Naratriptan hydrochloride is used for the acute treatment of attacks of migraine with or without aura in adults. The manufacturer states that naratriptan should not be used for the management of hemiplegic or basilar migraine or for the prophylaxis of migraine. Safety and efficacy have not been established for the management of cluster headaches.
Efficacy of naratriptan administered at the recommended dosage of 1 or 2.5 mg has been evaluated for the acute treatment of migraine attacks in several randomized, placebo-controlled studies in adult outpatients with moderate to severe headaches. In these studies, 50-54 or 60-66% of patients receiving naratriptan 1 or 2.5 mg, respectively, achieved a response (mild or no headache pain) 4 hours after treatment, compared with 27-34% of patients receiving placebo. The drug also relieved manifestations of migraine other than headache (including nausea, photophobia, and phonophobia) and reduced the need for supplemental migraine therapy.
The US Headache Consortium considers 5-HT1B/1D receptor agonists (e.g., naratriptan) an appropriate treatment choice for the acute management of moderate to severe migraine headaches in patients without contraindications to these drugs and recommends use of 5-HT1B/1D receptor agonists, dihydroergotamine, or ergotamine in patients with more severe migraine attacks as well as in patients in whom previous therapy with nonsteroidal anti-inflammatory agents (NSAIAs) or fixed-combination preparations such as acetaminophen, aspirin, and caffeine has been ineffective.