What is Lasmiditan: Uses, Dosage, Side Effects and More

Lasmiditan is a newer prescription medication specifically designed to treat migraine headaches in adults. It belongs to a class of drugs called selective serotonin receptor agonists, which work differently from traditional migraine medications by targeting specific brain receptors involved in migraine pain.

This medication offers hope for people who haven't found relief with other migraine treatments or who can't take certain migraine medications due to heart conditions. Understanding how lasmiditan works and what to expect can help you make informed decisions about your migraine care.

What is Lasmiditan?

Lasmiditan is a prescription medication that treats acute migraine attacks with or without aura in adults. Unlike some older migraine medications, it doesn't affect blood vessels in your heart, making it a safer option for people with certain cardiovascular conditions.

The drug works by activating specific serotonin receptors in your brain called 5-HT1F receptors. These receptors play a key role in migraine pain pathways. When lasmiditan binds to these receptors, it helps reduce the inflammation and pain signals that create your migraine symptoms.

You might know lasmiditan by its brand name, Reyvow. It was approved by the FDA in 2019 as the first medication in its class, representing a significant advancement in migraine treatment options.

What is Lasmiditan Used For?

Lasmiditan is specifically used to treat acute migraine attacks in adults. This means it's designed to stop a migraine that has already started, rather than prevent future migraines from occurring.

Your doctor might prescribe lasmiditan if you experience moderate to severe migraine headaches that interfere with your daily activities. It can help with the throbbing head pain, nausea, and sensitivity to light and sound that often accompany migraines.

This medication is particularly valuable for people who have heart disease, high blood pressure, or other cardiovascular conditions that make traditional triptan medications unsafe. It's also an option if you've tried other migraine treatments without success or experienced troubling side effects.

How Does Lasmiditan Work?

Lasmiditan works by targeting specific serotonin receptors in your brain called 5-HT1F receptors. When a migraine begins, certain pain pathways become overactive, sending intense pain signals throughout your head and triggering other symptoms like nausea.

By binding to these receptors, lasmiditan helps calm down the overactive nerve pathways that create migraine pain. It also reduces inflammation in the brain tissue that contributes to migraine symptoms. This targeted approach helps interrupt the migraine process once it has begun.

The medication is considered moderately strong and typically begins working within two hours of taking it. Unlike some migraine medications that narrow blood vessels, lasmiditan doesn't significantly affect your cardiovascular system, making it safer for people with heart conditions.

How Should I Take Lasmiditan?

Take lasmiditan exactly as your doctor prescribes, typically as a single dose when you feel a migraine starting. You can take it with or without food, though taking it with food might help reduce stomach upset if you experience nausea.

Swallow the tablet whole with a full glass of water. Don't crush, break, or chew the tablet, as this can affect how the medication is absorbed. The most common starting dose is 50mg, though your doctor might prescribe 100mg if needed.

It's important to take lasmiditan as soon as you recognize migraine symptoms beginning. The medication works best when taken early in the migraine process, before the pain becomes severe. If your migraine doesn't improve after two hours, don't take a second dose without consulting your doctor first.

How Long Should I Take Lasmiditan For?

Lasmiditan is designed for short-term use to treat individual migraine attacks, not for long-term daily prevention. You should only take it when you're experiencing an actual migraine, not as a preventive measure.

The medication typically provides relief within two hours, and its effects can last up to 24 hours. You shouldn't take more than one dose within a 24-hour period unless specifically directed by your doctor. Taking it too frequently can lead to medication overuse headaches.

If you find yourself needing lasmiditan more than 10 days per month, talk to your doctor about preventive migraine treatments. Frequent use of acute migraine medications can sometimes make headaches worse over time, so it's important to use them as directed.

What Are the Side Effects of Lasmiditan?

Like all medications, lasmiditan can cause side effects, though not everyone experiences them. The most common side effects are generally mild and temporary, resolving as the medication leaves your system.

