5-HT1 receptor inhibitors (triptans) for the treatment of migraine during pregnancy: an analysis of the instructions for medical use

Abstract

Considering the high prevalence of migraine among women of reproductive age, the impact of this pathology on the state of health of the mother and the fetus, the selection of adequate pharmacotherapy is an extremely important process.

Goal ‒ to analyze the possibility of using triptans registered on the pharmaceutical market of Ukraine for the treatment of migraine paroxysms in women during pregnancy on the basis of instructions, data from scientific literature, etc.

Materials ‒ data from informational reference and scientific literature, State Register of Medicinal Products of Ukraine, UTIS. Research methods – webometric, comparative analyses; systematization of data.

As of September 2022, eletriptan, zolmitriptan, rizatriptan, sumatriptan, frovatriptan are registered in Ukraine.

The most complete information on the use of sumatriptan is presented in the instructions for «Sumamigren», «Antimigraine-Zdorovya». Summarized information from all the instructions: «The use of sumatriptan is possible only in cases where the expected benefit for the mother exceeds possible risks for the fetus». The information in the instructions for rizatriptan is practically identical for Rizamigren and Rizoptan, and for Rizatriptan-Pharmaten it is presented significantly more succinctly: «During pregnancy, should be used only in case of urgent need». The instructions for zolmitriptan «Zolmigren Spray» indicate: «use of the drug by pregnant women is possible only when the expected therapeutic effect for the woman exceeds the potential risk for the fetus/child». Domestic and foreign manufacturers of tablets indicate similar information. 1 medicine of frovatriptan is registered, where it is indicated: «The safety of the use of in pregnant women has not been established» and 1 medicine of eletriptan: «There is no experience of clinical use of in pregnant women».

As of September 2022, the following medicines are registered in Ukraine: sumatriptan, rizatriptan, zolmitriptan, frovatriptan, eletriptan. Forms of release: tablets, tablets covered with a shell or a film shell, tablets dispersible in the oral cavity, capsules, dosed nasal spray. The content of the information in the instructions for the medical use of each triptan medicine taken separately for the analysis of the INN is similar, but not identical. Sumatriptan is considered the only relatively safe triptan for treatment of migraine paroxysms in pregnant women. A prospective direction for the development and expansion of the domestic pharmaceutical market of triptans is the registration of new release forms (and active substances (almotriptan, lasmiditan, naratriptan).