II. Indications
- Acute Migraine Headache
- Third-line agent in acute Migraine Headache regardless of aura refractory to NSAIDS and Triptans
- Consider in patients for whom Triptans are contraindicated (e.g. Cardiovascular Risk Factors)
III. Mechanism
- Selective Serotonin5-HT1F Receptor Agonist
- Differs from Triptan binding sites (no Vasoconstrictor activity)
IV. Preparations
- Reyvow (Lasmiditan)
- Costs $85 per tablet (contrast with 70 cents per Sumatriptan tablet)
- Limit to 4 doses per month
V. Dosing
- Single dose, and no benefit from re-dosing <24 hours
- Available as 50, 100 and 200 mg doses
- Do not drive a vehicle, operate machinery or other dangerous activities within 8 hours of dose
VI. Efficacy
- NNT 10 for one patient to be pain free at 2 hours
- Contrast with NNT 5 for Sumatriptan
- Although 50% are pain at 2 hours, 43% are pain free at 2 hours after Placebo
VII. Adverse Effects
- Does NOT cause vasospasm (in contrast to Triptans)
- Transient minor increases in Blood Pressure (2-3 mmHg) and decreased Heart Rate (5-10 bpm) after 200 mg dose
- Euphoria and Hallucinations
- Do not drive for 8 hours after dose
- Schedule V agent
- Serotonin Syndrome
- Other more common side effects
- Dizziness (17%, dose dependent)
- Fatigue
- Paresthesias
- Sedation
- Nausea and Vomiting
- Muscle Weakness
VIII. References
- (2020) Presc Lett 27(3): 13
- Bowman (2020) Crit Dec Emerg Med 34(11): 28
- LoVecchio (2019) Crit Dec Emerg Med 33(12): 31
Images: Related links to external sites (from Bing)
Related Studies
| reyvow (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| REYVOW 100 MG TABLET | $84.51 each | |
| REYVOW 50 MG TABLET | $84.51 each | |