Sumatriptan

By Medically reviewed by hellodoktor

Generic Name: Sumatriptan Brand Name(s): Sumatriptan.

Uses

What is Sumatriptan used for?

Sumatriptan is used to treat migraines. It helps to relieve headache, pain, and other migraine symptoms (including nausea, vomiting, sensitivity to light/sound). Prompt treatment helps you return to your normal routine and may decrease your need for other pain medications. Sumatriptan belongs to a class of drugs known as triptans. It affects a certain natural substance (serotonin) that causes narrowing of blood vessels in the brain. It may also relieve pain by affecting certain nerves in the brain.

Sumatriptan does not prevent future migraines or lessen how often you get migraine attacks.

How should I take Sumatriptan?

Take this medication by mouth with or without food as directed by your doctor, at the first sign of a migraine. The dosage is based on your medical condition and response to treatment. If there is no improvement in your symptoms, do not take more doses of this medication before talking to your doctor. If your symptoms are only partly relieved, or if your headache comes back, you may take another dose at least two hours after the first dose. Do not take more than 200 milligrams in a 24-hour period.

This medication may also be used as a backup for sumatriptan injection. If your symptoms are only partly relieved or your headache comes back, you may take a dose of sumatriptan by mouth at least two hours after the injection, up to a maximum of 100 milligrams in a 24-hour period.

If you have a higher risk for heart problems, your doctor may perform a heart exam before you start taking sumatriptan. He/she may also direct you to take your first dose of this medication in the office/clinic to monitor for serious side effects (such as chest pain). Talk to your doctor for details.

If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Tell your doctor if you need to use this medication more often, or if the medication is not working as well, or if your headaches get worse.

How do I store Sumatriptan?

Sumatriptan is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Sumatriptan in the bathroom or the freezer. There may be different brands of Sumatriptan that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Sumatriptan down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Sumatriptan?

Before using sumatriptan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood circulation problems (for example, in your legs, arms/hands, or stomach), certain types of headaches (hemiplegic or basilar migraine), heart problems (such as chest pain, irregular heartbeat, previous heart attack), liver disease, seizure, stroke or “mini-stroke” (transient ischemic attack).

Certain conditions can increase your risk for heart problems. Tell your doctor if you have any of these conditions, including: high blood pressure, high cholesterol, diabetes, family history of heart disease, overweight, smoker, postmenopausal (women), age more than 40 years (men).

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

The risk of heart disease, liver disease, and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk in small amounts. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Sumatriptan during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Sumatriptan. Sumatriptan is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Sumatriptan?

Flushing, feelings of tingling/numbness/prickling/heat, tiredness, weakness, drowsiness, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: blue fingers/toes/nails, cold hands/feet, hearing changes, mental/mood changes.

Sumatriptan can commonly cause chest/jaw/neck tightness, pain, or pressure that is usually not serious. However, these side effects are like symptoms of a heart attack, which may include chest/jaw/left arm pain, shortness of breath, or unusual sweating. Get medical help right away if these or other seriousfast/irregular heartbeat, fainting, severe stomach/abdominal pain, bloody diarrhea, seizure, signs of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes, confusion).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Sumatriptan?

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

If you also take any ergotamine medication (such as dihydroergotamine) or other “triptan” drugs (such as zolmitriptan, rizatriptan), you will need to separate your sumatriptan dose from your dose of these other medications to lessen the chance of serious side effects. Ask your doctor how long you should wait between your doses of these drugs.

Sumatriptan may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Sumatriptan?

Sumatriptan may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Sumatriptan?

Sumatriptan may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Sumatriptan.

What is the dose of Sumatriptan for an adult?

Usual Adult Dose for Migraine

Use only after a clear diagnosis of migraine has been established

Oral:

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

-If some response to first dose occurs, a second dose may be administered at least 2 hours after first dose if needed

-Oral doses of 50 and 100 mg may provide greater relief than 25 mg; however, a 100 mg dose may not provide greater effect than a 50 mg dose

Maximum dose: 200 mg per 24 hours

Subcutaneous:

Initial dose: 1 to 6 mg subcutaneously, once

-If some response to first dose occurs, a second dose may be administered at least 1 hour after first dose if needed.

Maximum dose: 12 mg per 24 hours

Intranasal:

Nasal spray: 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

Maximum dose: 40 mg per 24 hours

Nasal capsule/powder: Initial dose: 11 mg into each nostril via Xsail (R) breath-powered delivery device once

-If symptoms have not resolved in 2 hours, or return after transient improvement a second dose may be administered at least 2 hours after the first dose

Maximum dose: 2 doses (44 mg/4 nosepieces) per 24 hours

Comments:

-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.

Use: For the acute treatment of migraine with or without aura.

