Lasmiditan

Lasmiditan is a prescription medication used for the acute treatment of migraine attacks with or without aura in adults. 

• Lasmiditan is available under the following different brand names: Reyvow

Adult dosage

Tablet, Schedule V

• 50 mg
• 100 mg
• 200 mg

Acute Migraine

Adult and Geriatric dosage

• 50 mg, 100 mg, or 200 mg orally or as needed
• Not to exceed more than 1 dose/24 hour

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Lasmiditan include:

• dizziness,
• drowsiness,
• feeling tired,
• numbness,
• tingling, and
• burning pain

Serious side effects of Lasmiditan include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• agitation,
• hallucinations,
• fever,
• sweating,
• shivering,
• fast heart rate,
• muscle stiffness,
• twitching,
• loss of coordination,
• nausea,
• vomiting, and
• diarrhea

Rare side effects of Lasmiditan include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Lasmiditan has severe interactions with no other drugs.
• Lasmiditan has serious interactions with at least 122 other drugs.
• Lasmiditan has moderate interactions with at least 224 other drugs.
• Lasmiditan has minor interactions with no other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• None

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Lasmiditan?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Lasmiditan?”

Cautions

• Significant driving impairment may occur; advise patients not to engage in potentially hazardous activities requiring complete mental alertness (e.g., driving a motor vehicle, or operating machinery) for at least 8 hours after each dose; avoid use in patients who are unable to follow this advice
• Reactions consistent with serotonin syndrome reported; discontinue if symptoms of serotonin syndrome occur
• CNS depression (e.g., dizziness, sedation) reported
• Overuse of acute migraine drugs (e.g., ergotamine, triptans, opioids, or a combination of these drugs for above 10 per month) may lead to exacerbation of headache (i.e., medication overuse headache); may present as migraine-like daily headaches or as a marked increase in the frequency of migraine attacks; detoxification and treatment of withdrawal symptoms (which often includes a transient worsening of headache) may be necessary
• Drug interaction overview
  • Lasmiditan inhibits P-GP and breast cancer-resistant protein (BCRP); avoid coadministration
  • Owing to the potential for sedation, other cognitive and/or neuropsychiatric adverse reactions, and driving impairment, use with caution if used in combination with alcohol or other CNS depressants
  • Coadministration of Lasmiditan and drugs (e.g., SSRIs, SNRIs, TCAs, MAO inhibitors, trazodone), over-the-counter medications (e.g., dextromethorphan), or herbal supplements (.g, St. John’s wort) that increase serotonin may increase the risk of serotonin syndrome; use with caution in patients taking medications that increase serotonin.
  • In a drug interaction study, the addition of a single Lasmiditan 200-mg dose to propranolol decreased heart rate by an additional 5 bpm compared with propranolol alone, for a mean maximum of 19 bpm; use with caution in patients taking concomitant medications that lower heart rate

Pregnancy and Lactation

• No adequate data are available on the developmental risk associated with use in pregnant women
• Clinical considerations
  • Data suggest women with migraine may be at increased risk for preeclampsia and gestational hypertension during pregnancy
• Lactation
  • There are no data on the presence of human milk, effects on breastfed infants, or effects on milk production
  • Excretion of Lasmiditan and/or metabolites into milk, at levels approximately 3 times those in maternal plasma, was observed in lactating rats following oral administration