From the Guidelines
Oxitriptan is not a recommended treatment for migraine headaches, and instead, triptans like sumatriptan are the preferred choice for acute migraine treatment. The most recent and highest quality study, 1, suggests that triptans should be used in combination with an NSAID or acetaminophen for optimal pain relief. The study recommends starting with an NSAID or acetaminophen and adding a triptan if the patient does not achieve sufficient pain relief.
Key Considerations for Migraine Treatment
- The choice of a specific NSAID or triptan should be based on individualized decision making, taking into consideration patient preferences on factors such as route of administration and cost 1.
- Triptans are contraindicated in patients with coronary artery disease, uncontrolled hypertension, hemiplegic or basilar migraine, and should not be taken within 24 hours of ergotamine or other triptans, or within 2 weeks of MAO inhibitors.
- For patients with severe nausea or vomiting, a nonoral triptan and an antiemetic may be considered 1.
- The American College of Physicians recommends against using opioids or butalbital for the treatment of acute episodic migraine 1.
Recommended Treatment Protocol
- For mild episodic migraine headache, consider treating with an NSAID, acetaminophen, or the combination of an NSAID and acetaminophen 1.
- For moderate to severe acute episodic migraine headache, consider using a triptan in combination with an NSAID or acetaminophen, or using a CGRP antagonist-gepant or ergot alkaloid if the patient does not tolerate or has an inadequate response to combination therapy 1.
- Counsel patients to begin treatment of migraine headache as soon as possible after its onset, using combination therapy to improve efficacy 1.
From the FDA Drug Label
Dosage 1-5 spray(s); 1-3 time(s) per day or as recommended by your health care practitioner. The recommended treatment protocol for oxitriptan (triptan) in migraine headaches is:
- Dosage: 1-5 sprays
- Frequency: 1-3 times per day
- Administration: As recommended by your health care practitioner 2, 2
From the Research
Oxitriptan (Triptan) in Migraine Headaches
- Oxitriptan, a type of triptan, is used to treat migraine headaches by agonizing the 5-HT1B/1D receptors 3.
- Triptans are effective and generally well-tolerated in many patients, but up to one-third of migraine patients may not respond well to triptans or may have contraindications that preclude their use 3.
- The recommended treatment protocol for oxitriptan in migraine headaches involves prioritizing treatment according to headache severity and associated symptoms 4.
Efficacy and Safety of Triptans
- Triptans have a safe track record over more than a decade of use, with no strong evidence of serious adverse events 5.
- However, triptans may have demerits such as recurrence, triptan-related side effects, and cardiovascular constriction effects 3.
- The incidence of stroke, cardiovascular events, and death in triptan users is not increased compared to non-triptan users 6.
Alternative Treatment Options
- Non-CGRP antagonist/non-triptan options, such as NSAIDs, ß-blockers, calcium channel blockers, antidepressants, and antiepileptics, can be used to minimize migraine symptoms 7.
- These options have varied mechanisms of action and can be used for both acute symptoms and prophylaxis, with consideration of contraindications, effectiveness, and potential side effects 7.