Is Reyvow A Controlled Substance? Plus 5 Other Reyvow FAQs

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Reyvow (lasmiditan) is a prescription medication used to treat migraine headaches. But there's a bit more to taking Reyvow than just swallowing a pill. Knowing how to take it and what risks to watch out for can help you get the most out of your medication while also staying safe.

Here, we'll answer six frequently asked questions about this medication, including whether Reyvow is a controlled substance and how it works.

1. Is Reyvow a controlled substance?

Yes. Reyvow is a controlled substance. This means that it has a higher risk of misuse and dependence than medications that aren't controlled substances. All controlled substances also have restrictions around how they're prescribed and refilled.

Controlled substances fall into specific categories called "schedules." Schedules range from 1 to 5. Schedule 1 substances are considered to have the greatest risk of causing misuse or dependence. Schedule 5 substances are considered the least risky of the controlled substances but still riskier than non-controlled medications.

Reyvow is classified as a "Schedule 5" controlled substance. So it's less likely to cause misuse and dependence than medications in Schedules 1 through 4, such as opioids (which are in Schedule 2).

Following your prescriber's directions on how to take Reyvow can help prevent misuse. For example, only take 1 tablet per dose, and don't take Reyvow more frequently than what's recommended (one dose per 24-hour period and a maximum of four doses per 30 days).

If you or someone you know struggles with substance use, help is available. Call SAMHSA's National Helpline at 1-800-662-4357 to learn about resources in your area.

2. Is Reyvow a triptan?

No. Reyvow is different from triptans, a common group of migraine medications. Triptans include rizatriptan (Maxalt) and sumatriptan (Imitrex, Zembrace SymTouch, Tosymra, and others).

Triptans and Reyvow both attach to specific binding sites (receptors) in the body called serotonin receptors, but they affect different types of serotonin receptors (more on that below). And although they have some common side effects, such as dizziness and a "pins and needles" sensation, they also have different side effects. For example, sumatriptan can cause you to feel hot or cold, and it can also cause chest pain. Reyvow isn't known to cause these side effects, since it doesn't narrow blood vessels like triptans do.

Triptans and other migraine-relief medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are typically the preferred migraine treatments over Reyvow. But your prescriber might recommend Reyvow if NSAIDs or triptans aren't working for you or if you have a medical reason to avoid these medications.

3. How does Reyvow work?

It's not completely understood how Reyvow works. But we know that it activates a specific type of serotonin receptor in your brain. Serotonin is a chemical messenger that regulates many bodily functions. Low levels of serotonin can contribute to several health conditions, including migraines.

However, Reyvow's effects on serotonin are probably not how it treats migraines. Its anti-migraine effects are likely due to the fact that binding to these serotonin receptors blocks the release of two substances - calcitonin gene-related peptide (CGRP) and glutamate. CGRP is a protein, and glutamate is a chemical messenger. By blocking CGRP and glutamate, Reyvow reduces pain and inflammation caused by migraines.

Reyvow is unique because it's the only medication of its kind to treat migraines in this way.

4. How long does Reyvow stay in your system?

Reyvow can stay in your system for about a day. Because Reyvow lasts this long, and has side effects including dizziness and drowsiness, the manufacturer recommends avoiding driving or operating heavy machinery for at least 8 hours after you take a dose (when Reyvow levels are highest in your blood). After this, you should be able to resume your normal activities, as long as you feel up to it.

Another important question you might be wondering about is how long the effects of Reyvow last. Studies of Reyvow have found that more people taking Reyvow are pain-free at 24 and 48 hours after a dose than people taking a placebo (a pill with nothing therapeutic in it). At 24 hours, about 21% of people taking Reyvow 200 mg were pain-free. At 48 hours, this number dropped slightly to 18%.

5. How quickly does Reyvow work?

Reyvow may start working within 1 to 2 hours. A large study of Reyvow, called the Centurion study, compared Reyvow to a placebo. With close to 1,500 participants, the researchers found the following results:

• 1 hour after a dose: Close to 50% of people taking Reyvow 100 mg or 200 mg experienced pain relief. About 13% of people taking Reyvow 200 mg, and about 6% of people taking Reyvow 100 mg, were completely pain-free.

• 2 hours after a dose: Over 60% of people taking Reyvow 100 mg or 200 mg experienced pain relief. About 30% of people taking Reyvow 200 mg, and 26% of people taking Reyvow 100 mg, were completely pain-free.

These results show that Reyvow may be more effective than a placebo, but it doesn't work for everyone. However, even if Reyvow isn't working for you, you should only take one dose of Reyvow per 24-hour period. Taking a second dose hasn't been found to be more effective, and your risk of side effects increases. So if Reyvow isn't working for you, let your prescriber know. You may need a different medication.

6. Is Reyvow safe?

Yes. Reyvow is approved by the FDA, which means it was found to be safe and effective in clinical trials. Still, there are possible side effects that can occur when taking Reyvow. Common Reyvow side effects include:

• Dizziness

• Drowsiness

• Fatigue or weakness

• Nausea and vomiting

• "Pins and needles," or a tingling sensation

You might also experience more serious (but less common) side effects, including serotonin syndrome, increased blood pressure, and vision problems. And as mentioned above, Reyvow can cause dependence and misuse.

Although serious risks with Reyvow are rare, contact your healthcare team if you have side effects that don't improve. They can recommend ways to relieve your symptoms. If you feel that your symptoms are severe or life-threatening, get emergency medical care by calling 911 or going to the nearest emergency room.

Reyvow hasn't been studied in people who are pregnant, so we don't know if it's safe. Let your prescriber know if you are or plan to become pregnant. They can help you decide which medication or treatment approach is best for you.

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