TABLE 17.

Triptans for the management of migraine

Agent	Trade name	Usual dose (mg)	Tmax (h)	T1/2 (h)	Formulations	Advantages
Sumatriptan	Imitrex*	50–100	0.5–5	1.9–2.2	Tablets†
		6	0.25	1.7–2.3	Autoinjector
		5–20	1–1.5	1.3–5.4	Nasal spray†	Nasal spray is useful if vomiting present
Almotriptan malate	Axert‡	6.25–12.5	1–3	3–4	Tablets	Longer action but slower onset, useful for patients with longer duration headache
Eletriptan	Relpax§	20–40	2	4	Tablets	Works in patients who are refractory to sumatriptan
Naratriptan hydrochloride	Amerge*	1–2.5	2–5	5–8	Tablets
Rizatriptan benzoate	Maxalt¶	5–10	1–1.5	1.7–3	Tablets Wafer	The wafer is an advantage if access to water is difficult, it may be placed under the tongue and is still well absorbed
Zolmitriptan	Zomig**	2.5–5	2	2.5–3	Tablets	Nasal spray is useful if vomiting is present, rapimelt tablet similar advantage to the wafer, easy administration
		2.5–5	3	3	Nasal spray
		2.5–5	3	3	Rapimelt tablet

^*GlaxoSmithKline Inc, Canada;

^†Sumatriptan exhibits low oral and intranasal bioavailability related to incomplete absorption and hepatic and presystemic metabolism;

^‡Janssen-Ortho Inc, Canada;

^§Pfizer Canada Inc;

^¶Merck Frosst Canada Inc;

^**AstraZeneca Canada Inc. T_1/2 Half-life; T_max Time to maximum concentration