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Naratriptan oral

Updated 2 Feb 2023 | Acute migraine treatment


Oral formulations of naratriptan.

Drugs List

  • NARAMIG 2.5mg tablets
  • naratriptan 2.5mg tablets
  • Therapeutic Indications


    Acute treatment of migraine attacks with or without aura

    Unlicensed Uses

    Menstrual migraine: Prophylaxis


    Naratriptan tablets should be taken as early as possible after migraine headache but they are effective if taken at a later stage.

    Naratriptan tablets are recommended as monotherapy for the acute treatment of a migraine attack.


    Treatment of acute migraine:
    2.5mg as single dose, repeated after at least 4 hours if migraine recurs. If patient does not respond to first dose of naratriptan, a second dose should not be taken for the same attack, as it is unlikely to be of any benefit. However, naratriptan may be used for subsequent migraine attacks. Maximum dose should not exceed 5mg naratriptan in any 24 hour period.

    Menstrual migraine prophylaxis (unlicensed):
    2.5mg twice daily, to be taken from 2 days before until 3 days after bleeding starts.

    Additional Dosage Information

    If a patient does not respond to the first dose of naratriptan, a second dose should not be taken for the same attack, as it is unlikely to be of any benefit. However, naratriptan may be used for subsequent migraine attacks.


    Children under 18 years
    Patients over 65 years
    Suspected ischaemic heart disease
    Coronary vasospasm
    History of cerebrovascular accident
    History of myocardial infarction
    History of transient ischaemic attack
    Ischaemic heart disease
    Moderate hypertension
    Peripheral vascular disease
    Prinzmetal's angina
    Renal impairment - creatinine clearance below 15ml/minute
    Severe hepatic impairment - Child-Pugh score greater than or equal to 10
    Uncontrolled hypertension

    Precautions and Warnings

    Predisposition to ischaemic heart disease
    Glucose-galactose malabsorption syndrome
    Lactose intolerance
    Mild hepatic impairment
    Renal impairment

    Not for prophylactic use
    Not indicated in hemiplegic, ophthalmoplegic or basilar migraine
    Advise ability to drive/operate machinery may be affected by side effects
    Evaluate patients for cardiovascular disease prior to treatment
    Exclude other potentially serious neurological conditions
    Contains lactose
    Only for use where a clear diagnosis of migraine has been established
    Risk of cerebrovascular events
    When used with SSRIs, risk of Serotonin syndrome
    Excessive use may increase frequency of headache, may require withdrawal
    If angina-like symptoms occur, discontinue treatment and investigate.
    Advise patient not to take St John's wort concurrently
    Patients should not exceed recommended dose

    The safety and efficacy of naratriptan when administered during the aura phase, prior to the onset of migraine headache, has yet to be established.

    As with other 5-HT1 receptor agonists, naratriptan should not be given to patients who have risk factors for ischaemic heart disease, including those patients who are heavy smokers or users of nicotine substitution therapy without prior cardiovascular evaluation. Special consideration should be given to post menopausal women and males over 40 years old, naratriptan should not be used without a cardiovascular evaluation.

    Serotonin syndrome (including altered mental status, autonomic instability and neuromuscular abnormalities) has been reported following concomitant treatment with triptans and SSRIs/SNRIs. If concomitant treatment with naratriptan and an SSRI/SNRI is clinically warranted, appropriate observation of the patient is advised.

    Pregnancy and Lactation


    Naratriptan is contraindicated during pregnancy.

    The manufacturer does not recommend using naratriptan during pregnancy.

    At the time of writing there is limited published information regarding the use of naratriptan in pregnancy. Potential risks are unknown, however the molecular weight (about 336 for the free base) suggests that the drug will cross the placenta.

    Animal studies have not indicated any teratogenic effects or harmful effect on peri- and postnatal development. However, delays in foetal ossification and possible effects on embryo viability have been observed in the rabbit.


    Use naratriptan with caution during breastfeeding.

    The manufacturer states that breastfeeding should be avoided during and for 24 hours after naratriptan treatment.

    There is insufficient data regarding the use of naratriptan during human lactation. The molecular weight (about 336 for the free base) is low enough that excretion into breast milk should be expected. Animal data reports naratriptan and/or drug related metabolites are secreted into the milk of lactating rats.

    The effect of this exposure, if any, on a nursing infant is unknown. According to LactMed, if naratriptan is required by the mother of an older infant during breastfeeding , it is not a reason to discontinue breastfeeding; however, an alternate drug may be preferred, especially while breastfeeding a newborn or preterm infant.

    Side Effects

    Coronary vasospasm
    Facial oedema
    Hypersensitivity reactions including anaphylaxis
    Increased blood pressure (transient)
    Ischaemic colitis
    Myocardial infarction
    Peripheral ischaemia
    Sensation of heat
    Sensation of heaviness
    Sensation of pressure
    Sensation of tightness
    Sensation of tingling
    Tightness of chest and/or throat
    Transient ischaemic ECG changes
    Visual disturbances


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: July 2022

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Naramig Tablets 2.5mg. GlaxoSmithKline. Revised November 2020.

    NICE Evidence Services Available at: Last accessed: 21 July 2022

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Naratriptan Last revised: 17 May 2021
    Last accessed: 21 July 2022

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