Primary Care Migraine
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Use in Adults
Ditans

​THIS GUIDE PROVIDES A PARTIAL LISTING OF PRESCRIBING INFORMATION FOR THIS MEDICATION. FOR A FULL LISTING OF PRESCRIBING INFORMATION PLEASE REFER TO THE PACKAGE INSERT. CLICK ON THE BRAND NAME® TO VIEW THE LINK TO THE PACKAGE INSERT.
LASMIDITAN (REYVOW®) CLICK HERE TO EXPAND)
​
Brands:
  • Reyvow® (lasmiditan) For more complete prescribing information click here for PACKAGE INSERT
Dosages Available:
  • 50 and 100 mg tablets
Initial Dose: 
  • 100 mg is the preferred starting dose
  • May use 50 mg dose if 100 mg dose is not tolerated
  • May use two 100 mg tablets (total dose of 200mg) as starting dose if not pain free or adequate pain relief with lower dosages ​
Dose Schedule:  
  • Take one dose (50 mg, 100 mg or 200 mg) at onset of migraine attack as needed for the treatment of an acute migraine attack 
  • No evidence for benefit from second dose
​Max Daily Dose:
  • 200 mg
Side Effects:
  • Dizziness (severe 1% and mild to moderate in 15-20%)
  • Sedation, fatigue, paresthesia
Headache Specialist Comments: 
  • Consider use in the following patients:
    • Primary therapy in those with known cardiovascular disease or other contraindications to use of the triptans
    • Used as rescue therapy for those not attaining an adequate response after 2 hours to the initial dosage of an acute medication
  • There is no evidence from clinical studies that ditans are more efficacious than triptans, gepants or ergots.
  • The main advantages of lasmiditan are early pain free efficacy, despite treating later in a migraine attack (from clinical trial data) and its lack of a cardiovascular contraindication to its use. 
The main disadvantages include the need to avoid driving for 8 hours after use, and its side effects of dizziness, which is severe in 1% and mild to moderate in 15-20%, and the requirement of many insurance carriers for prior authorization
Precautions and Risk:  
  • Lasmiditan should not be taken unless the patient can wait at least 8 hours between dosing and driving or operating machinery. 
  • Lasmiditan is a Schedule V controlled substance (C-V). Avoid in patients with history of substance abuse.
Contraindications:  
  • None
Pregnancy:
  • Click Reyvow® and navigate to #8 Use in Specific Populations (8.1 & 8.2)
Common Drug Interactions:
  • Use with caution with any other CNS depressants known to cause sedation, to avoid combination effect
  • Be vigilant for development of serotonin syndrome in those receiving other serotonergic medications
  • May decrease heart rate when administered with a negative chronotropic drug
  • It is unknown if lasmiditan is associated with serotonin syndrome when used along with other serotonergic medications.
​Counseling Tips:  
  • Might be best administered when at home when no need to drive for 8 hours; 
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For Technical Support
  • Home
  • Education
    • CME Modules >
      • Module 1: Diagnose Migraine
      • Module 2: Secondary Headache
      • Module 3: Acute Therapy
      • Module 4: Preventive Therapy
    • Non-CME Modules >
      • Diagnose Migraine
      • Secondary Headache
      • Acute Therapy
      • Prevention
  • Diagnosis Tool
  • Med Guides
    • Acute Treatment Guide >
      • NSAIDs
      • Triptans
      • Gepants
      • Ditans
      • Combinations
      • Ergotamines
    • Preventive Guide >
      • Antidepressants
      • Antihypertensives
      • Antiepileptics
      • CGRP Monoclonal Antibodies
      • OnabotulinumtoxinA
      • CGRP Antagonists - Oral
    • Med-Guide
  • Infographics
    • Diagnose Migraine
    • ABCs of Migraine Management
    • Acute Migraine
    • Prevent Migraine