Triptans Ergot derivatives

Ergot derivatives and triptans are specific treatments for migraine. Both are 5HTib/id serotonergic agonists. 

Drug treatments include analgesics such as aspirin, opioids, ergot derivatives and triptans (5-HTi agonists). 

ERGOTAMINE, METHYSERGIDE 5-HT1 AGONISTS-TRIPTANS T risk of vasospasm Additive effect 1. Do not administer ergotamine and almotriptan, rizatriptan, sumatriptan or zolmitriptan within 6 hours of each other 2. Do not administer methy-sergide and almotriptan, rizatriptan, sumatriptan or zolmitriptan within 24 hours of each other 3. Do not administer an ergot derivative and eletriptan orfrovatriptan within 24 hours of each other... 

The drugs dealt with in this section are the ergot derivatives and the triptans (or more properly the serotonin 5-HTj agonists), whose main use is in the treatment of migraine. Table 16.1 , (below) lists some of the drugs commonly used in migraine. Drugs such as propranolol, which are more commonly used in other conditions, are discussed elsewhere in the publication. 

Vasoconstriction is a well known adverse effect of ergot derivatives, and coronary vasoconstriction may also occur rarely with the triptans. (Note that in 1992, soon after the marketing of sumatriptan, the CSM in the UK had received 34 reports of pain or tightness in the chest caused by sumatriptan, possibly due to coronary vasoconstriction. ) It is therefore theoretically possible that the drugs may have additive vasoconstrictive effects, although there is little evidence of this in practice. 

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