Sumatriptan

Sumatriptan is a prescription medicine used to treat acute migraine headaches. Sumatriptan works by narrowing blood vessels around the brain and reducing substances in the body that can trigger headache pain, nausea, sensitivity to light, and sound. Sumatriptan treats acute migraine, it will not prevent migraine or reduce the number of migraine attacks.

Sumatriptan is taken at the first sign of migraine symptoms and usually starts to work within 30 minutes; injections work more quickly. Sumatriptan is available as oral tablets, a nasal spray, and injections.

Sumatriptan brand names are Imitrex, Onzetra Xsail, Zembrace Symtouch, and Tosymra. Generic sumatriptan products are also available.

Sumatriptan FDA approval is for the treatment of adults with:

• Acute migraine headaches with or without aura - tablets, capsules, nasal spray, and injection
• Acute cluster headache - injection only

This medicine should only be used if there has been a clear diagnosis of migraine headache. If there is no response to the first migraine attack treated with sumatriptan succinate, then reconsider the diagnosis of migraine before it is administered to treat any further migraine attacks.

The safety and effectiveness of oral or nasal sumatriptan succinate for cluster headaches have not been established.

Sumatriptan succinate should not be used to treat a common tension headache or a headache that causes loss of movement on one side of your body. Use this medicine only if your condition has been confirmed by a doctor as migraine headaches.

Sumatriptan works by activating 5-HT receptors, which causes blood vessels to narrow, reducing pain signals and the sensitivity of pain receptors.

Sumatriptan is one of the triptan medicines used for migraines, its drug class is selective serotonin (5-HT₁) receptor agonists. The sumatriptan mechanism of action is a selective serotonin (5-HT₁B/1D receptor agonist); it mimics serotonin by activating specific serotonin receptors.

Use sumatriptan as soon as you notice your first headache symptoms. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

You may receive your first dose in a hospital or clinic setting to quickly treat any serious side effects.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Sumatriptan tablet

Take a sumatriptan tablet whole with a full glass of water. Do not split the tablet.

Do not take more than 200 milligrams of sumatriptan tablets within 24 hours.

Available as sumatriptan 50mg and sumatriptan 100mg

Sumatriptan injection

Sumatriptan injection is given as a subcutaneous injection (under the skin) using an autoinjector device or a single-use vial and syringe.

Call your doctor if your symptoms do not improve, or if you have more than 4 headaches in one month (30 days). The safety of treating an average of more than 4 headaches in a 30-day period has not been established.or if you have more than 4 headaches in one month (30 days).

Sumatriptan nasal spray

The 5-mg and 20-mg doses are given as a single spray in 1 nostril. The 10-mg dose may be achieved by the administration of a single 5-mg dose in each nostril.

Nasal capsule/powder with Xsail (R) breath-powered delivery device: 11 mg into each nostril once. See “How do you use Onzetra Xsail?” for more information.

You should not use sumatriptan succinate if you have uncontrolled high blood pressure, heart problems, certain heart rhythm disorders, a history of heart attack or stroke, or circulation problems that cause a lack of blood supply within the body.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Also tell your doctor if you are taking an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Sumatriptan succinate will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Do not use Sumatriptan succinate within 24 hours before or after using any other migraine headache medicine.

You should not use sumatriptan succinate if you are allergic to it or any of the inactive ingredients, or if you have ever had:

• heart problems, or a stroke (including "mini-stroke");
• coronary artery disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;
• circulation problems affecting your legs, arms, stomach, intestines, or kidneys;
• a heart disorder called Wolff-Parkinson-White syndrome;
• uncontrolled high blood pressure;
• severe liver disease; or
• a headache that seems different from your usual migraine headaches.

Do not use sumatriptan if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, serious infections, or prevention of nausea and vomiting. These medicines may interact with sumatriptan and cause a serious condition called serotonin syndrome.

To make sure sumatriptan is safe for you, tell your doctor if you have ever had:

• liver or kidney disease;
• epilepsy or other seizure disorder;
• high blood pressure, a heart rhythm disorder; or
• risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, or being older than 40 and a man).

Sumatriptan is not approved for use by anyone younger than 18 years old.

Pregnancy and breastfeeding

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Sumatriptan can pass into breast milk. Do not breast-feed within 12 hours after using this medicine. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.

