Precautions and Warnings With Triptans (Cont.)

• Triptans have been reported to increase the risk of a heart attack or a life-threatening change in a person's heart rhythm (arrhythmia). You should not take a triptan if you have heart disease or a history of heart attack, stroke, or transient ischemic attack (TIA or "mini-stroke") (see Triptans and Heart Problems for more information).

If you have risk factors for heart disease (see Heart Disease Risk Factors), it is also strongly recommended that you take your first dose of a triptan in your healthcare provider's office. This is so your healthcare provider can monitor your heart.

• In some cases, a stroke or transient ischemic attack can be misdiagnosed as a migraine. Your healthcare provider should make sure you are not having a stroke, especially if you have never had migraines in the past (see Stroke Symptoms for more information on the symptoms of a stroke).
   
• Triptans can cause blood vessels to spasm, including in the arms, legs, or colon (large intestine). This can cause a decrease in blood flow to these areas. Symptoms will vary based on the location. For example, a spasm in the colon can lead to severe abdominal pain or bloody diarrhea.
   
• Taking triptans with certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs), can increase your risk of a dangerous group of symptoms called serotonin syndrome. Do not use a triptan with antidepressants without first discussing it with your healthcare provider. Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:

o Confusion

o Seeing or hearing things that are not really there (hallucinations)

o Fast heartbeat (tachycardia)

o Feeling faint

o Fever

o Sweating

o Muscle spasms

o Difficulty walking

o Diarrhea.

• Triptans are considered pregnancy Category C medications. This means that they may not be safe for use during pregnancy. Talk to your healthcare provider before using a triptan if you are pregnant (see Triptans and Pregnancy for more information).
   
• Some triptans pass through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about this.
   
• If you have chest pain or jaw or neck tightness after taking a triptan, contact your healthcare provider immediately. These side effects are fairly common with triptans and are not usually serious. However, your healthcare provider may need to make sure you are not having heart problems.
   
• Tell your healthcare provider if you have liver problems (including liver failure or cirrhosis) or kidney problems (including kidney failure) before taking a triptan. This is because some triptans are removed from the body through the liver and kidneys.
   
• There have been rare cases of seizures in people taking triptans. If you a history of seizures, talk to your healthcare provider before starting a triptan.
   
• Triptans may cause changes in the eyes or vision problems. Tell your healthcare provider if you have eye or vision changes.