The Food and Drug Administration has approved lasmiditan (Reyvow), a serotonin 1F receptor agonist, to treat acute migraine with or without aura. Lasmiditan is not used for the prevention of migraine headaches.

In two randomized, double-blind, placebo-controlled trials that enrolled 3,177 adults, lasmiditan was found to be more effective than placebo in relieving pain and resolving, within two hours, other bothersome symptoms of migraine (such as nausea, light sensitivity, or noise sensitivity).

The most common adverse effects of lasmiditan are dizziness, fatigue, a burning or prickling sensation in the skin, and sedation.

Nurses should teach patients not to take more than one dose of lasmiditan within 24 hours. Each dose may be taken with or without food. Nurses should teach patients that lasmiditan is a central nervous system (CNS) depressant. Patients must avoid driving or other activities requiring full mental alertness, such as operating heavy machinery, for a minimum of eight hours after taking lasmiditan. Family members should also be told about the hazards of CNS depression and the need for patients to avoid driving after taking lasmiditan, as patients taking the drug may not be able to judge their mental alertness.

Because of lasmiditan's CNS depressant effects, the concomitant use of other CNS depressants and alcohol may exacerbate CNS depression. These should be avoided or used with extreme caution. Because the drug stimulates serotonin receptors, patients may develop serotonin syndrome; its symptoms include agitation or restlessness, confusion, tachycardia, hypertension, dilated pupils, loss of muscle coordination or twitching muscles, muscle rigidity, heavy sweating, diarrhea, headache, shivering, and goose bumps. Potentially life-threatening symptoms include high fever, seizures, arrythmias, and loss of consciousness.

Patients of childbearing age should contact their prescriber if considering pregnancy, or if they become pregnant while taking lasmiditan, as there is a possibility of fetal harm. This possibility is based on animal data; there is insufficient information regarding this effect in humans.

There is a risk that headaches may be exacerbated if lasmiditan is used more than 10 days per month. Nurses should instruct patients to keep a diary to monitor their headaches and drug use.

For full prescribing information for lasmiditan, go to http://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211280s000lbl.pdf.