Usual Adult Dose for Cluster Headache

Subcutaneous injection:

Initial dose: 6 mg subcutaneously, once. If symptoms recur, the dose may be repeated if at least 1 hour has elapsed since the first dose.

Maximum dose: 12 mg per 24 hours

Comments:

-Treatment should be started at the first sign of cluster headache, or associated symptoms such as nausea, vomiting, or photophobia. This drug should not be used prophylactically.

-The safety of treating an average of more than 4 headaches in a 30 day period has not been established.

Use: For the acute treatment of cluster headache.

Liver Dose Adjustments

Mild to moderate liver dysfunction:

Oral tablets: Maximum single dose of 50 mg should not be exceeded

Nasal spray: Data not available

Subcutaneous injection: No adjustment recommended

Severe liver dysfunction: Contraindicated

Dose Adjustments

Elderly:

-Dose selection for the older patient should be cautious, generally starting at the lower end of the dosing range due to a greater frequency of hepatic, renal, cardiac impairment as well as presence of concomitant disease or drug therapy.

For patients initiating therapy with subcutaneous injections:

-If migraine returns after an initial dose of subcutaneous injection, additional oral doses may be given up to 100 mg orally per day, with at least a 2 hour interval between tablet doses.

For patients initiating therapy with Xsail(R) Breath Powdered Delivery Device:

-If migraine returns after an initial intranasal dose, 1 dose of another sumatriptan product may be given as long as at least 2 hours has elapsed since intranasal administration.

Other Comments

Administration advice:

Oral tablets: Swallow whole with water or other liquids

Nasal spray: A 10 mg intranasal dose may be administered as 5 mg in each nostril.

Nasal capsule/powder: Administer using Xsail (R) breath-powered delivery device (see preparation below)

Subcutaneous injection: For subcutaneous use only; do not give IV or IM

-Preferred administration sites are the subcutaneous tissues of the lateral aspect of the thighs or the subcutaneous tissues overlying the deltoid muscles.

-An autoinjection system is available for self-administration.

-Needleless administration (Sumavel DosePro[R]) should be administered in the abdomen at least 2 inches from navel or thigh; do not give in the arm.

Preparation:

Xsail (R) Breath-Powered Delivery Device:

-Remove device cover; remove disposable nosepiece from foil pouch and insert into the device until a click is heard; fully press and release white button to pierce capsule.

-Insert nosepiece deeply into 1 nostril while rotating the device to place mouthpiece in mouth; blow forcefully through mouthpiece for 2 to 3 seconds to deliver powder into nasal cavity; vibration (e.g., a rattling noise) may be heard and this indicates the patients is blowing forcefully as directed.

-Once the first nosepiece has been administered, press the clear tab and remove the first nosepiece; check to see if the medication is gone from the capsule; discard used nosepiece and repeat with a second nosepiece in the second nostril; it is normal to see a thin white residue after use.

Storage requirements: The manufacturer’s product information should be consulted.

General:

-The first dose of this drug should be administered by, or under the direct supervision of, a physician in a medically supervised setting in patients with multiple cardiovascular risk factors who have a negative cardiovascular examination.

-This drug should not be used for prophylaxis.

-If a patient has no response to treatment, reconsider diagnosis before treating any subsequent attacks.

-All patients should be counseled on proper use of product including disposal.

General monitoring:

-Cardiovascular: Signs or symptoms consistent with ischemic heart disease

-Gastrointestinal: Abdominal pain and bloody diarrhea

-Local: Injection site reactions (subcutaneous injection)

-Nervous system: Atypical headache; medication overuse headache; signs or symptoms of cerebrovascular events such as stroke, serotonin syndrome

Patient advice:

-Take this medicine as soon as possible after the onset of a migraine or cluster headache or associated symptoms such as nausea, vomiting, or photophobia.

-If you do not get relief from the first dose of this medicine, do not take a second dose without first talking to your healthcare provider.

-Use of this medicine for 10 or more days per month may exacerbate headaches; use a headache diary to record how often you have a headache and when you take this medicine.

-Follow the instruction leaflet for the correct administration of the nasal spray, nasally administered breath-powered delivery system, subcutaneous injection or autoinjector device and the safe disposal after use.

-Drowsiness may occur during a migraine or during its treatment with this drug. Do not drive or operate machinery until you know how this drug affects you.

What is the dose of Sumatriptan for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Sumatriptan available?

Sumatriptan is available in the following dosage forms and strengths:

  • Oral tablet,
  • Subcutaneous solution,
  • Subcutaneous kit,
  • Nasal spray,
  • Transdermal film, extended release,
  • Nasal capsule.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Sumatriptan, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 1, 2018 | Last Modified: September 12, 2019

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