General Information

Reyvow (lasmiditan) is a serotonin (5-HT) 1F receptor agonist.

Reyvow is specifically indicated for the acute treatment of migraine with or without aura in adults.

Reyvow is supplied as a tablet for oral administration. The recommended dose of Reyvow is 50 mg, 100 mg, or 200 mg taken orally, as needed. No more than one dose should be taken in 24 hours, and Reyvow should not be taken unless the patient can wait at least 8 hours between dosing and driving or operating machinery. A second dose of Reyvow has not been shown to be effective for the same migraine attack. The safety of treating an average of more than 4 migraine attacks in a 30-day period has not been established. Reyvow may be taken with or without food.

Mechanism of Action

Reyvow (lasmiditan) binds with high affinity to the 5-HT1F receptor. Lasmiditan presumably exerts its therapeutic effects in the treatment of migraine through agonist effects at the 5-HT1F receptor; however, the precise mechanism is unknown.

Side Effects

Adverse effects associated with the use of Reyvow may include, but are not limited to, the following:

• dizziness
• fatigue
• paresthesia
• sedation

There is a risk of driving impairment while taking Reyvow. Patients are advised not to drive or operate machinery for at least eight hours after taking Reyvow, even if they feel well enough to do so. Patients who cannot follow this advice are advised not to take Reyvow. The drug causes central nervous system (CNS) depression, including dizziness and sedation. It should be used with caution if taken in combination with alcohol or other CNS depressants.

Clinical Trial Results

The FDA approval of Reyvow was based on two randomized, double-blind, placebo-controlled trials (SAMURAI and SPARTAN). A total of 3,177 adult patients with a history of migraine with and without aura treated a migraine attack with Reyvow. In both studies, the percentages of patients whose pain resolved and whose most bothersome migraine symptom (nausea, light sensitivity, or sound sensitivity) resolved two hours after treatment were significantly greater among patients receiving Reyvow at all doses compared to those receiving placebo. The percentage of responders is listed below: 

SAMURAI: Reyvow 100 mg (28.3%); Reyvow 200 mg (31.8%) and placebo (15.3%)

SPARTAN: Reyvow 50 mg (28.3%); Reyvow 100 mg (31.4%); Reyvow 200 mg (38.8%) and placebo (21.0%)