Triptans and Ergotamines: What’s the CV Risk?

April 2, 2015

Triptan and ergotamine drugs are staples of acute migraine treatment. But questions about their cardiovascular safety linger in the absence of clear evidence. A short slide show looks at what we do know.

Serious ischemic events related to the use of triptans and ergotamines to treat migraine headache are rare and so there is a paucity of data from randomized controlled trials that could help establish drug-related cardiovascular (CV) risk. The drugs’ potent vasoconstrictive properties, however, make a strong case for a more comprehensive understanding.In a recent systematic review of available observational studies, Roberto and colleagues found that “intense consumption” of ergotamines could increase the risk of serious ischemic complications but that CV safety issues with triptans are not prevalent and that no firm conclusions can be made.The slides above summarize this review.

References:

1. Roberto G, Raschi E, Piccinni C, et al. Adverse cardiovascular events associated with triptans and ergotamines for treatment of migraine: systematic review of observational studies. Cephalalgia. 2015;35:118-131.

2. Wammes-vander Heijden EA. Rahimtoola H, Leufkens HG, et al. Risk of ischemic complications related to the intensity of triptan and ergotamine use. Neurology. 2006; 67:1128-1134.

3. Velentgas P, Cole JA, Mo J, et al. Severe vascular events in migraine patients. Headache. 2004;44:642-651.

4. Becker C, Borbert GP, Almqvist PM, et al. Migraine and the risk of stroke, TIA, or death in the UK (CME). Headache. 2007;47:1374-1384.