Naratriptan: Usage, Dosage, Side Effects & More

Nearly 30 million Americans suffer from migraine.

Along with a pounding headache, migraines can cause symptoms like nausea, vomiting, and sensory disturbances called auras.

In some cases, over-the-counter medication can help with migraine pain; for others, prescription medications called triptans offer more relief.

One such triptan is naratriptan, sold under the brand name Amerge.

Taking this prescription drug during a migraine attack can improve symptoms.

But as with any other medication, it can result in side effects. If you get migraines, your doctor can help you determine whether naratriptan is a good choice for you. 

In this article, I’ll explore naratriptan dosage, how quickly naratriptan works, and its side effects.

Next, I’ll explain drug interactions with naratriptan and the precautions you should consider before taking it.

Finally, I’ll list a few alternatives to naratriptan, and talk about when to see a doctor. 

Naratriptan Dosage

Naratriptan (or naratriptan hydrochloride) is the generic form of Amerge, a type of medication called a selective serotonin receptor agonist, or triptan.

It is used to treat migraine symptoms such as headache, nausea, vomiting, and sensitivity to light and sound.

Triptans improve migraines by narrowing blood vessels around your brain, stopping pain signals from getting sent to your brain, and halting the release of chemicals known to cause migraine symptoms. 

Naratriptan is an acute migraine medication, which means you should take it when you already have migraine symptoms.

It won’t prevent migraine attacks from occurring. 

Dosage of naratriptan varies, and it’s important to follow your doctor’s instructions when you take it.

The most common dosage for naratriptan is 1 or 2.5 milligrams (mg) by mouth. If your migraine persists or comes back after going away, you can take one more dose four hours after the first one.

Don’t take more than 5 mg in a single 24-hour time period. 

How to use naratriptan

Naratriptan is sold in tablet form, which you should swallow by mouth with a drink.

You don’t need to eat food with naratriptan. 

It’s best to take naratriptan as soon as you notice migraine symptoms.

If you get an aura before a headache, wait until the headache starts to take naratriptan.

Don’t use naratriptan to treat other types of headaches, such as tension headaches. 

Always follow your doctor’s instructions for how much naratriptan to take and how often to take it.

If you experience unwanted side effects or your migraines aren’t relieved by naratriptan, talk to your doctor. 

How Fast Does Naratriptan Work?

Naratriptan generally works within one to three hours; for some people, it may take longer.

You begin to feel effects within 1-2 hours of taking it, but it takes 2-3 hours to reach peak levels.

If your migraine goes away but comes back, you can take another dose of naratriptan, but don’t exceed 5 mg in a 24-hour period.

It may help to lie down in a cool, dark room after taking naratriptan. 

Naratriptan Side Effects

Some of the most common naratriptan side effects include: 

• Dizziness
• Weakness
• Nausea
• Fatigue or drowsiness
• Numbness or tingling 
• Flushing (warmth or redness in your face)
• Pain or tightness in your jaw, throat, or neck

Less common side effects of naratriptan may include: 

• Anxiety 
• Trouble sleeping
• Joint pain 
• Stomach discomfort
• Trembling hands or feet
• Change in taste, dry mouth

In rare cases, people experience more serious adverse effects after taking naratriptan.

Call your doctor or go to the emergency department if you notice any of the below side effects of naratriptan: 

• Pounding or rapid heartbeat 
• Severe stomach pain
• Bloody diarrhea 
• Fever
• Numbness in your fingers or toes accompanied by pale or blue coloring
• Severe headache
• Blurred vision 
• Confusion 
• Shortness of breath
• Intense chest pain or pressure
• Hallucinations
• Fainting
• Agitation
• Slurred speech 
• Problems with vision or balance

While rare, these symptoms may indicate medical problems such as high blood pressure, stroke, heart attack, or serotonin syndrome, a potentially fatal condition that occurs when too much serotonin accumulates in your body. 

What happens when you overdose

Taking too much naratriptan can be dangerous.

Possible signs of naratriptan overdose include: 

• Tiredness
• Loss of coordination
• Feeling dizzy or lightheaded
• Neck stiffness

If you think you may have taken too much naratriptan, call 9-1-1 or go to the emergency room.

Call 9-1-1 or take someone else to the emergency department if they’ve had a seizure, are experiencing difficulty breathing, or you can’t wake them up.

You can also call Poison Control 24/7 at 1-800-222-1222.

Drug Interactions with Naratriptan

Before starting any new medication, including naratriptan, tell your doctor about any other drugs, even over-the-counter medications or herbal supplements, that you’re currently taking.

