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Frovatriptan

Frovatriptan is a selective serotonin receptor agonist belonging to the group of triptans, which is approved as a drug for acute treatment of migraine. The drug shows efficacy in the prophylactic treatment of Frovatriptancluster headaches, and was developed by Vernalis, frovatriptan is offered in Germany by Berlin-Chemie, and is subject to dispensing bymedical prescription only.

Frovatriptan belongs to the group of triptans, that are closed ring derivatives of 5-HT1/7-Rezeptoragonisten 5-carboxamidotryptamine and structurally similar to serotonin.

Pharmacology

How it works
Frovatriptan is a highly potent agonist targeting the serotonin receptors 5-HT1B and 5-HT 1D, on cerebral blood vessels that occur presynaptically on neurons. An activation of these receptors by frovatriptan during a migraine attack on the one hand, leads to a constriction of the dilation of the cerebral blood vessels and the other to a reduction in the secretion of inflammatory mediators.

Activation of the 5-HT1B receptors, can lead to adverse reactions associated with the cardiovascular system. With a half-life of 26 hours Frovatriptan has by far the longest duration of activity within the group of triptans, and is therefore used as a therapy against recurrence of migraine attacks.
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Although not certain of the risk benefit associated, with higher doses to the 5-HT7 receptors so far it is however possible with this drug.

Side-effects
One of the characteristic, but rare side effects of the use of frovatriptan are similar to angina pectoris pressure and feelings of chest tightness, which are attributed to a constriction of the coronary arteries. An increase in blood pressure is also observed in some patients.

Interactions
Frovatriptan should not be used in combination with ergotamine, since an increased risk of Koronarspasmen. Coadministration with serotonin reuptake inhibitors, SSRIs, such asFluoxetine, paroxetine, sertraline and citalopram, selective serotonin and norepinephrine reuptake inhibitors, SNRI, or the herbal antidepressant St. John’s wort may increase the effects and side effects of frovatriptan.
The FDA has warned in this connection against the potentially life-threatening interaction of serotonin syndrome, where the body accumulates too much serotonin in the nervous system.

Symptoms of serotonin syndrome may result in restlessness, hallucinations, loss of coordination, fast heartbeat, blood pressure fluctuations, increased body temperature, exaggerated reflexes, nausea, vomiting and diarrhoea.

Warnings include.
Absolute caution is warranted when co-administration of frovatriptan with MAO inhibitors.

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