Sumatriptan

Antimigraine Preparations · 5HT1-agonist

Indications

Treatment of acute migraine attacks, with or without aura, only where there is a clear diagnosis.

Dosage

Adults: ORAL: Migraine, cluster headache: 25 mg (taken with fluids); Max recommended dose is 100 mg. If a satisfactory response has not been obtained at 2 hr a 2nd dose of up to 100 mg may be given. Efficacy of this 2nd dose has not been examined. If a headache returns, additional dose may be taken at intervals of at least 2 hr up to daily max of 300 mg. There is no evidence that an initial dose of 100 mg provides substantially greater relief than 25 mg. Elderly: Due to increased risk of CAD, decreased hepatic function & more pronounced blood pressure increases, use of the tablet dosage form is not recommended. Children: Not recommended. Adults: INJECTION: SC: Cluster headache or migraine: Using auto-injector, 6 mg; dose may be repeated once after at least 1 hr if headache recurs; max 12 mg in 24 hr. Nasal Spray: Adults: Single dose of 5 mg, 10 mg, or 20 mg of nasal spray as soon as…

Administration

Administered by SC. It should not be given by other routes of administration. Stability: Store at 20°C-25°C; excursions permitted between 15°C-30°C. Do not freeze. Protect from light.

Adverse Effects

Tingling, dizziness, drowsiness, increase in BP, flushing, GI upset, sensation of heaviness, pressure or heat, pain, weakness. If angina-like symptoms (transient chest pain or throat symptoms) occur, withdraw and investigate immediately. Sensory disturbance incl paraesthesia and hypoaesthesia, increased BP, flushing, dyspnoea, pain at inj site.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Ischaemic heart disease, previous MI, cerebrovascular accident, coronary vasospasm, Prinzmetal's angina, moderate and severe hypertension, uncontrolled mild hypertension, severe hepatic impairment, peripheral vascular disease, transient ischaemic attack, stroke, history of stroke or TIA. Treatment of hemiplegic, basilar or ophthalmoplegic migraine. Precautions: Cardiac disease, risk factors for ischaemic heart disease; assess patients before initiating therapy. Hepatic or renal impairment. Controlled hypertension. History of, or risk factors for seizures. Sulphonamide sensitivity. Driving or operating machinery.

Interactions

MAOIs, ergotamine, SSRIs, St. John's Wort, methysergide, other 5HT1 agonist/triptans, SNRIs, other serotonergic drugs.

Advice to Patient

Take with or without meals. Do not chew or crush tablet, swallow whole with fluid. After taking first dose by nasal spray, if headache is not completely resolved, second dose may be taken after 2 hours. Do not take more than 40 mg of nasal spray in one day. After taking first dose of tablet or capsule, if headache is not completely resolved, second dose may be taken after 2 hours. Do not take more than 200 mg of tablet or capsule in one day. After taking first dose by injection, if headache is not completely resolved, second dose may be taken after 1 hour. Do not take more than two injections in one day. Lie down in a dark, quiet room after taking medication to help relieve migraine. Do not take this medication within 24 hours of taking another migraine medication without consulting prescriber. Contact prescriber if there is difficulty in breathing, chest tightness, chest pain, jaw or…

Pharmacokinetics

Onset of action: Oral: Approx. 30 min. Intranasal: Soln: Approx. 15-30 mins. SC: Approx. 10 mins. Peak effect: Oral: 2-4 hrs. Metabolism: Hepatic; extensive first-pass metabolism following oral administration. Bioavailability: Intranasal: Soln: 17%. Powd: 19% (compared to SC). Oral: 15%. SC: 97% ± 16%. Half-life elimination: Distribution: 15 mins. Terminal: 2 hrs. Time to peak, serum: Oral: 2-2.5 hrs. Intranasal: Powd: Approx. 45 mins. SC: 12 mins. Excretion: Intranasal: Urine. Oral: Urine. Faeces. SC: Urine.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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