Reactions 953 - 31 May 2003

★ SNaratriptan

First report of ischaemic colitis: case reportA 50-year-old woman developed ischaemic colitis while

receiving naratriptan treatment for migraines.About 4 hours after taking naratriptan 2.5mg, the woman

presented with acute haemorrhagic diarrhoea and abdominalpain localised mainly in her left iliac fossa and left flank; shehad taken naratriptan the same way for about a year formigraine attacks occurring approximately once a month.Rectosigmoidoscopy revealed inflammatory, oedematous andhaemorrhagic mucosa with large areas of ulceration. Fullcolonoscopy, carried out 24 hours after presentation,confirmed the presence of left colitis with mucosal oedema,erythema and ulcers extending from her sigmoid colon to theleft corner of her colon. Histological examination of mucosalbiopsies confirmed the diagnosis of ischaemic colitis; thewhole area had epithelial detachment and multiple abrasions,with mucus, polynuclear neutrophils with fibrin, a mucosaloedema and interstitial fibrosis.

The woman’s condition rapidly improved over several daysand her ischaemic colitis was attributed to naratriptan use. Shewas advised not to take migraine treatments of the sametherapeutic class as naratriptan and her digestive symptomsdid not recur.

Author comment: It is probable that naratriptan, a recentmigraine treatment in the triptan class, will induce ischaemiccolitis even in the absence of any other risk factor, specifically inthe absence of any drug interaction or overdose.Macaigne G, et al. Ischemic colitis associated with naratriptan administration.Gastroenterologie Clinique et Biologique 26: 1058, Nov 2002 [French; summarisedfrom a translation] - France 800923312

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of ischaemic colitisassociated with naratriptan. The WHO Adverse Drug Reactionsdatabase contained three reports of ischaemic colitis associatedwith naratriptan.

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Reactions 31 May 2003 No. 9530114-9954/10/0953-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved