- A Visual Guide to Migraine Headaches Slideshow
- Headache and Migraine Triggers Slideshow
- Take the Migraines Quiz
What is Imitrex (sumatriptan)?
Imitrex (sumatriptan) is a selective serotonin receptor agonist (a “triptan”) used to treat migraine headaches. Migraine headaches are believed to result from dilatation of blood vessels in the brain. Imitrex 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. Imitrex does not prevent or reduce the number of headaches.
Common side effects of Imitrex include:
- pain or tightness in the chest or throat,
- abdominal discomfort,
- nasal irritation,
- injection site reactions, and
- allergic reactions (rare).
Serious side effects of Imitrex are rare and include:
Combining Imitrex with sibutramine, selective serotonin reuptake inhibitors (SSRIs), or serotonin and norepinephrine reuptake inhibitors (SNRIs) may increase the concentration of serotonin in the brain, causing increased serotonin-related side effects.
Administering Imitrex within 24 hours of treatment with an ergot-containing medication is contraindicated because such combinations increase the likelihood of vasospasms.
What are the important side effects of Imitrex (sumatriptan)?
Side effects are generally transient. Some common side effects of sumatriptan:
- pain or tightness in the chest or throat,
- abdominal discomfort,
- 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.
Other important, but rare, side effects associated with sumatriptan include:
Imitrex (sumatriptan) side effects list for healthcare professionals
The following serious adverse reactions are described below and elsewhere in the labeling:
- Myocardial ischemia, myocardial infarction, and Prinzmetal's angina
- Chest, throat, neck, and/or jaw pain/tightness/pressure
- Cerebrovascular events
- Other vasospasm reactions
- Medication overuse headache
- Serotonin syndrome
- Increase in blood pressure
- Hypersensitivity reactions
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Table 1 lists adverse reactions that occurred in 2 US placebo-controlled clinical trials in migraine patients (Studies 2 and 3) following either a single 6-mg dose of Imitrex Injection or placebo. Only reactions that occurred at a frequency of 2% or more in groups treated with Imitrex Injection 6 mg and that occurred at a frequency greater than the placebo group are included in Table 1.
Table 1. Adverse Reactions in Pooled
Placebo-Controlled Trials in Patients with Migraine (Studies 2 and 3)
|Imitrex Injection 6 mg Subcutaneous
(n = 547) %
(n = 370) %
|Burning sensation||7||< 1|
|Feeling of heaviness||7||1|
|Feeling of tightness||5||< 1|
|Feeling strange||2||< 1|
|Tight feeling in head||2||< 1|
|Tightness in chest||3||< 1|
|Pressure in chest||2||< 1|
|Ear, nose, and throat|
|Throat discomfort||3||< 1|
|Discomfort: nasal cavity/sinuses||2||< 1|
|Injection site reactiona||59||24|
|Neck pain/stiffness||5||< 1|
|aIncludes injection site pain, stinging/burning, swelling, erythema, bruising, bleeding.|
The incidence of adverse reactions in controlled clinical trials was not affected by gender or age of the patients. There were insufficient data to assess the impact of race on the incidence of adverse reactions.
In the controlled clinical trials assessing the efficacy of Imitrex Injection as a treatment for cluster headache (Studies 4 and 5), no new significant adverse reactions were detected that had not already been identified in trials of Imitrex in patients with migraine.
Overall, the frequency of adverse reactions reported in the trials of cluster headache was generally lower than in the migraine trials. Exceptions include reports of paresthesia (5% Imitrex, 0% placebo), nausea and vomiting (4% Imitrex, 0% placebo), and bronchospasm (1% Imitrex, 0% placebo).
The following adverse reactions have been identified during postapproval use of Imitrex Tablets, Imitrex Nasal Spray, and Imitrex Injection. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
What drugs interact with Imitrex (sumatriptan)?
Ergot-containing drugs have been reported to cause prolonged vasospastic reactions. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) and Imitrex Injection within 24 hours of each other is contraindicated.
