Generic drug: lasmiditan
Brand name: Reyvow
What is Reyvow (lasmiditan), and how does it work?
Reyvow (lasmiditan) is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults.
- Reyvow is not used as a preventive treatment of migraine.
- It is not known if Reyvow is safe and effective in children.
What are the side effects of Reyvow?
Serious side effects of Reyvow include:
- serotonin syndrome. Serotonin syndrome is a rare but serious problem that can happen in people using Reyvow, especially if Reyvow is used with anti-depressant medicines called SSRIs or SNRIs. Call your healthcare provider right away if you have any of the following symptoms of serotonin syndrome:
- medication overuse headache. Some people who take medicines like Reyvow for the acute treatment of migraine attacks for 10 or more days each month may have worse headaches (medication overuse headache). If your headaches get worse, your healthcare provider may decide to stop your treatment with Reyvow.
The most common side effects of Reyvow include:
- feeling tired
Does Reyvow cause addiction or withdrawal symptoms?
Drug Abuse And Dependence
Reyvow contains lasmiditan, a Schedule V controlled substance (CV).
- Abuse is the intentional, non-therapeutic use of a drug, even once, for its desirable psychological or physiological effects.
- In a human abuse potential (HAP) study in recreational poly-drug users (n=58), single oral therapeutic doses (100 and 200 mg) and a supratherapeutic dose (400 mg) of Reyvow were compared to alprazolam (2 mg) (C-IV) and placebo.
- With all doses of Reyvow, subjects reported statistically significantly higher “drug liking” scores than placebo, indicating that Reyvow has abuse potential.
- In comparison to alprazolam, subjects who received Reyvow reported statistically significantly lower “drug liking” scores.
- In the HAP study, euphoric mood occurred to a similar extent with Reyvow 200 mg, Reyvow 400 mg, and alprazolam 2 mg (43-49%).
- A feeling of relaxation was noted in more subjects on alprazolam (22.6%) than with any dose of Reyvow (7-11%).
- Phase 2 and 3 studies indicate that, at therapeutic doses, Reyvow produced adverse events of euphoria and hallucinations to a greater extent than placebo. However these events occur at a low frequency (about 1% of patients).
- Evaluate patients for risk of drug abuse and observe them for signs of lasmiditan misuse or abuse.
- Physical withdrawal was not observed in healthy subjects following abrupt cessation after 7 daily doses of lasmiditan 200 mg or 400 mg.
What is the dosage for Reyvow?
- The recommended dose of Reyvow is 50 mg, 100 mg, or 200 mg taken orally, as needed. No more than one dose should be taken in 24 hours, and Reyvow should not be taken unless the patient can wait at least 8 hours between dosing and driving or operating machinery.
- A second dose of Reyvow has not been shown to be effective for the same migraine attack.
- The safety of treating an average of more than 4 migraine attacks in a 30-day period has not been established.
- Reyvow may be taken with or without food.
What drugs interact with Reyvow?
Concomitant administration of Reyvow and alcohol or other CNS depressant drugs has not been evaluated in clinical studies. Because of the potential of Reyvow to cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions, Reyvow should be used with caution if used in combination with alcohol or other CNS depressants.
Concomitant administration of Reyvow and drugs (e.g., SSRIs, SNRIs, TCAs, MAO inhibitors, trazodone, etc.), over-the counter medications (e.g., dextromethorphan), or herbal supplements (e.g., St. John's Wort) that increase serotonin may increase the risk of serotonin syndrome. Use Reyvow with caution in patients taking medications that increase serotonin.
Heart Rate Lowering Drugs
Reyvow has been associated with a lowering of heart rate. In a drug interaction study, addition of a single 200 mg dose of Reyvow to propranolol decreased heart rate by an additional 5 beats per minute compared to propranolol alone, for a mean maximum of 19 beats per minute. Use Reyvow with caution in patients taking concomitant medications that lower heart rate if this magnitude of heart rate decrease may pose a concern.
P-gp And Breast Cancer Resistant Protein (BCRP)
Reyvow inhibits P-gp and BCRP in vitro. Concomitant use of Reyvow and drugs that are P-gp or BCRP substrates should be avoided.
