Triptan Selection - Migraine Management Choosing triptans: • Reponse to given triptan do not predict to others • Try each triptan three times • Use < 10 times per month to avoid medication-overuse headache Rapidly progressing migraine attack: • Subcutaneous sumatriptan 6 mg or nasal spray sumatriptan 10 mg • Intranasal zolmitriptan 5mg • Fast-acting oral triptan preparation- eletriptan 40mg, rizatriptan 10 mg, zolmitriptan 2.5 mg • An additional pro-kinetic for example domperidone, 10mg Lack of triptan response: • Consider preventive • Try higher dose • Alternative triptan • Alternative formulation (subcutaneous, intranasal) • Combination therapy with NSAID (ibuprofen 800mg TDS or naproxen 500mg bid) doi:10.1136/practneurol-2015-001167 #Triptans #Migraine #Management #treatment #neurology #pharmacology #selection #headache #neurology
