Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: sumatriptan
BRAND NAME: Imitrex
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.
Reference: FDA Prescribing Information
Last Editorial Review: 2/27/2009
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