Is Reyvow safe to use while pregnant or breastfeeding?
- There are no adequate data on the developmental risk associated with the use of Reyvow in pregnant women.
- There are no data on the presence of lasmiditan in human milk, the effects of lasmiditan on the breastfed infant, or the effects of lasmiditan on milk production.
- The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Reyvow and any potential adverse effects on the breastfed infant from Reyvow or from the underlying maternal condition.
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Reyvow (lasmiditan) is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. Serious side effects of Reyvow include serotonin syndrome and medication overuse headache.
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Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Migraines and Seizures (Symptoms, Auras, Medication)
Migraines are a type of headache and seizures are the main symptom of epilepsy. Migraine headaches and seizures are two different neurological problems that have similar signs, symptoms, and auras, for example, sensitivity to light (photophobia) and sound, irritability, nausea, and vomiting. Symptoms unique to migraine and migraine auras are water retention, problems sleeping, appetite changes, and talkativeness. Symptoms unique to seizure and seizures auras are depression, a feeling of heaviness, a feeling that a seizure is approaching, and depression. Many of the symptoms of migraine and seizures are the same, however, seizures do not cause migraines; however, people who have seizures are twice as likely to have migraines and vice-versa. People who have migraines are twice as likely to have seizures, and people with seizures are twice as likely to have migraines; however, one condition does not cause the other.
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Migraine headache is a type of headache in which the exact cause is not known; however, they may be inherited, and certain foods and environmental factors can trigger and may contribute them. A stroke (brain attack) happens when a blood vessel in the brain leaks, bursts, or becomes blocked, which can be caused by many other health problems. Both migraines and strokes can can cause severe head pain (migraine pain usually is only on one side of the head). Migraine aura symptoms may mimic or feel like a stroke or mini-stroke (transient ischemic attack, TIA) because they have similar symptoms and signs like severe headache, numbness in the legs, feet, arms, hands, or face, nausea, vomiting, and dizziness. Other migraine aura symptoms include vision problems like flashing lights or blind spots in one eye. The main difference between migraine headache and stroke symptoms and signs is that a migraine headaches usually come on gradually while a stroke symptoms come on suddenly and unexpectedly.
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Abdominal Migraines in Children and Adults
Abdominal migraine in adults and children is a variant of migraine headaches. Abdominal migraine in children generally occurs in children who have a family history of migraines. Causes of abdominal migraine is not known. Symptoms of abdominal migraine include acute, severe, midline abdominal pain, nausea, vomiting, paleness, and inability to eat. Abdominal migraine is diagnosed through patient history, family history, and ruling out other medical causes. Treatment of abdominal migraine include tricyclic antidepressants and triptans.
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine. Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain. Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure. Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
Should I Go to the ER for a Migraine?
A migraine is a severe throbbing and pulsating headache that causes pain on one side of the head. A patient should visit an emergency department if they have a severe headache with or without nausea and vomiting.
Are Migraine Auras Serious?
Migraine with aura (also called classic migraine) is repeated episodes of headache that occur during or after sensory disturbances (aura or migraine aura). These disturbances may include symptoms such as flashes of light, blind spots, and other vision changes or tingling over the hand or face.
What Are the First Signs of a Migraine?
The first sign of a migraine is severe eye pain associated with a dull headache. Migraines gradually worsen with physical activity.
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The most common type of migraine is migraine without aura (common migraine). 70-90% of people with migraine experience this type. The frequency of this type of migraine may range from once a year to several times per week.
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Migraine is most commonly seen in women. Every three out of four women are affected by migraines. Some of the most common triggers affecting women are changes in hormonal levels or birth control pills, lack of sleep or too much sleep, and others
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What Is the Best Cure for Migraine?
The best cure for migraine involves preventive medications and lifestyle changes. Some newer medications and therapies are effective in controlling the symptoms of migraine. Avoiding or controlling triggers may provide considerable benefit. Migraine can be prevented mainly by using medications, avoiding triggers and implementing lifestyle changes.
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