Triptans in Pregnancy

Dahlin, Julia; O’Mara, Daniel M.

doi:10.1097/ftd.0b013e318162c89b

Cited by 54 publications

(37 citation statements)

References 36 publications

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“…In a population-based study of women with severe migraine during pregnancy, mean GA and birth weight were similar in infants of mothers with and without migraine, 7 but in a recent report mean GAs and birth weights were lower in offspring of women with migraine. 11 Three registries of women who used triptan drugs for migraine in pregnancy had somewhat elevated rates of preterm deliveries, not further analysed; [16][17][18] the role of drug exposure as compared with disease severity was not explored. Thus current evidence for an association of migraine with preterm birth is suggestive but ambiguous.…”

Section: Migraine and Preterm Birthmentioning

confidence: 99%

Migraine and preterm birth

Blair

Nelson

2010

J Perinatol

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Objective: To investigate whether maternal migraine was associated with preterm birth.Study Design: Case-control sample within a population-based study of risk factors for cerebral palsy (CP). Infants without CP were matched for gestational age with those with CP. Maternal migraine was self-identified at first prenatal visit, most in the first trimester.Result: Infants without CP born to women with migraine had a higher rate of preterm birth (odds ratio (OR) ¼ 3.5, 95% confidence interval (CI) 1.5, 8.5), as did infants who died in the perinatal period (OR ¼ 7.3, 95% CI 0.98, 54), the difference marginal for nominal statistical significance. In all outcome groups, infants of women with migraine had a higher observed rate of suboptimal intrauterine growth. In term infants, the rate of maternal migraine was higher in those with CP than in controls (OR ¼ 2.18, 95% CI 0.92, 5.25). Pre-eclampsia was reported more frequently in women with migraine who gave birth to a child with CP or a perinatal death, particularly in those born preterm; OR ¼ 5.1 (1.3, 20) and OR ¼ 2.9 (1.1, 7.6), respectively, but not in women giving birth to a control whether term or preterm.Conclusion: Maternal migraine, as self-reported early in pregnancy, was associated with preterm birth in survivors without CP and in infants who died in the perinatal period. The combination of maternal migraine and pre-eclampsia was associated with CP and perinatal death. The association of maternal migraine with outcomes of pregnancy warrants further study.

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Section: Migraine and Preterm Birthmentioning

confidence: 99%

Migraine and preterm birth

Blair

Nelson

2010

J Perinatol

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“…First, sumatriptan is quite widely used in pregnancy because migraine is relatively common among women in their reproductive years. Some studies have suggested an association between sumatriptan and preterm birth (Olesen et al, 2000), although other studies could not confirm this (for recent review, see Soldin et al, 2008;Kä llén and Lygner, 2001). The present study suggests that this drug would not be expected to stimulate myometrial contractility in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Serotonin Receptors in Pregnant Human Myometrium

Cordeaux

Pasupathy

Bacon³

et al. 2008

J Pharmacol Exp Ther

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The monoamine, 5-hydroxytryptamine (5-HT), stimulates contraction of human uterine smooth muscle (myometrium), but the receptor subtypes involved have not been characterized. We studied the effects of a range of 5-HT receptor subtype-selective agonists and antagonists in isolated strips of myometrium obtained at the time of caesarean section. The 5-HT 1A receptor agonist, 8-hydroxy-2-dipropylaminotetralin, produced an increase in contractions that was highly variable, of low potency, and was not significantly inhibited by the 5- These cell surface receptors are classified into seven distinct subtypes (5-HT 1 to 5-HT 7 ), and, with the exception of the ligand-gated ion channel 5-HT 3 , they are all members of the G-protein-coupled receptor superfamily (Alexander et al., 2008). In the central nervous system, these receptors are implicated in numerous conditions, including: depression, anxiety, schizophrenia, and migraine (Barnes and Sharp, 1999). Serotonin also plays a role in platelet activation (Kau-

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“…Furthermore, there is no previous information on increased risk of congenital malformations associated to triptan treatment during pregnancy, although the use of triptans during the second or third trimesters of pregnancy has been associated with a mild incremental increase in the risk of atonic uterus and hemorrhage [Nezvalová-Henriksen et al 2010]. However, much lower eletriptan concentrations were detected in human breast milk when compared with maternal serum levels and, consequently, it is not likely to induce adverse effects in infants [Soldin et al 2008].…”

Section: Tolerability and Safetymentioning

confidence: 99%

“…Likewise, considering the eletriptan metabolism and the increase of CYP3A4 activity during pregnancy, modifications on the eletriptan efficacy profile should be also taken into account [Soldin et al 2008].…”

Section: Tolerability and Safetymentioning

confidence: 99%

Eletriptan in the management of acute migraine: an update on the evidence for efficacy, safety, and consistent response

Capi

Curto

Lionetto

et al. 2016

Ther Adv Neurol Disord

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Migraine is a multifactorial, neurological and disabling disorder, also characterized by several autonomic symptoms. Triptans, selective serotonin 5-HT 1B/1D agonists, are the first-line treatment option for moderate-to-severe headache attacks. In this paper, we review the recent data on eletriptan clinical efficacy, safety, and tolerability, and potential clinically relevant interactions with other drugs. Among triptans, eletriptan shows a consistent and significant clinical efficacy and a good tolerability profile in the treatment of migraine, especially for patients with cardiovascular risk factors without coronary artery disease. It shows the most favorable clinical response, together with sumatriptan injections, zolmitriptan and rizatriptan. Additionally, eletriptan shows the most complex pharmacokinetic/dynamic profile compared with the other triptans. It is metabolized primarily by the CYP3A4 hepatic enzyme and therefore the concomitant administration of CYP3A4-potent inhibitors should be carefully evaluated. A relatively low risk of serotonin syndrome is given by the coadministration with serotoninergic drugs. No clinically relevant interaction has been found with drugs used for migraine prophylactic treatment or other acute drugs, with the exception of ergot derivatives that should not be co-administered with eletriptan.

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Triptans in Pregnancy

Cited by 54 publications

References 36 publications

Migraine and preterm birth

Migraine and preterm birth

Characterization of Serotonin Receptors in Pregnant Human Myometrium

Eletriptan in the management of acute migraine: an update on the evidence for efficacy, safety, and consistent response

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