Pharm

Ditan

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Ditan, Lasmiditan, Reyvow

  • Indications
  1. Acute Migraine Headache
    1. Third-line agent in acute Migraine Headaches refractory to NSAIDS and Triptans
  • Mechanism
  1. Selective Serotonin5-HT1F Agonist
    1. Differs from Triptan binding sites
  • Preparations
  1. Reyvow (Lasmiditan)
    1. Costs $85 per tablet (contrast with 70 cents per Sumatriptan tablet)
    2. Limit to 4 doses per month
  • Dosing
  1. Single dose, and no benefit from re-dosing <24 hours
  • Efficacy
  1. NNT 10 for one patient to be pain free at 2 hours
    1. Contrast with NNT 5 for Sumatriptan
  • 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
  • References
  1. (2020) Presc Lett 27(3): 13