Frovatriptan is an orally active
5-hydroxytryptamine (5-HT) receptor agonist which binds with high affinity to 5-HT(1B) and 5-HT(1D) receptors. Earlier clinical trials demonstrated that
frovatriptan 2.5 mg is significantly more effective than placebo in the acute management of
migraine and its associated symptoms. More recently,
frovatriptan was shown to be effective in the management of menstrual
migraine. The incidence of menstrual
migraine in subjects receiving
frovatriptan 2.5 mg twice daily during the six day perimenstrual period was 41% compared with 67% with placebo.
Frovatriptan treatment is generally well tolerated. The most commonly reported adverse effects were
dizziness,
paresthesia, dry mouth, and
fatigue. Pharmacologic studies demonstrated that
frovatriptan is cerebroselective. Its selectivity for cerebral vessels lessens the potential for undesirable peripheral effects.
Frovatriptan has a terminal deposition half-life of approximately 26 hours, which appears to be independent of age, gender, and renal function. This imparts that
frovatriptan may be particularly well suited to patients with prolonged
migraines and those who suffer
migraine recurrence.
Frovatriptan does not alter
cytochrome P450 (CYP450)
isoenzymes, as such it is unlikely to affect the metabolism of other drugs. No dosage adjustments are necessary based on age, renal, or mild to moderate hepatic impairment. Apart from its efficacy in the acute management of
migraine,
frovatriptan is an effective agent when used as either acute
therapy or as intermittent prophylaxis
therapy of menstrual
migraines, particularly in women who do not respond to conventional
therapies.