A randomized trial of frovatriptan for the intermittent prevention of menstrual migraine

Neurology. 2004 Jul 27;63(2):261-9. doi: 10.1212/01.wnl.0000134620.30129.d6.


Background: Menstrually associated migraine (MAM) is often prolonged and difficult to manage with conventional therapies. Frovatriptan is a new selective 5HT(1B/1D) receptor agonist indicated for short-term management of migraine. It has a long half-life and good tolerability. These characteristics suggest that frovatriptan may be useful for the intermittent prevention of MAM.

Methods: The study was a randomized, double-blind, placebo-controlled, three-way crossover design. Patients treated each of three perimenstrual periods (PMPs) with placebo, frovatriptan 2.5 mg QD, and frovatriptan 2.5 mg BID. The 6-day treatment started 2 days before the anticipated start of MAM headache. The primary efficacy endpoint was incidence of MAM headache during the 6-day PMP.

Results: The population comprised 546 women (mean age, 37.6 years). Use of frovatriptan reduced the occurrence of MAM headache. The incidence of MAM headache during the 6-day PMP was 67% for placebo, 52% for frovatriptan 2.5 mg QD, and 41% for frovatriptan 2.5 mg BID. Both frovatriptan regimens were superior to placebo (p < 0.0001), and the BID regimen was superior to the QD regimen (p < 0.001). Both frovatriptan regimens also reduced MAM severity (p < 0.0001), duration (p < 0.0001), and the use of rescue medication (p < 0.01 QD; p < 0.0001 BID) in a dose-dependent manner. The incidence and type of adverse events for both regimens were similar to placebo and consistent with those reported for short-term migraine management.

Conclusion: Frovatriptan given prophylactically for 6 days was effective in reducing the incidence of menstrually associated migraine. More than half of patients who used frovatriptan 2.5 mg BID had no menstrually associated migraine headache during the 6-day perimenstrual period. The findings are consistent with the long duration of action and good tolerability of frovatriptan observed in short-term migraine management.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carbazoles / administration & dosage
  • Carbazoles / therapeutic use*
  • Contraceptives, Oral, Combined / pharmacology
  • Contraceptives, Oral, Hormonal / pharmacology
  • Cross-Over Studies
  • Double-Blind Method
  • Drug Administration Schedule
  • Estrogens / physiology
  • Female
  • Humans
  • Hyperacusis / etiology
  • Hyperacusis / prevention & control
  • Incidence
  • Menstrual Cycle / physiology*
  • Migraine Disorders / drug therapy
  • Migraine Disorders / epidemiology
  • Migraine Disorders / etiology
  • Migraine Disorders / physiopathology
  • Migraine Disorders / prevention & control*
  • Nausea / etiology
  • Nausea / prevention & control
  • Patient Compliance
  • Photophobia / etiology
  • Photophobia / prevention & control
  • Serotonin Receptor Agonists / administration & dosage
  • Serotonin Receptor Agonists / therapeutic use*
  • Treatment Outcome
  • Tryptamines


  • Carbazoles
  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal
  • Estrogens
  • Serotonin Receptor Agonists
  • Tryptamines
  • frovatriptan