Certain drugs can increase naratriptan side effects or even cause medical problems. 

Drugs that increase serotonin can increase your risk of serotonin syndrome, a condition that happens when your body has too much serotonin.

Examples of serotonin-increasing drugs include: 

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants
• Monoamine oxidase inhibitor (MAOIs) antidepressants
• Nausea medications, such as ondansetron (Zofran)
• Pain medications, including opioids 
• St. John’s Wort
• Other migraine drugs, including triptans and ergotamines 
• Illicit drugs, such as ecstasy and MDMA

There are many other drugs that may interact with naratriptan.

Always tell your doctor of all the medications you take, including when you start a new medication, if you take naratriptan.

Precautions Before Taking Naratriptan

It’s best not to take naratriptan more than 10 days per month, because medication overuse can lead to worsening headaches.

If you find yourself taking naratriptan frequently, talk to your doctor about a preventive medication option. 

If you take naratriptan for migraines, do your best to reduce alcohol consumption.

Alcohol can cause or worsen headaches. 

Contraindications

Naratriptan is contraindicated, or unsafe to use, if you have certain medical conditions.

If you have any of the below conditions, tell your doctor, as taking naratriptan may be harmful for you: 

• Uncontrolled high blood pressure
• Heart problems (history of heart attack or ischemic coronary artery disease or vasospasm)
• Heart rhythm problems
• Stroke or Transient Ischemic Attack (TIA) history
• Liver disease
• Kidney disease
• Circulation problems (peripheral vascular disease)
• Ischemic bowel disease

People with basilar (migraines that cause changes in vision or hearing) or hemiplegic migraines (migraines that cause paralysis) also shouldn’t take naratriptan, because they’re at a higher risk for a stroke. 

It’s not known if it’s safe for pregnant or breastfeeding people to take naratriptan.

Tell your doctor if you’re pregnant, planning to become pregnant, or currently breastfeeding. 

What to avoid when taking naratriptan

Talk to your doctor before taking naratriptan if you’ve taken any other migraine medication in the last 24 hours, such as: 

• Other triptans, including almotriptan, eletriptan, frovatriptan, rizatriptan, sumatriptan, or zolmitriptan
• Ergot drugs such as dihydroergotamine, ergotamine, ergonovine, and methylergonovine

Keep in mind that naratriptan may make you tired or impair your thinking, so if you feel out of sorts or sleepy, do not drive or operate machinery. 

Naratriptan Alternatives

Your doctor can recommend alternatives to naratriptan if this medication doesn’t effectively treat your migraines, or if you can’t take naratriptan due to drug interactions or other medical conditions.

If you need additional relief for a headache, any of the following over-the-counter drugs may help: 

• Ibuprofen (Advil and Motrin)
• Naproxen (Aleve)
• Aspirin 
• Acetaminophen (Tylenol)
• Excedrin, which contains aspirin, acetaminophen, and caffeine

Another triptan may also help your migraine.

Other triptans approved by the FDA as acute migraine treatment include:

• Sumatriptan (Imitrex, Imitrex Statdose, Sumavel DosePro, Alsuma, Zembrace SymTouch)
• Eletriptan (Relpax)
• Rizatriptan (Maxalt, Maxalt Mlt)
• Zolmitriptan (Zomig, Zomig ZMT)
• Frovatriptan (Frova)
• Almotriptan (Axert)

Calcitonin gene-related peptide (CGRP) antagonists, a newer drug class used to treat acute migraine, are another option.

Some examples of CGRP antagonists for migraines include: 

• Ubrogepant (Ubrelvy)
• Rimegepant (Nurtect ODT)

Preventive medications may be an option if you experience migraines often.

Possible options include antidepressants, anticonvulsants, CGRP monoclonal antibodies, beta blockers, and calcium channel blockers. 

When to See a Medical Provider

If you have severe or frequent migraines that don’t go away when you take naratriptan or other medications, it’s important to check in with a doctor.

Your provider can rule out other causes of headaches, along with prescribing a medication that either prevents or treats your migraine episodes.

A doctor can also help if you’re experiencing naratriptan side effects, or if you start taking a new drug that may interact with naratriptan.

Call 911 or go to the emergency department if you take naratriptan and you experience signs of a heart attack, stroke, or serotonin syndrome.

You should also seek emergency medical care if you have signs of anaphylaxis, or an allergic reaction after taking naratriptan, such as: 

• Rash
• Itching
• Difficulty breathing
• Trouble swallowing
• Swelling of the hands, face, or mouth

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