility. Applies to: Diabetes Mellitus, History (Familial) - Ischemic Heart Disease, Hyperlipidemia, Menopausal Disorder, Obesity, Smoking

The group of drugs known as 5-hydroxytryptamine1 receptor (5-HT1) agonists can cause vasospastic reactions, including coronary vasospasm, peripheral vascular ischemia, and colonic ischemia. Rarely, serious adverse cardiac events including acute myocardial infarction, arrhythmia, cardiac arrest, and death have been reported within a few hours following the administration of 5-HT1 agonists, in some cases even in patients with no prior history or findings of coronary artery disease (CAD). Significant elevation in blood pressure, including hypertensive crisis, has also been reported on rare occasions in patients with and without a history of hypertension, as have transient increases in blood pressure and peripheral vascular resistance. In general, patients with potentially unrecognized CAD as predicted by the presence of risk factors (e.g., hypertension, hypercholesterolemia, tobacco use, obesity, diabetes, strong family history of CAD, female with surgical or physiological menopause, or male over 40 years of age) should not be administered 5-HT1 agonists unless a cardiovascular evaluation provides satisfactory clinical evidence indicating the lack of CAD, ischemic heart disease, or other significant underlying cardiovascular disease. As a precaution, the manufacturers recommend that the first dose be administered under medical surveillance in such patients, and that electrocardiographic monitoring be considered during the interval immediately following administration to help detect any asymptomatic cardiac ischemia that may occur. Periodic cardiovascular evaluations should be performed during intermittent, long-term use.

References

  1. "Product Information. Axert (almotriptan)" Pharmacia and Upjohn, Kalamazoo, MI.
  2. Visser WH, Jaspers NMWH, Devriend RHM, Ferrari MD "Chest symptoms after sumatriptan: a two-year clinical practice review in 735 consecutive migraine patients." Cephalalgia 16 (1996): 554-9
  3. "Product Information. Amerge (naratriptan)." Glaxo Wellcome, Research Triangle Park, NC.
  4. Mueller L, Gallagher RM, Ciervo CA "Vasospasm-induced myocardial infarction with sumatriptan." Headache 36 (1996): 329-31
  5. Cavazos JE, Caress JB, Chilukuri VR, Devlin T, Gray L, Hurwitz BJ "Sumatriptan-induced stroke in sagittal sinus thrombosis." Lancet 343 (1994): 1105-6
  6. MacLean MR, Smith GC, Templeton AG "Adverse reactions associated with sumatriptan." Lancet 341 (1993): 1092
  7. "Product Information. Maxalt (rizatriptan)." Merck & Co, Inc, West Point, PA.
  8. "Product Information. Imitrex (sumatriptan)." Glaxo Wellcome, Research Triangle Park, NC.
  9. Dulli DA "Naratriptan: an alternative for migraine." Ann Pharmacotherapy 33 (1999): 704-11
  10. "Product Information. Relpax (eletriptan)." Pfizer U.S. Pharmaceuticals, New York, NY.
  11. Kelly KM "Cardiac arrest following use of sumatriptan." Neurology 45 (1995): 1211-3
  12. "Product Information. Frova (frovatriptan)." Endo Laboratories LLC, Chadds Ford, PA.
  13. Ottervanger JP, Paalman HJ, Boxma GL, Stricker BH "Transmural myocardial infarction with sumatriptan." Lancet 341 (1993): 861-2
  14. Willett F, Curzen N, Adams J, Armitage M "Coronary vasospasm induced by subcutaneous sumatriptan." BMJ 304 (1992): 1415
  15. Ottervanger JP, van Witsen TB, Valkenburg HA, Stricker BH "Postmarketing study of cardiovascular adverse reactions associated with sumatriptan." BMJ 307 (1993): 1185
  16. Dooley M, Faulds D "Rizatriptan - A review of its efficacy in the management of migraine." Drugs 58 (1999): 699-723
  17. Ottervanger JP, Vanwitsen TB, Valkenburg HA, Grobbee DE, Stricker BHC "Adverse reactions attributed to sumatriptan - a postmarketing study in general practice." Eur J Clin Pharmacol 47 (1994): 305-9
  18. Boyd IW, Rohan AP "Sumatriptan-induced chest pain." Lancet 344 (1994): 1704-5
  19. Curtin T, Brooks AP, Roberts JA "Cardiorespiratory distress after sumatriptan given by injection." BMJ 305 (1992): d713-4
  20. Morgan DR, Trimble M, McVeigh GE "Atrial fibrillation associated with sumatriptan." Br Med J 321 (2000): 275
  21. Visser WH, Devriend RHM, Jaspers NMWH, Ferrari MD "Sumatriptan in clinical practice: a 2-year review of 453 migraine patients." Neurology 47 (1996): 46-51
  22. Plosker GL, Mctavish D "Sumatriptan - a reappraisal of its pharmacology and therapeutic efficacy in the acute treatment of migraine and cluster headache." Drugs 47 (1994): 622-51
  23. "Product Information. Zomig (zolmitriptan)." Zeneca Pharmaceuticals, Wilmington, DE.
View all 23 references
Major

5-HT1 agonists (Includes frovatriptan) ↔ cardiovascular disease

Major Potential Hazard, High plausibility. Applies to: Cardiovascular Disease, Cerebral Vascular Disorder, History - Cerebrovascular Disease, History - Myocardial Infarction, Heart Disease

