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Sumatriptan

Sumatriptan is used in the treatment of migraine, either with or without an aura, and cluster headaches.

What is the medicine, Sumatriptan?

Sumatriptan is one of the group of medicines called 5HT₁-receptor agonists, which may be referred to as ‘triptans’. This medicine attaches to and activates the receptors of a chemical that normally occurs in the brain called 5HT or serotonin. Its effect is to selectively constrict specific blood vessels in the brain. Since the blood vessels in brain dilate during a migraine attack, shrinking them back to normal results in relief of the headache.

How you take Sumatriptan

Sumatriptan is available as a tablet (standard or dispersible), a nasal spray, and as an injection. It is most effective when taken as soon as the migraine begins, although you can use it during the attack. It will not prevent a migraine so don’t take it if you do not have a headache.

As there are several preparations of sumatriptan, your doctor will select that which is best for you and explain exactly when and how to take it. What you should do if you get another attack or if the medicine does not relieve your symptoms will also be explained. Instructions on how to use the nasal spray and the injection ‘pen’ are also provided in the medicine pack. Doses usually comprise:

1. Tablets (standard and dispersible): take one 50 mg or 100 mg tablet whole with water. Another tablet can be taken 2 hours later for another attack. The maximum dose is 300 mg in 24 hours
2. Nasal spray: one 10 mg or 20 mg dose is sprayed into one nostril only. Another nasal spray can be administered after 2 hours for another attack. The maximum is two sprays in 24-hours
3. Injection: a pre-filled pen is used to give one 6 mg injection usually in the thigh muscle (avoid your veins). Another injection with a new pen can be given one hour later for another attack. The maximum dose is two injections in 24 hours

Medical advice should be sought if you take more than 2 doses in 24 hours.

Who can take Sumatriptan?

Sumatriptin is for individuals aged 18–65 years who suffer from migraines or cluster headaches. It is not recommended that children aged less than 18 years of age or people more than 65 years use sumatriptan. The exception is sumatriptan nasal spray that is permitted for adolescents aged 12–17 years.

Like all medicines, sumatriptan should be used if you have an allergy to it or to any of the constituents in the preparation. Sumatriptan may also be contraindicated if you have heart problems (e.g., ischaemic heart disease, angina, or heart attack), high blood pressure, circulatory problems in the legs, liver disease, or if you have suffered a stroke. It is necessary to also let your doctor know if you have seizures, kidney disease, brain disease or an antibiotic allergy. The doctor will carry out a risk assessment, and so will want to know if you have certain risk factors: are you a man older than 40 years, a post-menopausal woman, a smoker, overweight, or have you diabetes, a high blood cholesterol level, or relatives with heart disease?

Report all your medicines to your doctor as these may also present a problem with sumatriptan. Notably, these include other migraine treatments (such as other 5HT₁ agonists and ergotamine/egotamine-like therapies), and any antidepressants (including the herbal remedy St John’s wort).

Before using sumatriptan, notify your doctor if you are pregnant or breast feeding. Avoid breast feeding and using expressed milk for 12 hours after a dose of sumatriptan.

Side effects of Sumatriptan

What you experience may not always be due to the medicine – some effects are caused by the method of administration and others may actually be the symptoms of migraine. You may experience an unpleasant taste and nose/throat irritation with the nasal spray, while pain, redness, and swelling at the injection site are very common. Symptoms of migraine such as visual disturbances (e.g., flickering, reduced or double or loss of vision) and feeling or being sick may also occur.

Common side effects include a heavy/ tight feeling or pain in the chest and strange sensations such as numbness or hot/cold. People often report feeling flushed, tired, dizzy and faint, weak, aches, short of breathe, and an increase in blood pressure. Although very rare, there may also be changes in liver function. Sumatriptan has also been known to cause heart problems such as changes in heart rate/rhythm, seizures or stiffness, pale painful fingers, toes, nose brought on by cold or stress (Raynaud’s disease), stomach pain, diarrhoea, joint pain, and anxiousness. Let your doctor know it sumatriptan worsens your headaches or causes pain/tightness in your chest. However, all side effects that continue or becomes severe should be reported to your doctor.