Acute Porphyria Drug Database

N02CC02 - Naratriptan
Propably not porphyrinogenic
PNP

Rationale
Naratriptan is a minor substrate of CYP1A2, CYP3A4, CYP2C19, CYP2C9 and CYP2D6. It does not inhibit or induce CYP enzymes. Risk for gastrointestinal adverse events in the form of nausea and vomiting motivates vigilance against insufficient intake of food, especially of carbohydrate.
Chemical description
Naratriptan is a serotonin-receptor agonist.
Therapeutic characteristics
Naratriptan is indicated for the acute treatment of migraine attacks with or without aura. Common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are nausea and vomiting. There is however unclear whether it is related to naratriptan or the underlying condition. Naratriptan is indicated for the acute treatment of migraine attacks with or without aura. Common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are nausea and vomiting. There is however unclear whether it is related to naratriptan or the underlying condition.
Metabolism and pharmakokinetics
In vitro data indicates that naratriptan is metabolised by several CYP450 isoenzymes (SPC). It is listed as a minor substrate of CYP1A2, CYP3A4, CYP2C19, CYP2C9 and CYP2D6 (Ferrari 2003). 50% of an administered dose is excreted as unchanged drug and 30% as inactive metabolites (SPC). In vitro data indicates that it does not inhibit any CYP450 enzymes (SPC). No drug-drug interactions with naratriptan as a perpetrator are observed (Interaksjoner and Interaktionsdatabasen), which indicate that naratriptan is not an inhibitor or inducer of CYP enzymes.

References

  1. Scientific articles
  2. Ferrari A, Sternieri E, et al. Emerging problems in the pharmacology of migraine: interactions between triptans and drugs for prophylaxis. Pharmacol Res. 2003 Jul;48(1):1-9. PMID 12770508. #4655
  3. Drug interaction databases
  4. Interaksjoner. Naratriptan #2552
  5. Interaktionsdatabasen. Naratriptan #2553
  6. Summary of Product Characteristics
  7. Norwegian medicines agency. Summary of Product Characteristics (SPC). Naratriptan. #2554

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