Here are the most frequently reported side effects that you might experience:

• Dizziness or feeling lightheaded
• Drowsiness or fatigue
• Nausea or stomach discomfort
• Muscle weakness or feeling unsteady
• Tingling or numbness in hands or feet
• Dry mouth
• Feeling disconnected or "spacey"

These common side effects usually improve within a few hours as your body processes the medication. The dizziness and drowsiness can be particularly noticeable, which is why you shouldn't drive or operate machinery for at least eight hours after taking lasmiditan.

Less common but more serious side effects that require immediate medical attention include:

• Severe dizziness or fainting
• Difficulty breathing or chest tightness
• Severe muscle weakness
• Confusion or disorientation
• Allergic reactions like rash, itching, or swelling

If you experience any of these serious side effects, contact your healthcare provider immediately or seek emergency medical care. While rare, these symptoms could indicate a serious reaction that needs prompt treatment.

Who Should Not Take Lasmiditan?

Lasmiditan isn't suitable for everyone, and certain medical conditions or situations make it unsafe to use. Your doctor will carefully review your medical history before prescribing this medication.

You should not take lasmiditan if you have severe liver disease, as your body may not be able to process the medication properly. People with a history of stroke, heart attack, or certain other serious cardiovascular conditions should also avoid this medication.

Here are the main conditions and situations where lasmiditan is not recommended:

• Severe liver disease or liver failure
• Previous stroke or transient ischemic attack (TIA)
• History of heart attack or serious heart rhythm problems
• Uncontrolled high blood pressure
• Pregnancy or breastfeeding
• Age under 18 years
• Known allergies to lasmiditan or its ingredients

Additionally, you should use caution if you have kidney problems, take certain antidepressants, or have a history of substance abuse. The sedating effects of lasmiditan can be enhanced by alcohol or other central nervous system depressants, so avoid these combinations.

Lasmiditan Brand Name

Lasmiditan is sold under the brand name Reyvow in the United States. This brand name medication is manufactured by Eli Lilly and Company and was first approved by the FDA in October 2019.

Reyvow is available in two strengths: 50mg and 100mg tablets. Both strengths contain the same active ingredient, lasmiditan, but in different amounts to allow for personalized dosing based on your specific needs and response to treatment.

Currently, there are no generic versions of lasmiditan available, as the medication is still under patent protection. This means Reyvow is the only brand available, which can make it more expensive than older migraine medications that have generic alternatives.

Lasmiditan Alternatives

If lasmiditan isn't suitable for you or doesn't provide adequate relief, several other migraine treatment options are available. Your doctor can help you find the best alternative based on your specific medical history and needs.

Traditional triptan medications like sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig) are often tried first. These medications work by narrowing blood vessels in the brain and are effective for many people, though they're not suitable for those with heart conditions.

Here are the main categories of migraine treatment alternatives:

• Triptans (sumatriptan, rizatriptan, eletriptan)
• CGRP receptor antagonists (ubrogepant, rimegepant)
• Ergot alkaloids (dihydroergotamine)
• Anti-nausea medications (metoclopramide, ondansetron)
• Pain relievers (ibuprofen, naproxen, acetaminophen)
• Combination medications (sumatriptanaproxen)

Newer options like ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) work similarly to lasmiditan by targeting different receptors involved in migraine pain. These CGRP antagonists might be good alternatives if you can't take lasmiditan but need a cardiovascular-safe option.

Is Lasmiditan Better Than Sumatriptan?

Both lasmiditan and sumatriptan are effective migraine treatments, but they work differently and have distinct advantages depending on your individual situation. Neither is universally "better" than the other, as the best choice depends on your specific medical profile and response to treatment.

Sumatriptan has been available longer and has more extensive research backing its effectiveness. It's often tried first because it's available in multiple forms (tablets, injections, nasal spray) and has generic versions that make it more affordable. However, sumatriptan can narrow blood vessels, making it unsuitable for people with heart conditions.

Lasmiditan's main advantage is its safety profile for people with cardiovascular conditions. It doesn't affect blood vessels in the heart, making it a safer choice if you have heart disease, high blood pressure, or other cardiovascular risks. It also may cause fewer rebound headaches with frequent use.

The choice between these medications often comes down to your specific health profile. If you have heart conditions, lasmiditan might be the better option. If you don't have cardiovascular concerns and cost is a factor, sumatriptan might be more practical.