Sumigran

Indications

Sumatriptan is used to relieve a migraine attack, with or without aura (warning signs such as flashing lights before the headache). It is also used for cluster headache in some forms. It treats an attack that has already started; it does not prevent migraines and is not meant for ordinary tension headaches.

How It Works

Sumatriptan belongs to the triptan group. During a migraine, blood vessels around the brain widen and nerves release substances that cause pain and inflammation. Sumatriptan acts on serotonin (5-HT1B/1D) receptors to narrow these vessels again and to block the release of pain signals, easing the headache, nausea and sensitivity to light and sound.

Dosage and Administration

Tablets: the usual adult dose is 50 mg taken with water as soon as the migraine headache begins; some adults need 100 mg. If the headache comes back, a second dose may be taken at least 2 hours after the first. Do not take more than 300 mg in 24 hours. Nasal spray: usually 10 mg or 20 mg into one nostril, as directed on the label. Injection forms are given as prescribed. If the first dose does not help at all, do not take a second dose for the same attack; talk to your doctor.

Interactions

• Do not use within 24 hours of Ergotamine or other triptans such as Rizatriptan or Zolmitriptan.
• MAO inhibitors (e.g. Moclobemide) can raise Sumatriptan levels; avoid within 2 weeks of stopping them.
• Antidepressants such as Fluoxetine, Sertraline or Venlafaxine, and Lithium, can increase the risk of serotonin syndrome.
• St John's Wort may also add serotonin effects.

Contraindications

• Allergy to Sumatriptan.
• Heart disease, previous heart attack, angina or coronary artery spasm.
• Previous stroke or mini-stroke, or poor circulation in the legs.
• Uncontrolled high blood pressure.
• Severe liver disease.
• Hemiplegic or basilar migraine.

Side Effects

Common effects include tingling, warmth or flushing, a feeling of tightness or heaviness in the chest, throat or neck, dizziness, tiredness, drowsiness and nausea. The nasal spray may leave a bad taste.

Get urgent medical help if you have severe or lasting chest pain, signs of a heart attack or stroke, a fast or irregular heartbeat, severe stomach pain, a severe allergic reaction (swelling of the face or throat, difficulty breathing), or agitation, fever, sweating and muscle twitching (possible serotonin syndrome).

Pregnancy and Lactation

Use in pregnancy only if your doctor feels the benefit outweighs the risk. Sumatriptan passes into breast milk in small amounts; it is often advised to avoid breastfeeding for 12 hours after a dose. Ask your doctor first.

Precautions and Warnings

Tell your doctor if you have risk factors for heart disease (smoking, diabetes, high cholesterol, family history), epilepsy, or liver or kidney problems. Using pain relievers or triptans too often can cause medication overuse headache. Sumatriptan can cause drowsiness, so take care when driving.

Overdose

Taking too much may cause high blood pressure, chest discomfort, dizziness or other heart symptoms. Seek medical help at once; treatment is supportive with monitoring of the heart.

Therapeutic Class

Anti-migraine agent, selective serotonin 5-HT1 receptor agonist (triptan).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.