Amerge

Before taking this medicine

Do not take Amerge (naratriptan) if you have: • Coronary artery disease, including angina, a previous heart attack or reduced blood flow to the heart, or coronary artery spasms such as Prinzmetal’s angina. • Wolff-Parkinson-White syndrome or another disorder involving an extra electrical pathway in the heart. • A history of stroke, transient ischemic attack (TIA), or hemiplegic or basilar migraine. • Peripheral vascular disease or ischemic bowel disease. • Uncontrolled high blood pressure. • Severe kidney or liver impairment. • An allergy to naratriptan, including a previous severe allergic reaction or angioedema. Do not take naratriptan within 24 hours of another triptan or an ergot-type medicine, such as ergotamine, dihydroergotamine or methysergide. A heart assessment is needed before starting naratriptan if you have never used a triptan and have several cardiovascular risk factors, such as older age, diabetes, high blood pressure, smoking, obesity or a strong family history of coronary artery disease. Even if that assessment finds no heart disease, medically supervised initial treatment and an ECG may be considered. Blood pressure should be monitored during treatment. Serious heart problems, abnormal heart rhythms, stroke, reduced blood flow to the bowel or limbs, and severe allergic reactions have been reported. Chest, throat, neck or jaw tightness is usually not heart-related, but needs assessment in people at high cardiac risk. New or unusual headache symptoms should be assessed to exclude other serious neurological conditions. Naratriptan can cause serotonin syndrome, especially when taken with SSRI, SNRI or tricyclic antidepressants, or MAO inhibitors. Symptoms can include agitation, hallucinations, fever, a fast heartbeat, changing blood pressure, poor coordination, nausea, vomiting or diarrhea. Naratriptan should be stopped if serotonin syndrome is suspected. Overuse of medicines for migraine attacks can make headaches more frequent or worse. During pregnancy, naratriptan may harm the unborn baby, based on animal studies.