Reyvow (Lasmiditan) - Oral

What Is Reyvow?

Reyvow (lasmiditan) is an oral prescription medication used to treat migraine episodes in adults. It comes in tablet form.

This medication is considered a ditan, which is a drug category that works against migraines through its action as a serotonin (5-HT) 1F receptor agonist.

Reyvow is classified as a Schedule V controlled substance, meaning it has the potential for abuse or dependence.

Drug Facts

Generic Name: Lasmiditan

Brand Name(s): Reyvow

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Antimigraine

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Lasmiditan

Dosage Form(s): Tablet

What Is Reyvow Used For?

The Food and Drug Administration (FDA) approved Reyvow for the acute treatment of migraines, with or without aura, in adults.

Migraines are episodic events usually characterized by severe headaches, often with other symptoms such as nausea, dizziness, neck pain, and irritability. Sometimes these episodes also involve an aura, including symptoms such as seeing spots or visual changes. 

This medication is used during a migraine episode to make the symptoms go away. It cannot prevent migraines from occurring, so you shouldn’t take it when you don’t have a migraine.

Reyvow ( Lasmiditan ) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Reyvow

You can take Reyvow with or without food. It is meant to be taken during a migraine episode and used as needed, with a maximum of one dose in 24 hours. When taking your dose, swallow the tablets whole. Do not crush, split, or chew them.

Storage

Store this medication in its original container. Because Reyvow is a controlled substance, it is crucial to keep it in a protected place away from children or pets.

Keep it at a standard room temperature of 68 degrees to 77 degrees Fahrenheit (F). You can briefly keep it in temperatures of at least 59 degrees to 86 degrees F.

How Long Does Reyvow Take to Work?

Reyvow can begin to have effects within an hour or two. Clinical studies showed pain relief within two hours after taking Reyvow for a migraine attack.

What Are the Side Effects of Reyvow?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Reyvow are:

  • Dizziness
  • Fatigue
  • Paresthesia (tingling or other unusual sensations in one or more areas of the body) 
  • Sleepiness

The sedative effects of this medication that cause sleepiness may last for eight hours or longer. This side effect can cause serious consequences if you drive or use dangerous equipment after taking this medication. Be aware of how Reyvow affects you before doing anything that requires alertness.

Severe Side Effects

Serotonin syndrome is a rare and potentially dangerous side effect of Reyvow, especially if you take Reyvow in combination with antidepressant medications called selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors.

Signs of serotonin syndrome include:

  • Irritability or agitation 
  • Fever, sweating, and/or shivering 
  • Nausea and vomiting 
  • Diarrhea 
  • Fast heartbeat 
  • Increased blood pressure 
  • Dilated (widened) pupils 
  • Confusion 
  • Muscle stiffness, which can impair your ability to breathe

These symptoms can progress rapidly, so seek immediate medical attention if you notice any signs. Although serotonin syndrome is dangerous, it is treatable. If you develop this side effect, your healthcare provider will recommend that you stop using Reyvow and avoid other medications that can cause serotonin syndrome.

Medication overuse headache, also known as a rebound headache, can also occur with Reyvow. Medication overuse headaches occur when your headaches worsen due to using acute migraine therapies too much (often 10 or more days each month). Tell your healthcare provider if you experience this. They may decide to stop your treatment.

Long-Term Side Effects

This medication is a controlled substance that has the potential to be abused and overused. Some people have reported a feeling of euphoria when using this drug, which can lead to abuse.

Report Side Effects

Reyvow may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Reyvow Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For migraine headaches:
      • Adults—50 milligrams (mg), 100 mg, or 200 mg per day, as needed. Do not take more than one dose within 24 hours.
      • Children—Use and dose must be determined by your doctor.

Modifications

Your healthcare provider will prescribe this medication at the lowest dose that controls your migraines. There are no established dosing adjustments used for specific medical conditions.

Missed Dose

You will use Reyvow as needed to treat migraine attacks when they happen. If you don’t have a chance to take Reyvow when your migraine first occurs, you can take it if your symptoms do not improve.

Overdose: What Happens If I Take Too Much Reyvow?

Taking too much Reyvow at one time or within 24 hours can increase your risk of side effects, including serotonin syndrome.

Taking too much of this medication or taking it too frequently can cause medication overuse headaches. As the medicine wears off, the imbalance of serotonin may increase your chance of developing a migraine—increasing your tendency to take it and causing more severe or frequent migraines.

What Happens If I Overdose on Reyvow?

If you think you or someone else may have overdosed on Reyvow, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses, has a seizure, has trouble breathing, or can’t wake up after taking too much Reyvow, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Check with your doctor if you used this medicine and your migraine did not go away, or if your migraine got worse or started occurring more often.

Lasmiditan may cause drowsiness or dizziness. Wait at least 8 hours after taking lasmiditan before you drive, use machines, or do anything else that requires you to be alert.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with lasmiditan may worsen the side effects of this medicine, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

Using lasmiditan alone or in combination with other migraine medicines for 10 or more days per month may lead to worsening of headache. You may keep a headache diary to record your headache frequency and drug use.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Reyvow?

