Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Sumatriptan is a drug that is used for
treating migraine headaches. It belongs to a class of drugs called selective
serotonin receptor agonists. Other members of this class include
naratriptan
(Amerge), zolmitriptan (Zomig),
rizatriptan (Maxalt),
frovatriptan (Frova),
eletriptan (Relpax), and
almotriptan (Axert). Migraine headaches are believed to
result from dilatation of blood vessels in the brain. Sumatriptan relieves
migraines by stimulating serotonin receptors in the brain which cause the
muscles surrounding the blood vessels in the brain to contract and narrow the
blood vessels. At the same time, it also reduces transmission of pain signals by
nerves to the brain. While it is very effective in relieving migraine headaches,
it does not prevent or reduce the number of headaches. The FDA approved
sumatriptan in December 1992.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25, 50, 100 mg. Intranasal Solution: 5, 20 mg.
Injection Solution: 4 and 6 mg/0.5 ml
STORAGE: Sumatriptan should be stored between 2-30 C (36-86 F).
PRESCRIBED FOR: All formulations of sumatriptan are used for acute
treatment of migraine headaches with or without an aura in adults. The
injectable formulation also is used for
treating cluster headaches.
DOSING: The recommended oral dose is 25-100 mg and the maximum dose is
200 mg daily. The recommended intranasal dose is 5-20 mg and the maximum dose is
40 mg daily. The recommended injection dose is 4 or 6 mg injected under the
skin. The maximum dose is two 6 mg injections separated by 1 hour.
DRUG INTERACTIONS: Monoamine oxidase inhibitors, for example,
isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and
procarbazine (Matulane), may reduce the breakdown of sumatriptan in the liver,
leading to increased blood levels and side effects of sumatriptan.
Combining sumatriptan with sibutramine (Meridia), selective serotonin
reuptake inhibitors or SSRIs, including fluoxetine (Prozac), citalopram
(Celexa), paroxetine (Paxil), and sertraline (Zoloft) or serotonin and
norepinephrine reuptake inhibitors, including venlafaxine (Effexor), duloxetine
(Cymbalta), and desvenlafaxine (Pristiq) may increase the concentration of
serotonin in the brain, causing increased serotonin-related side effects.
Administering sumatriptan within 24 hours of treatment with an
ergot-containing medication (dihydroergotamine
[Migranal], ergotamine [Methergine]) is
contraindicated because such combinations increase the likelihood of vasospasms.
PREGNANCY: Safe use in pregnancy has not been established.
NURSING MOTHERS: Sumatriptan is excreted in
breast milk. Infant
exposure may be reduced by avoiding breast feeding for 12 hours after
administration of sumatriptan.
SIDE EFFECTS: Side effects are generally transient. Some common side
effects include pain or tightness in the chest or throat, tingling, flushing,
weakness, dizziness, abdominal discomfort, sweating, nasal irritation, and
injection site reactions. Rarely, allergic reactions have been reported, usually
in individuals who are highly allergic to multiple allergens. Sumatriptan may
elevate blood pressure in individuals with or without a history of high blood
pressure. Individuals with uncontrolled high blood pressure should not use
sumatriptan. Sumatriptan rarely has been associated with coronary artery spasm,
heart attacks, stroke,
abnormal heart beats, and
seizures.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
The term cluster headache is a type of headache that recurs over a period of time. There are episodes that last one to three times a day during a period of time, which may last from 2 weeks to 3 months. There are three main types of treatment abortive medications, preventive medications, or surgery which involves blocking the trigeminal nerve.
The term "cluster headache" refers to a type of headache that recurs over a period of time. People who have cluster headaches experience an episode one to three times per day during a period of time (the cluster period), which may last from 2 weeks to 3 months. The headaches may disappear completely (go into "remission") for months or years, only to recur. A cluster headache typically awakens a person from sleep 1 to 2 hours after going to bed. These nocturnal attacks can be more severe than the daytime attacks. Attacks appear to be linked to the circadian rhythm (or "biological" clock). Most people with cluster headaches will develop cluster periods at the same time each year -- either in the spring or fall or the winter or summer.
Cluster headaches are one of the most severe types of headache. It can be 100 times more intense than a migraine attack.
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