sumatriptan (Nasal route, Oral route, Subcutaneous route)

soo-ma-TRIP-tan

Commonly used brand name(s):

In the U.S.

• Imitrex

Available Dosage Forms:

• Spray
• Tablet
• Kit
• Solution

Therapeutic Class: Antimigraine

Pharmacologic Class: Serotonin Receptor Agonist, 5-HT1

Uses For sumatriptan

Sumatriptan is used to treat severe migraine headaches. Many people find that their headaches go away completely after they take sumatriptan. Other people find that their headaches are much less painful, and that they are able to go back to their normal activities even though their headaches are not completely gone. Sumatriptan often relieves other symptoms that occur together with a migraine headache, such as nausea, vomiting, sensitivity to light, and sensitivity to sound.

Sumatriptan is not an ordinary pain reliever. It will not relieve any kind of pain other than migraine headaches. sumatriptan is usually used for people whose headaches are not relieved by acetaminophen, aspirin, or other pain relievers.

Sumatriptan injection is also used to treat cluster headaches.

Sumatriptan has caused serious side effects in some people, especially people who have heart or blood vessel disease. Be sure that you discuss with your doctor the risks of using sumatriptan as well as the good that it can do.

Sumatriptan is available only with your doctor's prescription.

Before Using sumatriptan

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sumatriptan, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to sumatriptan or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

sumatriptan has been tested in a limited number of children aged 12 to 17 years, however use is not recommend in children younger than 18 years of age.

Geriatric

Use of sumatriptan in elderly patients is not recommended.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using sumatriptan with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Almotriptan
• Dihydroergotamine
• Ergoloid Mesylates
• Ergonovine
• Ergotamine
• Frovatriptan
• Isocarboxazid
• Linezolid
• Methylergonovine
• Methysergide
• Naratriptan
• Phenelzine
• Procarbazine
• Rizatriptan
• Tranylcypromine
• Zolmitriptan

Using sumatriptan with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Citalopram
• Desvenlafaxine
• Dexfenfluramine
• Duloxetine
• Escitalopram
• Fluoxetine
• Fluvoxamine
• Milnacipran
• Paroxetine
• Reboxetine
• Sertraline
• Sibutramine
• St John's Wort
• Tapentadol
• Venlafaxine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of sumatriptan. Make sure you tell your doctor if you have any other medical problems, especially:

• Angina (chest pain) or
• Fast or irregular heartbeat or
• Heart or blood vessel disease or
• High blood pressure or
• Kidney disease or
• Liver disease or
• Stroke (history of)—The chance of side effects may be increased. Heart or blood vessel disease and high blood pressure sometimes do not cause any symptoms, so some people do not know that they have these problems. Before deciding whether you should use sumatriptan, your doctor may need to do some tests to make sure that you do not have any of these conditions.

Proper Use of sumatriptan

Do not use sumatriptan for a headache that is different from your usual migraines . Instead, check with your doctor.

To relieve your migraine as soon as possible, use sumatriptan as soon as the headache pain begins. Even if you get warning signals of a coming migraine (an aura), you should wait until the headache pain starts before using sumatriptan. Using sumatriptan during the aura probably will not prevent the headache from occurring. However, even if you do not use sumatriptan until your migraine has been present for several hours, the medicine will still work.

Lying down in a quiet, dark room for a while after you use sumatriptan may help relieve your migraine.

If you are not much better in 1 or 2 hours after an injection of sumatriptan or after sumatriptan nasal solution, or in 2 to 4 hours after a tablet is taken, do not use any more of sumatriptan for the same migraine. A migraine that is not relieved by the first dose of sumatriptan probably will not be relieved by a second dose, either. Ask your doctor ahead of time about other medicine to be taken if sumatriptan does not work. After taking the other medicine, check with your doctor as soon as possible. Headaches that are not relieved by sumatriptan are sometimes caused by conditions that need other treatment. However, even if sumatriptan does not relieve one migraine, it may still relieve the next one.

If you feel much better after a dose of sumatriptan, but your headache comes back or gets worse after a while, you may use more sumatriptan. However, use sumatriptan only as directed by your doctor. Do not use more of it, and do not use it more often, than directed. Using too much sumatriptan may increase the chance of side effects.

Your doctor may direct you to take another medicine to help prevent headaches. It is important that you follow your doctor's directions, even if your headaches continue to occur. Headache-preventing medicines may take several weeks to start working. Even after they do start working, your headaches may not go away completely. However, your headaches should occur less often, and they should be less severe and easier to relieve. This can reduce the amount of sumatriptan or pain relievers that you need. If you do not notice any improvement after several weeks of headache-preventing treatment, check with your doctor.

