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  • Title: Optimal balance of efficacy and tolerability of oral triptans and telcagepant: a review and a clinical comment.
    Author: Tfelt-Hansen P.
    Journal: J Headache Pain; 2011 Jun; 12(3):275-80. PubMed ID: 21350792.
    Abstract:
    Dose-response curves for headaches relief and adverse events (AEs) are presented for five triptans: sumatriptan, zolmitriptan, naratriptan, almotriptan, and frovatriptan, and the CGRP antagonist telcagepant. The upper part of the efficacy curve of the triptans is generally flat, the so-called ceiling effect; and none of the oral triptans, even in high doses, are as effective as subcutaneous sumatriptan, In contrast, AEs increases with increasing dose without a ceiling effect. The optimal dose for the triptans is mainly determined by tolerability. Telcagepant has an excellent tolerability and can be used in migraine patients with cardiovascular co-morbidity. Based on the literature the triptans and telcagepant are rated in a table for efficacy and tolerability.
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