Imitrex (Sumatriptan) – Subcutaneous

What Is Imitrex?

Imitrex (sumatriptan) is an injection used to treat acute migraine and cluster headaches. It belongs to a class of medications called triptans.

Triptans work by binding to certain receptors in the blood vessels of the brain and certain nerves that contribute to headache pain. This causes the narrowing of the blood vessels, which stops pain signals from being sent to the brain.

Imitrex is a prescription drug, which means you need an order for it from your healthcare provider. You’ll pick it up from your pharmacy rather than purchasing it over the counter (OTC) from a drugstore or grocery store.

It is a subcutaneous (under the skin) injection. Sumatriptan also comes in other administration forms, such as oral and nasal routes. However, this article will focus on the injectable version of sumatriptan.

What Is Imitrex Used For?

The Food and Drug Administration (FDA) approved Imitrex for acute (sudden onset) treatment of migraines with or without aura (changes in your vision such as bright lights or zigzag lines) and cluster headaches.

Migraines and cluster headaches are types of headaches. Migraines often come in stages and can produce symptoms besides head pain, like nausea or vomiting and sensitivity to light or sound. They can last for hours at a time or up to several days.

Cluster headaches often cause pain in several bouts throughout the day, meaning the pain will go and come multiple times. They can be triggered by bright lights or overexertion. Like migraines, they are often unilateral (attacking one side of the head).

How to Take Imitrex

Imitrex is an injection that comes as a device called an auto-injector. The full name for the kit is Imitrex STATdose, which is also available generically as sumatriptan Statdose.

While it can be intimidating or scary to think about injecting yourself, the auto-injector simplifies the process. Sumatriptan is given subcutaneously, which means the drug is injected right under your skin, as opposed to into a muscle or a vein.

The following are general tips for preparing and using your STATdose system. Always read the prescription label for complete instructions on preparing and administering your dose. Ask your healthcare provider to show you how to do it first, so you become comfortable with the process.

It is important to understand what the STATdose system comes with and how to prepare, as follows:

• You'll receive the medication in a case with the auto-injector, which looks like a pen, and two doses of medicine in small tubes or cartridges with needles attached.
• Before administering the medication, load the medicine onto the injector pen. To do this, push one of the cartridges into the pen and turn it clockwise.

To administer the medication:

• Make sure to inject it into your stomach, thigh, or upper arm areas. These are areas that commonly have the fattiest tissue, making it easier to inject.
• Hold the auto-injector firmly against your skin, then push the button on top of the injector.
• You will hear a click, after which you will hold the injector in place for five seconds to ensure you receive the total dose.

After you give yourself the injection:

• Put the auto-injector with the cartridge attached back into the slot the cartridge was in initially, and turn the auto-injector counterclockwise to separate it from the cartridge.
• Store the injector in its slot in the case until your next use.
• When you’ve used both doses, close the case and you can throw away the entire kit.

Used medicine cartridges should go back in the case before discarding them into the trash, so there are no loose needles. Ask your pharmacist about getting a sharps container for proper disposal of your medicine and needles. They will also be able to tell you how and where to bring your container when it’s full.

Storage

Store your Imitrex STATdose, in its case, between 36 and 86 degrees F and out of direct sunlight.

Each STATdose kit comes with two doses of sumatriptan. Once you’ve used the second dose, contact your pharmacy or healthcare provider for refills.

If you’re traveling by plane, keep Imitrex in your carry-on luggage in case your checked baggage goes missing.

What Are the Side Effects of Imitrex?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or pharmacist. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

These are the most common side effects of Imitrex injections:

• Pain or redness at your injection site
• Tingling or numbness in your fingers or toes
• Dizziness
• Flushing (a hot or burning feeling in your face)
• Discomfort or stiffness in your neck
• Feeling sleepy or weak

Notify your healthcare provider if these side effects become severe or do not go away.

Severe Side Effects

Contact your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Severe side effects and their symptoms can include:

• Changes in color or sensation in your fingers or toes, also known as Raynaud’s syndrome
• Stomach or gastrointestinal (GI) problems such as severe stomach pain, nausea or vomiting, constipation, or diarrhea
• Problems with blood circulation to your legs and feet (peripheral vascular ischemia), in which you experience cramping or pain in your legs or hips or a tight, heavy feeling in your leg muscles
• Swelling of tongue, mouth, or throat
• Medication overuse headaches, in which headaches can occur from using Imitrex if you use it too often (around 10 or more days per month)
• Seizures
• Serotonin syndrome, with symptoms such as agitation, fast heart rate, high body temperature, and trouble walking, particularly if you also take antidepressant medicines like selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs)

Long-Term Side Effects

As mentioned above, remember that using Imitrex too often (10 days or more per month) can increase the risk of medication overuse headaches. This could mean that your symptoms get worse when you give yourself an injection.

