Home Drug Guide Lasmiditan

Drug Guide

Generic Name

Lasmiditan

Brand Names Reyvow

Classification

Therapeutic: Antimigraine agent

Pharmacological: 5-HT1F receptor agonist

FDA Approved Indications

Acute treatment of migraine with or without aura in adults

Mechanism of Action

Lasmiditan selectively agonizes the 5-HT1F receptor, leading to inhibition of neuropeptide release and modulation of pain pathways, which helps relieve migraine symptoms.

Dosage and Administration

Adult: 50 mg taken orally as needed. May repeat after 2 hours if migraine persists; maximum dose is 200 mg/day.

Pediatric: Not approved for pediatric use; safety and efficacy not established.

Geriatric: No specific dosage adjustments are generally necessary; however, caution advised due to comorbidities.

Renal Impairment: Use with caution; no specific dosage adjustment recommended but monitor accordingly.

Hepatic Impairment: Use with caution; limited data; consider lower starting doses.

Pharmacokinetics

Absorption: Rapid, with peak plasma levels in approximately 1.5 hours.

Distribution: Low protein binding (~5%).

Metabolism: Primarily metabolized by CYP3A4; no active metabolites.

Excretion: Excreted mainly via feces, with some urinary excretion.

Half Life: About 5.7 hours.

Contraindications

Hypersensitivity to lasmiditan or any component of the formulation.

Precautions

Use caution in patients with ischemic heart disease, cerebrovascular disease, or uncontrolled hypertension. Due to central nervous system effects, avoid activities requiring mental alertness for at least 8 hours after dosing.
Potential for dizziness and sedation; caution advised.

Adverse Reactions - Common

Dizziness (Common)
Somnolence (Common)
Fatigue (Common)
Paraesthesia (Common)

Adverse Reactions - Serious

Serotonin syndrome (rare) (Serious)
Hypersensitivity reactions including rash, hives (rare) (Serious)

Drug-Drug Interactions

CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) – increase lasmiditan levels.
Other serotonergic drugs – increased risk of serotonin syndrome.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of serotonin syndrome, dizziness, sedation, and blood pressure changes.

Diagnoses:

Risk for injury due to dizziness or sedation.
Ineffective coping related to migraine pain.

Implementation: Administer as prescribed; assess pain relief; advise patients to avoid driving or operating machinery for at least 8 hours post-dose.

Evaluation: Evaluate effectiveness in reducing migraine pain and associated symptoms.

Patient/Family Teaching

Instruct patient to take lasmiditan at the first sign of migraine.
Warn about possible dizziness, sedation, and impairment; avoid driving or hazardous activities for at least 8 hours.
Advise on the importance of reporting any adverse effects or hypersensitivity reactions.

Special Considerations

Black Box Warnings:

Central nervous system depression: Use with caution; may impair ability to perform tasks requiring alertness.

Genetic Factors: None specified.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Dizziness, sedation, hypotension, weakness, dysarthria.

Treatment: Supportive care; consider activated charcoal if ingestion is recent; hemodialysis is not effective due to high protein binding.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F), away from moisture and light.

Stability: Stable for at least 24 months under recommended conditions.