The use of 5-hydroxytryptamine receptor (5-HT1) agonists is contraindicated in patients with a history or current symptoms or signs of ischemic cardiac, cerebrovascular, and/or peripheral vascular diseases. In addition, these agents should not be used in patients with any other significant underlying cardiovascular disease or uncontrolled hypertension. 5-HT1 agonists can cause vasospastic reactions, including coronary vasospasm, peripheral vascular ischemia, and colonic ischemia. Some serious adverse cardiac events including acute myocardial infarction, arrhythmia, cardiac arrest, and death have been reported within a few hours following the administration of 5-HT1 agonists, in some cases even in patients with no prior history or findings of coronary artery disease (CAD). Significant elevation in blood pressure, including hypertensive crisis, has also been reported on rare occasions in patients with and without a history of hypertension, as have transient increases in blood pressure and peripheral vascular resistance. Cerebrovascular events have included cerebral hemorrhage, subarachnoid hemorrhage, and stroke, some resulting in fatalities. However, the relationship to 5-HT1 agonists is uncertain and, in a number of cases, the cerebrovascular events may have been primary where symptoms were mistaken to be migraine.

References

  1. Ottervanger JP, Paalman HJ, Boxma GL, Stricker BH "Transmural myocardial infarction with sumatriptan." Lancet 341 (1993): 861-2
  2. "Product Information. Axert (almotriptan)" Pharmacia and Upjohn, Kalamazoo, MI.
  3. Kelly KM "Cardiac arrest following use of sumatriptan." Neurology 45 (1995): 1211-3
  4. Boyd IW, Rohan AP "Sumatriptan-induced chest pain." Lancet 344 (1994): 1704-5
  5. Ottervanger JP, van Witsen TB, Valkenburg HA, Stricker BH "Postmarketing study of cardiovascular adverse reactions associated with sumatriptan." BMJ 307 (1993): 1185
  6. "Product Information. Zomig (zolmitriptan)." Zeneca Pharmaceuticals, Wilmington, DE.
  7. MacLean MR, Smith GC, Templeton AG "Adverse reactions associated with sumatriptan." Lancet 341 (1993): 1092
  8. "Product Information. Amerge (naratriptan)." Glaxo Wellcome, Research Triangle Park, NC.
  9. Dulli DA "Naratriptan: an alternative for migraine." Ann Pharmacotherapy 33 (1999): 704-11
  10. Dooley M, Faulds D "Rizatriptan - A review of its efficacy in the management of migraine." Drugs 58 (1999): 699-723
  11. Plosker GL, Mctavish D "Sumatriptan - a reappraisal of its pharmacology and therapeutic efficacy in the acute treatment of migraine and cluster headache." Drugs 47 (1994): 622-51
  12. Willett F, Curzen N, Adams J, Armitage M "Coronary vasospasm induced by subcutaneous sumatriptan." BMJ 304 (1992): 1415
  13. "Product Information. Frova (frovatriptan)." Endo Laboratories LLC, Chadds Ford, PA.
  14. Cavazos JE, Caress JB, Chilukuri VR, Devlin T, Gray L, Hurwitz BJ "Sumatriptan-induced stroke in sagittal sinus thrombosis." Lancet 343 (1994): 1105-6
  15. Curtin T, Brooks AP, Roberts JA "Cardiorespiratory distress after sumatriptan given by injection." BMJ 305 (1992): d713-4
  16. "Product Information. Relpax (eletriptan)." Pfizer U.S. Pharmaceuticals, New York, NY.
  17. "Product Information. Maxalt (rizatriptan)." Merck & Co, Inc, West Point, PA.
  18. "Product Information. Imitrex (sumatriptan)." Glaxo Wellcome, Research Triangle Park, NC.
  19. Visser WH, Jaspers NMWH, Devriend RHM, Ferrari MD "Chest symptoms after sumatriptan: a two-year clinical practice review in 735 consecutive migraine patients." Cephalalgia 16 (1996): 554-9
  20. Mueller L, Gallagher RM, Ciervo CA "Vasospasm-induced myocardial infarction with sumatriptan." Headache 36 (1996): 329-31
  21. Morgan DR, Trimble M, McVeigh GE "Atrial fibrillation associated with sumatriptan." Br Med J 321 (2000): 275
  22. Ottervanger JP, Vanwitsen TB, Valkenburg HA, Grobbee DE, Stricker BHC "Adverse reactions attributed to sumatriptan - a postmarketing study in general practice." Eur J Clin Pharmacol 47 (1994): 305-9
  23. Visser WH, Devriend RHM, Jaspers NMWH, Ferrari MD "Sumatriptan in clinical practice: a 2-year review of 453 migraine patients." Neurology 47 (1996): 46-51
View all 23 references
Moderate

Frovatriptan (Includes frovatriptan) ↔ liver disease

Moderate Potential Hazard, High plausibility. Applies to: Liver Disease

Frovatriptan is primarily metabolized by the liver. Following oral administration in patients with mild (Child-Pugh 5-6) to moderate (Child-Pugh 7-9) hepatic impairment, the systemic exposure of frovatriptan was approximately twice that observed in young, healthy subjects but still considerably lower than the values attained with higher dosages of frovatriptan (up to 40 mg), which were not associated with any serious adverse effects. Dosage adjustments are not necessary in patients with mild to moderate hepatic impairment. Caution is advised in patients with severe hepatic impairment, as there are no clinical or pharmacokinetic data on the use of frovatriptan in this population.

References

  1. "Product Information. Frova (frovatriptan)." Endo Laboratories LLC, Chadds Ford, PA.

Frovatriptan drug interactions

There are 83 drug interactions with frovatriptan

Frovatriptan alcohol/food interactions

There are 2 alcohol/food interactions with frovatriptan

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.