All the triptans are most effective when taken early during a migraine, and all may be repeated in 2 hours as needed, with a maximum of two doses daily.
Although different formulations of a specific triptan may be used in the same 24-hour period, only one triptan may be used during this time frame.
The longer-acting triptans (eg, frovatriptan, naratriptan) may be used continuously for several days (mini-prophylaxis) to treat menstrual migraine.
Triptans should not be used more than 3 days weekly, to avoid transformed migraine and medication overuse headache.
The effectiveness and tolerability of triptans varies among patients.
Lack of response or side effects experienced with one triptan does not predict the response to another.
Acute treatment is most effective when given within 15 minutes of pain onset and when pain is mild.
Propoxyphene (Darvon®) was formerly used as an abortive agent in patients with migraine; however, propoxyphene products were withdrawn from the United States market in 2010 because this agent can cause prolonged PR interval, widened QRS complex, and prolonged QT interval at therapeutic doses.
