1.1. Adults
Serotonin 5-HT1B/1D receptor agonists (SRAs), commonly referred to as triptans, are FDA-approved to manage acute migraine headache attacks with or without aura [1-16]. Imitrex (sumatriptan) injection is also FDA-approved to manage cluster headache episodes.1,2,9 The maximum recommended adult doses for available SRAs are summarized in Tables 1 and 2. Dosages exceeding these recommendations will be reviewed.
| Drug Name | Dosage Form/Strength | Treatment Indication | Maximum Recommended Dosage |
|---|---|---|---|
| almotriptan (generic) | tablets (6.25 mg, 12.5 mg) | migraine with or without aura | 25 mg/day |
| eletriptan (Relpax, generic) | tablets (20 mg, 40 mg) | migraine with or without aura | 80 mg/day |
| frovatriptan (Frova, generic) | tablets (2.5 mg) | migraine with or without aura | 7.5 mg/day |
| naratriptan (generic) | tablets (1 mg, 2.5 mg) | migraine with or without aura | 5 mg/day |
| rizatriptan (Maxalt, generic) | tablets (5 mg, 10 mg) | migraine with or without aura | 30 mg/day |
| rizatriptan (Maxalt -MLT, generic) | orally disintegrating tablets (5 mg, 10 mg) | migraine with or without aura | 30 mg/day |
| rizatriptan propranolol patients | migraine with or without aura | 15 mg/day | |
| sumatriptan (Imitrex, generic) | intranasal spray (5mg/spray, 20 mg/spray - 6 per package) | migraine with or without aura | 40 mg/day |
| sumatriptan (Onzetra Xsail) | intranasal powder (11 mg/actuation) | migraine with or without aura | 44 mg/day* |
| sumatriptan (Imitrex, generic) | oral tablets (25 mg, 50 mg, 100 mg) | migraine with or without aura | 200 mg/day |
| sumatriptan (Imitrex, generic) | subcutaneous injection (4 mg and 6 mg STATdose system; 4 mg/ 0.5 mL, 6 mg/0.5 mL single dose vial) | migraine with or without aura | 12 mg/day |
| cluster headache | 12 mg/day | ||
| sumatriptan (Tosymra) | Intranasal spray (10 mg/ spray - 6 per package) | migraine with or without aura | 30 mg/day |
| sumatriptan (Zembrace SymTouch) | 3 mg/0.5 mL auto injector | migraine with or without aura | 12 mg/day |
| zolmitriptan (Zomig, generic) | tablets (2.5 mg, 5 mg) | migraine with or without aura | 10 mg/day |
| zolmitriptan (generic) | orally disintegrating tablets (2.5 mg, 5 mg) | migraine with or without aura | 10 mg/day |
| zolmitriptan (Zomig) | intranasal (2.5 mg/ actuation, 5 mg/ actuation) | migraine with or without aura | 10 mg/day |
Legend:
- * Alternatively, patients may receive a maximum Onzetra Xsail dose of 22 mg plus one dose of another sumatriptan product at least 2 hours later
| Drug Name | Treatment Indication | Dosage Form/Strength | Maximum Recommended Dosage |
|---|---|---|---|
| sumatriptan/naproxen (Treximet, generics) | migraine with or without aura | tablets (85 mg/500 mg) | 170 mg/1000 mg per day |