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Author: Admin | 2025-04-28
For migraine prevention.Some anti-epilepsy drugs make birth control pills or oral contraceptives (OCPs) less effective. Taking topiramate at the FDA recommended dose of 100mg per day has no reported effect on birth control effectiveness. However, taking topiramate at over 200mg per day decreased the estrogen part of OCPs by 18%. Anticonvulsants gabapentin (Neurontin®) and valproate (Depakote®) don’t interact with OCPs.Taking valproate (Depakote®) with butalbital (Fiorinal®) and benzodiazepines such as alprazolam (Xanax®), lorazepam (Ativan®), and zolpidem (Ambien®) and others can potentially cause liver problems.What medications interact with lasmiditan (Reyvow®)?Lasmiditan (Reyvow®) is a new medication for acute migraine relief similar to triptans. One possible side effect is sleepiness, which may be more significant if you combine the treatment with other central nervous system (CNS) depressants (such as benzodiazepines like Valium® and Xanax®). Another possible side effect is lower heart rate, especially if you combine lasmiditan with other heart rate lowering medications (such as propranolol).What medicines interact with onabotulinumtoxinA (Botox®)?OnabotulinumtoxinA (Botox®) is an approved treatment for chronic migraine (more than 15 headache days per month). Doctors inject this treatment into head and neck muscles every three months. OnabotulinumtoxinA does not have interactions with other migraine drug classes and may be a good option for patients on multiple other medications.However, onabotulinumtoxinA can interact with certain antibacterial medications, muscle relaxants and anticholinergic drugs (used to treat many conditions, including urinary incontinence). It’s important to talk to your doctor about all the medications you’re taking prior to starting onabotulinumtoxinA treatments.What medications interact with CGRP antagonists?Anti-CGRP migraine treatments were specifically created to prevent migraine and are designed to target CGRP (calcitonin gene-related peptide), the protein known for causing migraine. They are a newer class of treatment and include fremanezumab (AJOVY®), erenumab (Aimovig®) Galcanezumab (Emgality®) and eptinezumab (Vyepti). Anti-CGRP medications do not have any known interactions with other migraine drug classes. They may be a good option for patients on multiple other medications.What medications interact with gepants?Gepants are a newer class of migraine drug that also works to block CGRP (calcitonin gene-related peptide), the protein known for causing migraine. Gepants work to block CGRP from attaching to its receptor and initiating those pain signals.Ubrogepant (Ubrelvy®) and Rimegepant (Nurtec® ODT) are metabolized by the same liver enzyme as DHE (Migranal®), almotriptan (Axert®) and eletriptan (Relpax®). Using more than one drug broken down by that enzyme could raise the levels of one or both of the drugs. Many drugs break down through this same liver enzyme, so it’s important to talk to your doctor or pharmacist about all of the medications you’re taking to check for potential interactions.Other drugs that affect the same liver enzyme include ketoconazole, itraconazole, clarithromycin, cyclosporine, ciprofloxacin, fluconazole, fluvoxamine, rifampin, phenytoin and barbiturates. We don’t recommend using gepants when combining with any of those medications, or else you may need to modify your dosage.Gepants can also interact with certain fruits, including grapefruit, pomegranate and starfruit. Common supplements, including turmeric, licorice, feverfew, evening primrose, dong quai, echinacea, goldenseal, curcumin and St. John’s Wart also interact with Gepants.There
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