In certain cases, Reyvow may not be the preferred treatment option. Avoid taking this medication if you have had serotonin syndrome in the past.

You also should not take a dose of Reyvow if you are unable to avoid driving or operating machinery for at least eight hours. If you know this medication makes you excessively tired, make sure you take it when you know you do not have to drive or use machinery when your drowsiness lasts, even if that is longer than eight hours.

What Other Medications Interact With Reyvow?

Other medications and substances can interact with Reyvow, sometimes causing more severe side effects when combined. These include:

  • Alcohol or sedative medications: Taken with Reyvow, these can make sedation more severe.
  • Other serotonergic drugs that can increase the risk of serotonin syndrome such as SSRIs, SNRIs, tricyclic antidepressants, monoamine oxidase inhibitors, trazodone, dextromethorphan, or St. John’s Wort.
  • Medications that can lower your heart rate, such as propranolol
  • Medications that are P-gp substrates, such as digoxin, and breast cancer resistant protein (BCRP) substrates, such as methotrexate

What Medications Are Similar?

Other prescription medications used to treat acute migraine episodes include:

  • Triptans
  • Calcitonin gene-related (CGRP) peptide antagonists

Triptans such as Imitrex (sumatriptan) and Relpax (eletriptan) are similar to Reyvow, but they bind to the 5-HT1B and 5-HT1D receptors, which can cause blood vessel constriction (narrowing). People who are at risk of heart attacks or stroke should not take Triptans. However, Reyvow is considered safe to take if you have these risks.

CGRP peptide antagonists used to treat migraines include Ubrelvy (ubrogepant) and Aimovig (erenumab), and Nurtec (rimegepant).

Frequently Asked Questions

  • What is Reyvow used for?

    Reyvow is used to treat ongoing migraines in adults.

  • How does Reyvow work?

    Reyvow is a serotonin (5-HT) 1F receptor agonist. It is also classified as a ditan. It promotes the effects of serotonin, a neurotransmitter that is involved in mediating pain and migraines.

  • What drugs should not be taken with Reyvow?

    You should not take this medication with sedatives, medications that lower blood pressure, serotonergic medications (including many antidepressants and St. John’s Wort), or P-gp and breast cancer resistant protein (BCRP) substrates (which are used in the treatment of certain types of cancer).

  • How long does it take for Reyvow to work?

    Reyvow can begin to have effects within an hour or two. In clinical studies, people who took Reyvow within four hours of migraine onset were significantly more likely to be pain-free two hours after treatment compared with those who received a placebo.

  • What are the side effects of Reyvow?

    The side effects of Reyvow can include tingling, dizziness, severe fatigue, and sleepiness. It can also rarely cause serotonin syndrome, a dangerous side effect.

    Reyvow can also lead to abuse or dependence. Taking too much can also cause medication overuse headache, which can make your headaches worse.

  • How do I safely stop taking Reyvow?

    You can stop using Reyvow for your migraines if you do not experience any benefits or if the side effects bother you. If you don’t think Reyvow is the right medication for you, talk to your healthcare provider about other treatment options.

How Can I Stay Healthy While Taking Reyvow?

If you have migraines, your healthcare provider may prescribe Reyvow to help treat migraine attacks. In addition to taking your medication as needed, there are other steps you can take to stay healthy and find migraine relief.

Considerations for staying safe and healthy when taking this medication include:

  • Avoid your migraine triggers whenever possible. These can include certain foods or smells, sleep deprivation, skipping meals, bad posture, and excessive stress. 
  • Consider taking another medication, such as an over-the-counter anti-inflammatory (such as ibuprofen) for your milder headaches to avoid overusing Reyvow.  
  • When you need to take your dose of Reyvow, add lifestyle modifications to help reduce your migraine symptoms. These can include avoiding bright lights and loud noises, an ice pack, a heating pad, or relaxing—whichever strategy works for you. 
  • Do not drive, climb ladders, swim alone, or use machinery when you feel drowsy from this medication. 

Talk to your healthcare provider if your migraines are becoming more severe or frequent. Get prompt medical attention if you develop serious side effects.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Maiti R, Mishra A, Puliappadamb HM, Jena M, Srinivasan A. Efficacy and safety of lasmiditan for acute treatment of migraine in adults: a meta-analysis. J Clin Pharmacol. 2021;61(12):1534-1544. doi:10.1002/jcph.1962

  2. Food and Drug Administration. Reyvow label.

  3. Johnston K, Popoff E, Deighton A, et al. Comparative efficacy and safety of rimegepant, ubrogepant, and lasmiditan for acute treatment of migraine: a network meta-analysis. Expert Rev Pharmacoecon Outcomes Res. 2021;22(1):155-166. doi:10.1080/14737167.2021.1945444

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.