Monoamine Oxidase-A Inhibitors
MAO-A inhibitors increase systemic exposure by 2-fold. Therefore, the use of Imitrex Injection in patients receiving MAO-A inhibitors is contraindicated.
Other 5-HT1 Agonists
Because their vasospastic effects may be additive, co-administration of Imitrex Injection and other 5-HT1 agonists (e.g., triptans) within 24 hours of each other is contraindicated.
Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors And Serotonin Syndrome
Cases of serotonin syndrome have been reported during co-administration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors.
Imitrex (sumatriptan) is a selective serotonin receptor agonist (a “triptan”) used to treat migraine headaches. Common side effects of Imitrex include pain or tightness in the chest or throat, tingling, flushing, weakness, dizziness, abdominal discomfort, sweating, nasal irritation, injection site reactions, and allergic reactions (rare). Safe use of Imitrex in pregnancy has not been established. Imitrex is excreted in breast milk. Infant exposure may be reduced by avoiding breastfeeding for 12 hours after administration of Imitrex.
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Related Disease Conditions
Abdominal Migraines in Children and Adults
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Abdominal Migraines in Children and Adults
Abdominal migraine in adults and children is a variant of migraine headaches. Abdominal migraine in children generally occurs in children who have a family history of migraines. Causes of abdominal migraine is not known. Symptoms of abdominal migraine include acute, severe, midline abdominal pain, nausea, vomiting, paleness, and inability to eat. Abdominal migraine is diagnosed through patient history, family history, and ruling out other medical causes. Treatment of abdominal migraine include tricyclic antidepressants and triptans.
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine. Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain. Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure. Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
Migraines and Seizures (Symptoms, Auras, Medication)
Migraines are a type of headache and seizures are the main symptom of epilepsy. Migraine headaches and seizures are two different neurological problems that have similar signs, symptoms, and auras, for example, sensitivity to light (photophobia) and sound, irritability, nausea, and vomiting. Symptoms unique to migraine and migraine auras are water retention, problems sleeping, appetite changes, and talkativeness. Symptoms unique to seizure and seizures auras are depression, a feeling of heaviness, a feeling that a seizure is approaching, and depression. Many of the symptoms of migraine and seizures are the same, however, seizures do not cause migraines; however, people who have seizures are twice as likely to have migraines and vice-versa. People who have migraines are twice as likely to have seizures, and people with seizures are twice as likely to have migraines; however, one condition does not cause the other.
Migraine and Stroke (Symptoms, Types, Causes, Treatment)
Migraine headache is a type of headache in which the exact cause is not known; however, they may be inherited, and certain foods and environmental factors can trigger and may contribute them. A stroke (brain attack) happens when a blood vessel in the brain leaks, bursts, or becomes blocked, which can be caused by many other health problems. Both migraines and strokes can can cause severe head pain (migraine pain usually is only on one side of the head). Migraine aura symptoms may mimic or feel like a stroke or mini-stroke (transient ischemic attack, TIA) because they have similar symptoms and signs like severe headache, numbness in the legs, feet, arms, hands, or face, nausea, vomiting, and dizziness. Other migraine aura symptoms include vision problems like flashing lights or blind spots in one eye. The main difference between migraine headache and stroke symptoms and signs is that a migraine headaches usually come on gradually while a stroke symptoms come on suddenly and unexpectedly. A migraine may cause photophobia (sensitivity to light and sound). Migraine triggers include hormonal changes, alcohol, insomnia, caffeine, stress, anxiety, bright lights, loud noises, strong odors, aspartame, MSG, and changes in the weather. Symptoms of a stroke that do not occur with migraines include confusion, speech, vision, and balance problems. You can have a migraine headache and a stroke at the same time, but migraines do not cause strokes. However, in certain individuals with migraines with auras there may be related to a higher risk of stroke. Stroke is a medical emergency. If you have stroke symptoms, call 9-1-1 and get medical attention immediately.
Treatment & Diagnosis
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.