Common sumatriptan side effects

Common sumatriptan side effects may include:

• pain or tight feeling in your chest, throat, or jaw;
• pressure or heavy feeling in any part of your body;
• numbness or tingling, feeling hot or cold;
• dizziness, drowsiness, weakness;
• unusual or unpleasant taste in your mouth after using the nasal medicine;
• pain, burning, numbness, or tingling in your nose or throat after using the nasal medicine; or
• runny or stuffy nose after using the nasal medicine.

Serious sumatriptan side effects

Get emergency medical help if you have signs of an allergic reaction to sumatriptan: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Other serious side effects of sumatriptan succinate can occur. Stop using sumatriptan and call your doctor at once if you have:

• sudden and severe stomach pain and bloody diarrhea;
• severe chest pain, shortness of breath, irregular heartbeats;
• a seizure (convulsions);
• severe headache, blurred vision, pounding in your neck or ears;
• blood circulation problems in your legs or feet - cramps, tight or heavy feeling, numbness or tingling, muscle weakness, burning pain, cold feeling, color changes (pale or blue), hip pain;
• heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
• high levels of serotonin in the body - agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, vomiting, diarrhea; or
• signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Use only after a clear diagnosis of migraine has been established

Sumatriptan oral dose

Initial dose: 25 mg, 50 mg, or 100 mg orally, once

• If there is a response to the first dose, a second dose may be administered at least 2 hours after the first dose, if needed.
• Oral doses of sumatriptan 50 and sumatriptan 100 mg may provide greater relief than 25 mg; however, a 100 mg dose may not provide greater effect than a sumatriptan 50 mg dose
• The safety of treating an average of more than 4 headaches in a 30-day period has not been established.

Maximum dose: 200 mg per 24 hours

Sumatriptan injection dose

Initial dose: one 6mg subcutaneous injection. If some response to a first injection was observed a second injection may be administered, separated by at least 1 hour from the first dose

• For the treatment of migraine, if side effects are dose limiting, the lower dose of 4 mg may be used.
• For the treatment of cluster headache, the efficacy of lower doses has not been established.

Maximum dose: The maximum dose that may be given in 24 hours is 12 mg, two 6 mg injections separated by at least 1 hour. A second 6 mg dose should only be considered if some response to a first injection was observed.

Sumatriptan nasal spray dose

Initial dose: 5 mg, 10 mg, or 20 mg into one nostril, once

• Administer the 5 and 20 mg doses as a single spray in 1 nostril; the 10 mg dose may be administered as 5 mg into each nostril
• If some response to first dose occurs, a second dose may be administered at least 2 hours after first dose if needed
• The safety of treating an average of more than 4 headaches in a 30-day period has not been established.

Maximum dose: 40 mg per 24 hours

Nasal powder Nasal capsule/powder with Xsail (R) breath-powered delivery device:

Initial dose: 11 mg (1 nose piece) into each nostril once.

• Treatment should be started at the first sign of a migraine headache, or associated symptoms such as nausea, vomiting, or photophobia; this drug should not be used for migraine prophylaxis.
• Higher doses may have a greater effect, but also carry a greater risk of adverse reactions.
• The safety of treating an average of more than 4 headaches in a 30-day period has not been established

Maximum dose: two doses of Onzetra Xsail (44 mg/4 nosepieces) or one dose of Ozetra Xsail and one dose of another sumatriptan product, separated by at least 2 hours.

Since sumatriptan is used when needed, it does not have a daily dosing schedule. Call your doctor if your symptoms do not improve after using this medicine.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include tremors, skin redness in your arms or legs, weakness, loss of coordination, breathing problems, blue-colored lips or fingernails, vision problems, or a seizure (convulsions).

Using sumatriptan succinate while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:

• medicine to treat depression or a psychiatric disorder;
• medicine for Parkinson's disease;
• medicine for serious infections;
• herbal products;
• stimulant medicine;
• opioid medicine; or
• medicine to prevent nausea and vomiting.

This list is not complete. Other drugs may interact with sumatriptan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Do not use Sumitriptan within 24 hours before or after using another migraine headache medicine, including:

• other sumatriptan products, almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, zolmitriptan; or
• ergot medicine such as dihydroergotamine, ergotamine, ergonovine, or methylergonovine.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.