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Triptans Pose Potential Risks for People with Heart Disease

In further news about the potential risks of some pharmaceuticals, a recent study of 120,000 migraineurs found that people with heart conditions, who should not take certain migraine medications called triptans, had been prescribed the medications anyway.

The study, reported in September at the annual meeting of the American Neurological Association, found that one in five patients with heart disease had been prescribed these medications in a year-long period. These drugs, including Amerge® (naratriptan), Axert®, Frova®, Imitrex® (sumatriptan), Maxalt®, Relpax®, Treximet® and Zomig®, are sometimes the only medications that will work for migraine sufferers, but because they narrow blood vessels by 10 to 20%, they are contraindicated with certain types of heart disease.

Stewart Tepper, MD, a headache specialist at the Cleveland Clinic who was not involved in the study, reviewed the results for WebMD, which reported them. He called the findings upsetting.

“I never would have thought it was that high,” he said.

For most people, Tepper noted, triptans are safe and effective. But in people with a history of heart disease, the medications can have serious consequences.

He recommends all people who have migraines and have one or more risk factors for heart disease talk to their physicians to find an appropriate medication.

According to Arthur Elkind, MD, president of the NHF board of directors, it is important for people who take triptans to know the risk factors and symptoms related to the contraindication of the medications, including elevated lipid levels, hypertension and a history of smoking. A history of angina pectoris (heart pain because of lack of blood), a past episode of ischemic heart disease and myocardial infarction (heart attack) also indicate that triptans should not be prescribed, he noted.

“The prescribing physician should be aware of the specific contraindications and if doubt exists, consult an appropriate specialist,” Dr. Elkind said.

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