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10 Triptan Facts You Need to Know Now

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Triptans are abortive drugs commonly prescribed for migraine.  Common triptans include eletriptan (Relpax), frovatriptan (Frova, Migard) and sumatriptan (Imitrex, Imigran).

10 Triptan Facts

Should you take them?  What facts will help you find the best one?  Here are 10 facts you need to know to make an informed decision.

  1. Triptans are not “pain killers”:  Triptan medications are used to simply stop pain, although they can do that too.  Their use is much more complex, targeting various symptoms of migraine, such as nausea and sensitivity to light and sound.
  2. Triptans are not all the same:  When one triptan doesn’t work for you, it’s likely that another will.  Some work faster than others.  Some may cause side effects, when others will not.  Some interact with certain drugs, some work better for certain types of migraine.
  3. Don’t just rely on triptans:  Triptans are better used as a part of a full treatment plan.  Talk with your doctor and other health professionals about lifestyle and other treatments.  Your doctor may recommend taking something else with a triptan, such as an NSAID (ie ibuprofen).
  4. Triptans and heart conditions:  Because of the way triptans act on blood vessels, there have been concerns about taking triptans if you are at higher than normal risk for heart conditions.  Although some researchers have had concerns about triptans causing heart problems, other studies have questioned this.  You’ll need to evaluate the risks with your doctor, particularly if you have high blood pressure, peripheral vascular disease, heart disease, or a risk of stroke or heart attack.  Other risk factors include smoking and diabetes.
  5. Triptans will likely help:  Triptans do not help everyone, and you may need to try different triptans and different ways of taking them before you find the one that works.  In 2004, a panel of headache experts suggested that triptans would probably help 4 out of 5 patients.  Again, triptans should be used as a part of a full treatment plan.
  6. Triptan side effects:  Generally, triptans don’t cause significant side effects.  You may be concerned if you’re feeling pain or pressure in the chest, jaw, or other parts of your body.  This probably is nothing to worry about and is not related to heart problems.  However, you should tell your doctor right away so she can check it out.
  7. Triptans and other drugs:  Be sure to stick to the prescribed dosage and tell your doctor about any other medications you may be taking.  There is particular danger with certain antidepressants, which when taken with a triptan may cause serotonin syndrome.  Also dangerous can be ergot based drugs, drugs for fungal infections, and some others.
  8. Triptans long term:  All patients should be cautious if they’re taking triptans over a long period of time more than twice a month.  As mentioned above, there are concerns about heart conditions.  You should see a specialist regularly if you’re taking triptans regularly, and also have your eyes checked on a regular basis.
  9. Brand names vs generic:  You can take either a brand name or generic triptan, but remember one may help while another may not.  This could be because of delivery technology or small differences in dosage.
  10. Triptans may be worth it:  Because of the success rate of triptan medications, and questions about previous concerns, many specialists are re-evaluating triptans and prescribing them more often.  Triptans may be prescribed for children with migraine, and migraine during pregnancy.  Talk to your doctor and get a second opinion if you’re not sure.

More about triptans and migraine here.

Miracle Medication helps 3 in 10 Migraine Sufferers!

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Yes, there is an amazing medication that helps – 3 in 10 migraineurs!  Ok, that doesn’t sound like much.  Actually, it isn’t.

It is great for those 3, of course!  But for the rest, no so great.

Miracle Drugs?

So what is this medication?  Actually, it’s not just one medication – it’s most of the common ones you’ve heard of.  No, I’m not saying that all medications only help 3 in 10, but that a single medication will probably only help 3 in 10.

This is based on research done at the Minnesota Evidence-based Practice Center.  Researchers wanted to pool results from 5,244 clinical trials of migraine medications.

They examined 59 drugs in 14 different drug classes.  This would include medications like:

  • Topamax
  • Depakote
  • Inderol
  • Toprol-xl

…and many more.

The researchers concluded that, generally speaking, individual drugs helped – at least, better than a placebo – about 200-400 people out of 1000.

Of course, whether they helped or not, many medications aren’t continued because of side effects.  Some of the worst offenders include topiramate (Topamax), other antiepileptics used off label, and antidepressants.

Some drugs did much better when it came to side effects vs. benefit.  These included angiotensin inhibitors (such as lisinopril (ie Zestril)) and beta-blockers (such as metoprolol or propranolol).

Other than the lack of a miracle drug, there were a couple of other things that did not impress the researchers.  One was that many trials were of poor quality.  Another was that there is a lack in research into the long term effects of these drugs, particularly when it comes to quality of life.

Again, this report is not suggesting that only 3 in 10 migraineurs can be helped with medication.  Considering all the various drugs and treatments and combinations, that number is much higher.  There is good treatment available!

But once again we’re reminded that migraine is very individual – what helps one person won’t help another.

We’re also reminded that much of the excellent migraine-fighting medication available today is still very new.  We don’t have good studies, and we don’t know what the risks are when it comes to taking these meds long term.