For patients taking sumatriptan tablets:

• Sumatriptan tablets are to be swallowed whole with a full glass of water. Do not break, crush, or chew the tablets before swallowing them.

For patients using sumatriptan injection:

• sumatriptan comes with patient directions. Read them carefully before using the medicine, and check with your health care professional if you have any questions.
• Your health care professional will teach you how to inject yourself with the medicine. Be sure to follow the directions carefully. Check with your health care professional if you have any problems using the medicine.
• After you have finished injecting the medicine, be sure to follow the precautions in the patient directions about safely discarding the empty cartridge and the needle. Always return the empty cartridge and needle to their container before discarding them. Do not throw away the autoinjector unit, because refills are available.

For patients using sumatriptan nasal solution :

• sumatriptan comes with patient directions. Read them carefully before using the medicine, and check with your health care professional if you have any questions.

Dosing

The dose of sumatriptan 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 sumatriptan. 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 nasal dosage form (nasal solution):
  • For migraine headaches:
    • Adults—5 milligrams (mg) (1 spray into one nostril) or 10 mg (2 sprays in one nostril or 1 spray in each nostril) or 20 mg (1 spray into one nostril). If pain is not relieved, another spray (5 mg, 10 mg, or 20 mg) should not be used for the same migraine attack. Another spray (5 mg, 10 mg, or 20 mg) may be used for a migraine that occurs at a later time as long as it has been at least two hours since the last spray. Do not use more than 40 mg in a twenty-four-hour period (one day).
    • Children—Use and dose must be determined by your doctor.
• For oral dosage form (tablets):
  • For migraine headaches:
    • Adults—25, 50 or 100 mg as a single dose. If you get some relief, or if the migraine comes back after being relieved, another dose may be taken two hours after the last dose. Do not take more than 200 mg in any twenty-four-hour period. If you are taking the tablets after using an injection, you may take single doses up to 100 mg a day with two hours between doses. Do not take more than 200 mg in a twenty-four-hour period.
    • Children—Use and dose must be determined by your doctor.
• For parenteral dosage form (injection):
  • For migraine or cluster headaches:
    • Adults—One 6-mg injection. One more 6-mg dose may be injected, if necessary, if the migraine comes back after being relieved. However, the second injection should not be given any sooner than one hour after the first one. Do not use more than two 6-mg injections in a twenty-four-hour period (one day). However, some people may be directed to use no more than two 6-mg doses in a forty-eight-hour period (two days).
    • Children—Use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using sumatriptan

Check with your doctor if you have used sumatriptan for three headaches, and have not had good relief. Also, check with your doctor if your migraine headaches are worse, or if they are occurring more often, than before you started using sumatriptan.

Drinking alcoholic beverages can make headaches worse or cause new headaches to occur. People who suffer from severe headaches should probably avoid alcoholic beverages, especially during a headache.

Some people feel drowsy or dizzy during or after a migraine, or after taking sumatriptan to relieve a migraine. As long as you are feeling drowsy or dizzy, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

sumatriptan Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Most side effects of sumatriptan are milder and occur less often with the tablets than with the injection. Although not all of these side effects may occur, if they do occur they may need medical attention.

Stop taking sumatriptan and get emergency help immediately if any of the following effects occur:

• Chest pain (severe)
• changes in skin color on face
• convulsions (seizures)
• fast or irregular breathing
• puffiness or swelling of eyelids, area around the eyes, face, or lips
• shortness of breath, troubled breathing, or wheezing

Check with your doctor immediately if any of the following side effects occur:

• Chest pain (mild)
• heaviness, tightness, or pressure in chest and/or neck

Check with your doctor as soon as possible if any of the following side effects occur:

• Difficulty in swallowing
• pounding heartbeat
• skin rash, hives, itching, or bumps on skin

Other side effects may occur that usually do not need medical attention. Some of the following effects, such as nausea, vomiting, drowsiness, dizziness, and general feeling of illness or tiredness, often occur during or after a migraine, even when sumatriptan has not been used. Most of the side effects caused by sumatriptan go away within a short time (less than 1 hour after an injection or 2 hours after a tablet). However, check with your doctor if any of the following side effects continue or are bothersome:

• Burning, discharge, pain, and/or soreness in the nose
• burning, pain, or redness at place of injection
• change in sense of taste
• discomfort in jaw, mouth, tongue, throat, nose, or sinuses
• dizziness
• drowsiness
• feeling of burning, warmth, heat, numbness, tightness, or tingling
• feeling cold, “strange,” or weak
• flushing
• lightheadedness
• muscle aches, cramps, or stiffness
• nausea or vomiting

• Anxiety
• general feeling of illness or tiredness
• vision changes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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