Triptan side effects
Side effects are difficult to detect.
415 adult migraineurs in the U.S. and Italy were asked (while they were at a clinic) if they had observed any adverse effects of their triptans. More than 2 out of 3 migraineurs could not tell that they had side effects when they themselves were to describe them. Those who had experienced side effects did not think they were particularly bad. So the migraineurs got a questionnaire with 49 specific questions about side effects, and more than half wrote that they had experienced one or more side effects. 8% of participants believed their side effects were bad when they filled out the questionnaire, but could not remember them without seeing the list of possible side effects.
So the physicians concluded that patients probably tend to report more when they see a list of possible side effects (1).
Doctors have described the following side effects:
* Allodynia - ie. increased skin sensitivity to touch and heat / cold; this effect is short term and particularly evident at injection (seen around 20 minutes after injection) (2).
* Lethargy, about 15% of triptan users believed to experience adverse events related to the central nervous system, for example. lethargy. It is critical to what extent the active substance is fat soluble. Almogran, Naragran and Imigran is the least lipophilic triptans (3) and should therefore also be least prone to producing lethargy. Some triptan users (almost 10%) talked about fatigue when using the triptans. (4)
* Blood clots - All triptans tend to contract the coronary artery (at the heart), in addition to effects on the blood vessels in the brain that cause migraine (5). Therefore, triptans should not be used if one is in grade 2 or 3 (medium to high risk) for coronary heart disease (6).
* Chest tightness - The symptoms of the chest that migraineurs experience are usually transient and does not imply that the blood supply is inadequate for parts of the heart (7).
We do not know the exact number of patients with chest tightness, but if you ask directly whether triptan users have experienced this, 2 out of 5 said that they have. In experiments, 1 to 4% of subjects told about this side effect (8). Another study showed that about 20% of triptan users got chest symptoms, while others had tingling and a feeling of warmth.
There are no reports that triptans should result in increased risk of cancer (9).
Some triptans includes a sulpha group (a sulphur atom). If one takes a lot of doses of these triptans, you can get a green coloured blood because sulphur colours hemoglobin in the red blood cells green.
The sulphur group may also contribute to the formation of bacterial strains in the example the bladder, which are resistant to sulpha drugs. So does the normal medicine for cystitis does not work.
| Triptans | Contains sulfagruppe |
| Almogran Almotriptan |
Yes |
| and Imigran Sumatriptan * sumatriptan |
Yes |
| Maxalt Rizatriptan |
No |
| Migard Frovatriptan |
No |
| Naragran Naratriptan |
Yes |
| RELPAX Eletriptan |
Yes |
| Zomig Zolmitriptan |
All tablets contain fillers. Most are harmless, but if you have a specific allergy or intolerance it can be good to look at the filler material. Melting Tablets often contain aspartame, which may contain phenylethylamine, which may trigger migraine attacks. Table with all the filler material
(1) F. D. Sheftell, M. Feleppa, S. J. Tepper, A. M. Rapoport, L. Ciannella and M. E. Bigal, 2004. Assessment of adverse events Associated med triptan-methods of assessment influence the results. Headache 44, 978-82.
(2) M. Linde, M. Elam, L. Lundblad, H Olausson and C. Dahlof. The 2004th Sumatriptan (5-HT agonist) Causes a transient allodynia. Cephalalgia 24, 1057-66. (3) D. W. Dodick and V. Martin, 2004. Triptans and CNS side-effects: pharmacokinetic and metabolic Mechanisms Cephalalgia, 24, 417-24. (4). L. Robbins, 2004.Frequent triptan use: observations on safety issues.Headache 44, 178-82. (5) A. Maassen Van Den Brink and P. R. Saxena, 2004. Coronary vasoconstrictor potential of triptans: a review of in vitro pharmacologic data. Headache 44, Suppl 1, S13-9. (6) V. Papademetriou, 2004 Cardiovascular risk assessment and triptans.Headache 44, Suppl 1, S31-9. (7) D. W. Dodick, V. T. Martin, T. Smith and S. Silberstein, 2004. Cardiovascular tolerability and safety of triptans: a review of clinical data. Headache 44, Suppl 1, S20-30. (8) D. W. Dodick, 2004. Triptans and chest symptom: the Role of pulmonary vasoconstriction. Cephalalgia 24, 298-304. (9) G. Nappi, G. Sandrini and G. Sance, 2003. Tolerability of the triptans: clinical Implications. Drug Safety 26, 93-107.
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