A neurologist reflects on these findings:  Effective Migraine Prevention per 215 Trials
Also see:  Is your migraine preventive treatment balanced between drugs’ benefits and harms?

The Top 12 Mistakes People Make With Nasal Sprays

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Medication isn’t cheap.  So when you’re using a nasal spray, make sure you’re making the most of it by using it properly!

Here are the top 12 nasal spray mistakes that people make.  Learn from their mistakes!

Nasal Spray Mistakes
Photo courtesy of Kristina
  1. They don’t blow their nose first:  Don’t rush!  Gently blow your nose before using a nasal spray.  You don’t want the medication to get stuck, or just come out again.
  2. They tilt their head too much:  Sometimes it’s recommended that you tilt your head slightly forward or back, but leaning way over can make your medication less effective.  And remember, keep your head up for a while after you’ve taken the medication.
  3. They point the spray the wrong way:  The nozzle should not point toward the centre of your nose.  Point it up, and slightly out (away from the centre of the nose).
  4. They keep both nostrils open:  Close the other nostril with your other hand.  You don’t want the spray just to go out the other side.
  5. They hold their breath:  Breath in gently as you spray.  
  6. They snort:  Breath in gently, like you’re smelling a flower.  Don’t “snort” the medicine.  The spray could end up in the wrong place.
  7. They don’t clean the nozzle:  Obviously, this isn’t needed for a one-time use medication (for example a one-dose migraine spray).  But if you’re using the spray over and over, follow instructions on how to clean the nozzle.  Otherwise tiny bugs will soon have large families, and they’ll vacation in your nose.
  8. They blow their nose afterwards:  Yes, some people really do.  Don’t!  Give the medication a little time before you blow your nose again.
  9. They prime – or don’t prime:  Some nasal sprays should be primed first – that is, you give it a little spray into the air first.  Other medications you should not prime.  If it’s a one-dose medication, you’ll lose your only dose!
  10. They use it past the expiry date:  Not only may the medication be less effective, it may be contaminated over time.
  11. They share their nasal spray:  Never, ever share a nasal spray with someone else.
  12. They don’t read through the instructions:  Read the instructions in the package carefully before using.  It will answer many questions, such as – should I shake it first?  Should I prime it?  How do I clean it (if needed)?  How much is safe to use, and for how long?

    13. Nasal sprays can be much more effective than other medication “delivery systems”.  But they do need to be used properly so that the right dose can get where it needs to go when it needs to be there.

Can Pregnant Migraineurs Take Drugs?

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Can a migraine patient take drugs while she’s pregnant?  Common wisdom says “No – just suffer”.  Well, that ain’t good enough.

First, take a look at this chart:

Migraine attacks during pregnancy

See that nasty orangy-reddish colour?  That represents 1/3 of all pregnant women.  Their migraine attacks just keep going all through pregnancy – and may get worse.

I know, I’m full of good news today.

So – just suffer?  No way.  Surprise surprise, migraine attacks are not good for you – or the baby.  Yes, your pain (and other symptoms such as vomiting) can affect the baby.

Now many people ignore the many excellent non-drug treatments that are available, as if they “don’t work”.  Well, they do work – as do drugs – for some.  And in some cases they’ll work better than drugs.  Take for example massage and biofeedback and relaxation techniques and chiropractic treatment and foot massage and changes in diet and … the list goes on.

But it’s a myth that pregnant women cannot take drugs for migraine.  Many doctors do regularly prescribe medications for migraine during pregnancy.

As you probably know, it’s a question of risk.  For obvious reasons, few drugs have been carefully studied during pregnancy.  But knowing that migraine attacks can do long term damage, the benefits may outweigh the risk – and the risk in some cases may be relatively small.

This month at the American Congress of Obstetricians and Gynecologists annual meeting in New Orleans, the news was that triptans were the go-to drugs, even during pregnancy, for more serious forms of migraine.

If you’d like to read the comments from some doctors, it may help you make an informed decision.  The two articles below will get you started:

5 Migraine Medications that may cause Weight Gain

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5 Migraine Medications that may cause Weight Gain

sodium valproate (Epival)
paroxetine (Paxil)
metoprolol (Toprol-XL)
divalproex sodium (Depakote)
amitriptyline (Elavil)

DO NOT stop taking medication without talking to your doctor.
DO talk to your doctor if you’re gaining weight – there are options available.

These are medications that are often used as migraine preventatives – and often help – but that are also notorious for contributing to weight gain in some people.  Obviously there are other examples.  (Note:  I just included one brand name for the sake of space.  These medications are included in various other brand names.)

I appreciated the recent post from Diana-Lee – Avoiding & Coping With Migraine Medication-Related Weight Gain and Kerrie’s thoughts in Migraine Preventives & Weight Gain, so I thought I’d add some specifics to the conversation.

Have you experienced weight gain with any of these medications?  What about others – topiramate?  Propranolol?  What else?

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The articles on Headache and Migraine News are © 2004-2025 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.