II. Indications

  1. Acute Migraine Headache
    1. Third-line agent in acute Migraine Headaches refractory to NSAIDS and Triptans

III. Mechanism

  1. Selective Serotonin5-HT1F Agonist
    1. Differs from Triptan binding sites

IV. Preparations

  1. Reyvow (Lasmiditan)
    1. Costs $85 per tablet (contrast with 70 cents per Sumatriptan tablet)
    2. Limit to 4 doses per month

V. Dosing

  1. Single dose, and no benefit from re-dosing <24 hours

VI. Efficacy

  1. NNT 10 for one patient to be pain free at 2 hours
    1. Contrast with NNT 5 for Sumatriptan

VII. Adverse Effects

  1. Does NOT cause vasospasm (in contrast to Triptans)
  2. Transient minor increases in Blood Pressure or Heart Rate
  3. Euphoria and Hallucinations
    1. Do not drive for 8 hours after dose
    2. Schedule V agent
  4. Serotonin Syndrome

VIII. References

  1. (2020) Presc Lett 27(3): 13

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