Sumatriptan for Migraine Relief

Its various forms are a significant benefit of this drug

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Sumatriptan is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of migraines with or without aura in adults. It is one of the triptans, a group of prescription migraine medications used for acute migraine attacks.

The brands of sumatriptan available in the United States include:

  • Imitrex (pill, nasal spray, or suppository)
  • Imitrex STAT dose System (injection via a pen)
  • Onzetra Xsail (nasal powder)
  • Zembrace SymTouch (injection)

The variable routes of sumatriptan delivery offer some practical options when it comes to managing your migraines. If you experience severe nausea and vomiting with your migraines, you may not want to take your medicine by mouth, and you may not be able to keep it down long enough to absorb it into your body. An alternative route allows your body to absorb the medicine so it can work.

The sumatriptan injections in particular also have a faster onset of action than a pill, providing more rapid relief.

How It Works

Vasodilation (widening of the blood vessels) in the brain is associated with migraines. It isn't clear whether vasodilation is the physiological event that triggers migraines, or whether it occurs after other changes, such as neurotransmitter alterations or changes in electrical activity occur.

Nevertheless, sumatriptan, like other triptans, targets the serotonin (5-HT) receptors in the brain. It is believed to work blocking pain pathways in the brain and by narrowing blood vessels to provide migraine relief.

Dosing

Sumatriptan is intended to be taken as needed, with some restrictions. Before taking sumatriptan, be sure to review the dose that your doctor recommends for you. There are different recommended starting points for several of the forms, and each has a maximum recommended dose that can be taken at one time, as well as over a 24-hour period.

Pill

Oral sumatriptan is available in 25 mg, 50 mg, or 100 mg pills. If a migraine is not relieved within two hours of the first dose, a second dose may be taken.

The total daily dose should not exceed 200 mg.

Powder

With the sumatriptan nasal powder, a single dose of 22 mg (an 11 mg nose piece in each nostril) is taken. Similar to the oral sumatriptan, if the migraine headache does not resolve within two hours (or if it comes back), the treatment may be repeated once.

The maximum daily dose should not exceed 44 mg (four nose pieces).

Spray

With the sumatriptan nasal spray, a single dose of 5 mg, 10 mg, or 20 mg is taken in one nostril, or a 10 mg total dose can be taken as a 5 mg dose in each nostril. If the migraine headache persists or returns within two hours of use of the spray, a second spray may be administered.

Research suggests that a 20 mg dose is more effective than 5 mg or 10 mg.

The maximum daily dose is 40 mg.

Injection

Sumatriptan and Imitrex injection dosages vary from 1 to 6 mg applied subcutaneously (under the skin). A second injection may be repeated if the first is not effective.

The maximum daily dose is 12 mg in 24 hours.

Zembrace is used at an initial dose of 3 mg and can be repeated up to three times, with each injection separated by one hour.

The maximum daily dose is 12 mg.

Remember to take sumatriptan at the onset of your migraine. Taking it early can help prevent an attack from reaching its peak intensity.

Side Effects

The most common side effects of sumatriptan result from vasoconstriction, which can occur not just in the brain, but throughout the body as well.

Common side effects include:

  • Pins-and-needles sensation in the fingers, hands, or arm
  • Warm or cold sensation, especially in the hands

Sumatriptan nasal spray or nose powder may cause a bad taste in your mouth, as well as nose and throat irritation. The nasal spray may also produce a burning sensation when applied, and the nose powder may cause a runny or stuffy nose.

With the sumatriptan injection, some people develop irritation at the skin site where the shot is given.

Serious adverse events include:

  • Chest pain, tightness. pressure, and/or heaviness
  • Neck, throat, or jaw pain, tightness, and/or pressure

If you experience any of the serious side effects of sumatriptan, seek medical help immediately.

Complications

Sumatriptan and other triptans have been associated with cardiovascular and vasospastic (blood vessel spasm) events. These type of events can cause serious consequences, including heart attack and stroke.

A rare complication, serotonin syndrome, can occur if you take a triptan along with antidepressants in the selective serotonin reuptake inhibitor (SSRI) or selective serotonin-norepinephrine reuptake inhibitor (SNRI) medication categories.

You should be aware of the symptoms of serotonin syndrome if you are taking such a combination.

Contraindications

It is not safe for you to use a triptan if you have a history of heart attack, stroke, transient ischemic attack (TIA), coronary heart disease, peripheral vascular disease, ischemic bowel disease, or any type of angina (stable or Prinzmetal's).

Likewise, experts suggest caution in taking a triptan if you have a risk factors for coronary heart disease, such as obesity, a history of smoking or diabetes, or a family history of heart disease.

Other contraindications include:

It's important to note that sumatriptan is a pregnancy category C drug, which means that it may be used if prescribed, but with caution. If you use sumatriptan, be sure to let your doctor know if you are pregnant or planning on becoming pregnant, because you may need to switch your migraine medication.

A Word From Verywell

Keep in mind that sumatriptan is generally safe and effective for treating moderate to severe migraine episodes. Knowing about the different routes of delivery and the side effects and contraindications can help you as you discuss this option with your doctor.

It is usually recommended that you try over-the-counter treatments for your migraines first before advancing to prescription-strength medications. If sumatriptan works for you, keep track of how many pills you are using per month. If you are taking more than two doses per week on a regular basis, you should discuss migraine prevention strategies with your doctor, as it is easier and safer to prevent migraines than to constantly try to treat them.

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