Naramig

Naramig contains naratriptan, a selective serotonin (5-HT1B/1D) receptor agonist of the triptan class, indicated for the acute treatment of the headache phase of migraine attacks with or without aura in adults.

It does not prevent migraine attacks and should not be used prophylactically.

Naratriptan works by stimulating serotonin receptors on intracranial blood vessels, causing vasoconstriction that reverses the abnormal dilatation thought to contribute to migraine pain.

It also inhibits the release of vasoactive neuropeptides from trigeminal nerve endings, reducing neurogenic inflammation. The net effect is relief from headache, nausea, photophobia, and phonophobia.

Compared with other triptans, naratriptan has a slower onset of action but a longer half-life, which is associated with a lower rate of headache recurrence within 24 hours.

It is often preferred by patients who experience prolonged migraine attacks or frequent headache recurrence with faster-acting triptans.

Naratriptan is also generally better tolerated, with fewer chest-related and central nervous system side effects.

Take one Naramig tablet as soon as the headache phase of a migraine begins. Swallow it whole with water. The tablet may be taken with or without food.

If the headache improves but then returns, a second tablet may be taken provided at least four hours have elapsed since the first dose. Do not exceed two tablets (5 mg) in any 24-hour period.

If the first tablet provides no relief at all, do not take a second tablet for the same attack, as it is unlikely to be effective.

Treat the attack with an alternative medication and discuss the response with your doctor. Naramig is not for use in hemiplegic or basilar migraine.

The recommended adult dose is 2.5 mg as a single tablet at the onset of migraine headache. If symptoms recur, a second 2.5 mg dose may be taken after a minimum interval of four hours.

The maximum dose in 24 hours is 5 mg (two tablets). In patients with mild to moderate renal or hepatic impairment, the maximum dose is 2.5 mg in 24 hours.

Naratriptan is contraindicated in severe renal or hepatic impairment. It is not recommended for use in patients over 65 or children under 18.

Common side effects (1 in 10 to 1 in 100 patients) include fatigue, drowsiness, nausea, and malaise. A sensation of tingling, warmth, or heaviness in the limbs or trunk is reported occasionally.

Uncommon effects include dizziness, flushing, visual disturbance, and bradycardia.

Chest symptoms such as tightness, pressure, or heaviness occur infrequently and are usually non-cardiac in origin; however, they should be assessed if persistent or severe.

Rare but serious effects include coronary vasospasm, myocardial ischaemia or infarction (particularly in patients with unrecognised cardiovascular disease), peripheral vascular ischaemia, colonic ischaemia, and serotonin syndrome (especially if combined with SSRIs, SNRIs, or other serotonergic drugs).

Seek immediate medical attention for severe chest pain, sudden abdominal pain, or signs of serotonin toxicity (agitation, tremor, hyperthermia).

Naramig should not be taken within 24 hours of ergotamine-containing products or other triptans. It is not intended for prophylactic use or for cluster headache.

Before prescribing, undiagnosed headache should be properly evaluated.

Patients with risk factors for ischaemic heart disease (hypertension, hypercholesterolaemia, smoking, diabetes, family history of coronary disease, men over 40, postmenopausal women) should have a cardiovascular evaluation before first use.

If you experience chest symptoms, discontinue use and seek medical review.

Naramig is contraindicated in patients with a history of ischaemic heart disease, coronary vasospasm (including Prinzmetal's angina), cerebrovascular disease, peripheral vascular disease, uncontrolled hypertension, severe renal or hepatic impairment, and known hypersensitivity to naratriptan or any excipient.

It must not be used concurrently with ergotamine or other triptans.