Keep track of how often you use Imitrex so that you can discuss it with your healthcare provider.

Dosage: How Much Imitrex Should I Take?

Modifications

Your healthcare provider may adjust the treatment or choose not to use Imitrex for certain people:

• Pregnancy: It is not known whether Imitrex is safe to use while pregnant. If you are pregnant, it’s best to avoid using this medication unless the benefits outweigh any potential risk of harm to the fetus.
• Breastfeeding: Imitrex does pass into breast milk, but its effects on the nursing infant are not well understood. You can minimize the amount of Imitrex your baby may receive by waiting to breastfeed for at least 12 hours after your injection.
• Children and adolescents younger than 18: The safety of using Imitrex in individuals younger than 18 years old is not well established and, therefore, not recommended. In clinical trials, younger children experienced more side effects than older children.
• Adults 65 and older: Not enough people in this age group were included in clinical studies of Imitrex to know if they might respond differently. Trials did show similar Imitrex levels in a small group of older adults with an average age of 72 compared with younger people with an average age of 30. It’s best to start with the lowest dose of Imitrex possible in older populations.

Missed Dose

Since Imitrex is a medication taken only as needed, you do not have to worry about missing doses. It’s best to give yourself an injection as soon as your symptoms begin, but you can inject at any time during your headache.

Overdose: What Happens If I Take Too Much Imitrex?

If you only take Imitrex as directed, you shouldn’t be too concerned about using too much or overdosing. Remember to wait at least one hour before repeating a dose if needed. Only repeat the dose if the first one helped, but your symptoms returned.

If you do take too much Imitrex, you may have:

• Convulsions
• Tremors
• Swelling of the arms or legs
• Slow heart rate
  

Precautions

What Are Reasons I Shouldn’t Take Imitrex?

Imitrex should not be taken if you have any of the following:

• Ischemic coronary artery disease (CAD) such as angina pectoris, history of heart attack, or coronary artery vasospasm, including Prinzmetal angina (a type of chest pain)
• Wolff-Parkinson-White syndrome or other type of heart arrhythmia
• History of stroke or transient ischemic attack (TIA)
• History of hemiplegic or basilar migraine, as these types of migraine pose a higher stroke risk
• Ischemic bowel disease
• Uncontrolled hypertension (high blood pressure)
• Having taken ergotamine-containing medication including dihydroergotamine or methysergide within the previous 24 hours
• Taking a monoamine oxidase inhibitor (MAOI) antidepressant medication, such as Zelapar (selegiline), at the same time (Imitrex should not be used if an MAOI has been taken within the last 14 days)
• Allergy to Imitrex that caused a severe reaction, such as swelling
• Severe liver impairment
• Use of a different 5-HT1 agonist (e.g., another triptan) within the previous 24 hours

What Other Medications Interact With Imitrex?

Imitrex can interact with other drugs. Before starting treatment, notify your healthcare provider of all prescription or over-the-counter (OTC) medications, vitamins, and herbal supplements you take.

Do not take the following drugs with Imitrex:

• Ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) within 24 hours of taking Imitrex
• MAOI antidepressants like selegiline or Nardil (phenelzine), which can increase your exposure to Imitrex
• Other triptans at the same time, such as almotriptan, Maxalt (rizatriptan), and Zomig (zolmitriptan)
• Other drugs that may increase the amount of serotonin in your system such as SSRIs like Zoloft (sertraline), SNRIs like Effexor XR (venlafaxine), and tricyclic antidepressants like amitriptyline

This is not a complete list of drugs that interact with Imitrex. Ask your pharmacist or healthcare provider for a full list of potential interactions that can occur.

What Medications Are Similar?

There are many medications in the same triptan class as sumatriptan that work similarly, including:

• Almotriptan
• Relpax (eletriptan)
• Frova (frovatriptan)
• Amerge (naratriptan)
• Maxalt (rizatriptan)
• Zomig (zolmitriptan

This is a list of drugs also prescribed for headaches and migraines. It is not a list of drugs recommended to take with Imitrex. In fact, you should not take these drugs together. Talk to your pharmacist or a healthcare provider if you have questions.

How Can I Stay Healthy While Taking Imitrex?

Migraines and headaches are common health conditions that can be debilitating, sometimes causing people to miss work and lowering their quality of life. Adjusting your life and schedule around headache and migraine symptoms can be incredibly frustrating.

Unfortunately, there is no cure for headaches. Since Imitrex does not prevent headaches and migraines, you should use this medication with other preventive methods. For example, learning your headache and migraine triggers can help you avoid them and stop migraines and headaches from developing in the first place. Healthy lifestyle modifications, like changing what you eat and exercising regularly, can also help.