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5-HT1B/1D agonist (triptan) Pregnancy: There are no or limited data from use in pregnant women; animal studies have shown reproductive toxicity and the potential risk for humans is unknown. Not recommended during pregnancy or in women of childbearing potential not using contraception, unless clearly necessary. Not recommended during breast-feeding unless clearly needed; if used, a 24-hour interval must be observed.

Frovatriptan

Brand names: Migard

Frovatriptan is a triptan used for the acute treatment of the headache phase of migraine attacks in adults.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 2.5 mg
Route: Oral — tablets should be swallowed whole with water
Frequency: Single dose taken as early as possible after the onset of a migraine attack; if the migraine recurs after initial relief a second dose may be taken, provided there is an interval of at least 2 hours between the two doses
Max: The total daily dose should not exceed 5 mg per day
Acute treatment of migraine attack in adults 18-65 years. Frovatriptan should NOT be used prophylactically. If a patient does not respond to the first dose, a second dose should not be taken for the same attack, since no benefit has been shown; frovatriptan may still be used for subsequent attacks. PAEDIATRIC: safety and efficacy in children and adolescents below 18 years have not been established and use in this age group is not recommended (no data available). OLDER PEOPLE: data in patients over 65 years remain limited, so use in this category is not recommended. HEPATIC: no dosage adjustment in mild to moderate impairment; contraindicated in severe hepatic impairment (Child-Pugh C). It is advised to wait 24 hours after using frovatriptan before giving an ergotamine-type medication, and at least 24 hours should elapse after an ergotamine-containing preparation before frovatriptan is given. Too frequent use (repeated administration several days in a row) can cause accumulation and increased side effects; prolonged use of any painkiller for headache can cause medication overuse headache. NOTE ON US LABELLING: the US prescribing information permits a total daily dose of up to 3 tablets (3 x 2.5 mg) per 24-hour period, which differs from the UK SPC maximum of 5 mg/day — follow the UK SPC.

Dose adjustments

Renal

No dosage adjustment is required in patients with renal impairment.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to frovatriptan or to any of the excipients
  • History of myocardial infarction, ischaemic heart disease, coronary vasospasm (e.g. Prinzmetal's angina), peripheral vascular disease, or symptoms/signs compatible with ischaemic heart disease
  • Moderately severe or severe hypertension, or uncontrolled mild hypertension
  • Previous cerebrovascular accident (CVA) or transient ischaemic attack (TIA)
  • Severe hepatic impairment (Child-Pugh C)
  • Concomitant administration with ergotamine or ergotamine derivatives (including methysergide) or other 5-HT1 receptor agonists

Side effects

  • Dizziness — among the most common (<10%)
  • Fatigue — among the most common (<10%)
  • Paraesthesia — among the most common (<10%)
  • Headache and somnolence — among the most common (<10%)
  • Vascular flushing; also nausea, dry mouth, dyspepsia, throat tightness, palpitations/tachycardia; hypersensitivity reactions including cutaneous disorders, angioedema and anaphylaxis (post-marketing); myocardial infarction and coronary arteriospasm (post-marketing)

Interactions

  • Ergotamine, ergotamine derivatives and other 5-HT1 receptor agonists — concomitant administration is contraindicated (§4.3); wait 24 hours between frovatriptan and an ergotamine-type medication in either direction (§4.4)
  • Other triptans / 5-HT1B/1D agonists — vasospastic effects may be additive; co-administration within 24 hours is contraindicated (US label §7.2)
  • SSRIs, SNRIs, TCAs and MAO inhibitors — cases of serotonin syndrome have been reported during combined use with triptans (US label §7.3)
  • NOTE: the UK SPC §4.5 was not captured in this bundle; the second and third entries are from the US prescribing information and must be checked against the UK SPC §4.5

Clinical monograph

How it works

It is a selective serotonin 5-HT1B/1D receptor agonist that causes cranial vasoconstriction and inhibits release of pro-inflammatory neuropeptides in the trigeminovascular system.

Prescribing in practice

  • It is contraindicated in ischaemic heart disease, coronary vasospasm, uncontrolled hypertension and cerebrovascular disease because of its vasoconstrictor action.
  • It should not be combined with ergot alkaloids or used close to other triptans, and overuse can cause medication-overuse headache.
  • It treats the acute attack and has no role in migraine prophylaxis; assess cardiovascular risk before first use.

Monitoring

No routine laboratory monitoring is required, but cardiovascular risk should be assessed before starting and the frequency of use reviewed to detect medication-overuse headache.

Counselling the patient

  • Take it as soon as the migraine headache starts rather than at the aura stage.
  • Do not use it on too many days each month, as frequent use can cause more headaches.
  • Seek advice if you get chest tightness, pressure or pain after taking it.

Evidence & guidelines

Frovatriptan is an effective acute migraine therapy; its relatively long half-life among the triptans has prompted study in menstrual migraine.

Reference: NICE CG150; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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