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Triptans in Pregnancy

Soldin, Offie P PhD, MBA*†; Dahlin, Julia; O'Mara, Daniel M BA

Therapeutic Drug Monitoring: February 2008 - Volume 30 - Issue 1 - p 5-9
doi: 10.1097/FTD.0b013e318162c89b
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Abstract: The triptans are a class of tryptamine-based drugs indicated for in the treatment of migraine headaches. The triptans act as serotonin (5-hydroxytriptamine) (5-HT) agonists by binding to various serotonin receptors, causing vasoconstriction and neuronal inhibition to alleviate migraines. There are 7 types of triptans currently available on the U.S. market: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan and zolmitriptan. The objective of this study was to examine the use and effects of triptans in pregnancy. Although three of the triptans have pregnancy registries maintained by the manufacturer, triptan use in pregnancy has not been extensively studied. Information on the use of sumatriptan during pregnancy is relatively more abundant, because it has been on the market longer than the other triptans and may also have a higher percentage of the market share. There are no data to suggest teratogenicity for any of the triptans, although preterm birth rates appear to be elevated.

From the *Departments of Medicine, Oncology, and Physiology, Georgetown University Medical Center, Washington, DC; †Center for Drug Evaluation and Research, US Food and Drug Administration, for the Obstentric-Fetal Pharmacology Research Unit Network, Sponsored by National Institute of Child Health and Development; and ‡Department of Oncology, Georgetown University Medical Center, Washington, DC.

Received for publication September 18, 2007; accepted November 7, 2007.

Financial support: No funding from any pharmaceutical firm was received for this project, and the authors' time on this project was supported by their respective employers. Dr. Soldin is partially supported by 5U10HD047890-03 NIH/NICHD Obstetrics Pharmacology Research Unit (OPRU) and by the Office of Research on Women's Health. Ms. Julia Dhalin is a Colaso Scholarship Student.

Correspondence: Dr. Offie Soldin, Associate Professor of Medicine, Oncology, and Physiology, Lombardi Comprehensive Cancer Center, LL S-166, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, DC 20057 (e-mail: os35@georgetown.edu).

© 2008 Lippincott Williams & Wilkins, Inc.