Sumatriptan

Sumatriptan interacts with the brain to remove the pain symptoms of cluster headaches and migraines.

Overview

Sumatriptan is a member of the group of triptans medicines. It interacts with the brain to relieve pain symptoms of cluster headaches and migraines in adult patients. The medicine is injected subcutaneously (under the skin).

Many patients will find that their headaches and migraines will go away completely when they take Sumatriptan. For other patients, they may still experience pain but may enjoy enough relief to be able to function normally and return to normal activities.

Sumatriptan can also relieve other symptoms that come with the pain of headaches. These other symptoms can include sensitivity to light, vomiting, sensitivity to sound and nausea. While these symptoms are not directly treated, the treatment of the pain can relieve their effect on the patient.

Sumatriptan is not a pain reliever and does not work in the same way as other pain relievers. This medication will only have an affect on migraine and headache pain.

Sumatriptan is usually only prescribed when other medications fail to relieve the pain of migraines and cluster headaches. Usually, the patient would have already tried other pain relievers, including aspirin and acetaminophen.

Sumatriptan has a wide range of side effects and some of these can be very severe. People who have heart disease or blood vessel disease, in particular, should be cautious of the use of this medicine as it can cause complications with these illnesses.

This medication is only available with a doctor’s prescription and you should seriously consider the risks of taking this medicine before you begin treatment. Ensure that you discuss all medications that you take and illnesses that you have with your doctor too as interactions occur with a wide range of treatments and conditions.

This medication is appropriate for self-administration by the patient in some cases and is available as both a pre-prepared kit and as a solution.

Condition treated

  • Migraine
  • Cluster headaches

Type of medicine

  • Triptan
  • Serotonin Receptor Agonist

Side Effects

In addition to the desired effects of migraine and headache relief, the use of subcutaneous Sumatriptan can also cause unwanted effects in the patient. Some of these will require urgent medical attention, while others will not. The following list of side effects may not be all-inclusive and other side effects may be experienced.

If you experience any of the following side effects from use of Sumatriptan then you should inform your doctor immediately:

Occurring less commonly:

  • Blurry vision or changes in vision
  • Chest pain or feeling of discomfort
  • Chilliness
  • Confusion or disorientation
  • Difficult breathing or labored intake of breath
  • Dizziness
  • Faintness when getting up suddenly from lying or sitting down
  • Fainting
  • Fast or irregular heartbeat
  • Headache
  • Nervousness
  • Pounding in the ears or soreness inside the ear
  • Shakiness or spasms in the legs, arms, hands, or feet
  • Slow heart rate
  • Sweating when cold
  • Tight feeling inside the head
  • Tightness or feeling of pressure in the chest
  • Trembling or shaking of the hands or feet
  • Unusual tiredness
  • Unusual weakness

Occurring only rarely:

  • Black stools with a tarry coloration
  • Blood appearing in the urine
  • Blood appearing in the vomit
  • Burning sensation while urinating
  • Cough
  • Decreased volume of urination
  • Depression of the skin
  • Diarrhea
  • Dry mouth or feeling of dehydration
  • Feeling of warmth or heat on skin
  • Fever
  • Flushing of the skin. Especially when occurring on the face and neck
  • General feeling of discomfort or illness
  • Inability to move the eyeballs
  • Inability to move the limbs
  • Increase in heart rate
  • Increased blinking or twitching or spasms of the eyelid
  • Increased sensitivity to pain
  • Increased sensitivity to touch
  • Indentation of the skin
  • Joint pains
  • Loss of appetite or lack of hunger
  • Muscle aches and pains
  • Nausea and/or vomiting
  • Pain in the groin or genital area
  • Paleness in appearance of the skin
  • Paleness or cold feelings in the extremities
  • Paralysis of any part of the body
  • Rapid breathing rhythm
  • Runny nose
  • Severe, sharp or continuing stomach pain
  • Sharp back pain beneath the ribs
  • Shivering when warm
  • Sore throat or hoarseness
  • Sticking out of the tongue involuntarily
  • Sunken eyes or appearance of extreme tiredness
  • Thirstiness
  • Tingling in the hands, feet and extremities
  • Tingling or pain in the fingers and/or the toes when they are exposed to cold
  • Troubled sleep
  • Trouble or difficulty in speaking or swallowing
  • Uncontrolled twisting movements of the neck, trunk, arms, or legs. Any loss of flexibility
  • Unusual facial expressions being made involuntarily
  • Wrinkling of the skin

Incidence of occurrence unknown:

  • Abdominal pain and discomfort and/or tenderness of the stomach
  • Agitation for no reason
  • Back, leg, or stomach soreness
  • Bleeding gum
  • Blood visible in the stools
  • Bluish coloration of the extremities, particularly lips, nailbeds and palms of hands
  • Changes in skin color anywhere on the body
  • Changes in vision and/or sensitivity to light
  • Coma
  • Depression or unhappiness
  • Double vision
  • General swelling of the body
  • Headaches
  • High fevers
  • Hives or itching on body
  • Hostility or quickness to anger
  • Inability to communicate coherently or to the usual standard
  • Irritability or annoyance
  • Large swellings on the face, in the mouth, or on the hands, legs, feet, and sexual organs. These may appear to look like hives.
  • Lethargy or undue tiredness
  • Loss of ability to use or understand speech or language to usual levels
  • Loss of appetite or lack of hunger
  • Loss of vision or quality of vision
  • Migraine headache
  • Muscle twitching or spasm
  • Noisy or unusually audible breathing
  • Nosebleeds
  • Overactive reflexes to touch
  • Pain, tenderness, or swelling of the foot or leg
  • Pinpoint spots on the skin. These usually appear red
  • Poor coordination or disorientation
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Rapid weight gain
  • Rectal bleeding or bleeding around the anus
  • Redness, soreness, or itching skin
  • Restlessness
  • Seizures or convulsions
  • Severe or sudden headaches
  • Slurred speech
  • Sores or ulcers inside the mouth or white spots on the lips
  • Sores or blisters on the skin
  • Stupor or inability to engage
  • Swelling of face, feet and lower legs
  • Swollen glands in the neck
  • Talking or acting with excitement you cannot control
  • Temporary blindness or very poor vision
  • Trembling or shaking uncontrollably
  • Twitching
  • Unexplained bleeding or bruising occurring on the body
  • Unusual bleeding or bruising on the body
  • Unusually warm skin or feeling of heat
  • Unusual weakness in the arm or leg on one side of the body
  • Weight loss occurring rapidly
  • Yellowing of the eyes or skin

Other side effects may occur that do not need urgent medical attention. These side effects may abate as your body adjusts to the treatment and may have only a minimal impact. If you are concerned about these side effects, if they become bothersome, or if they are ongoing then you can discuss with your doctor how they may be alleviated. The following side effects would not necessitate informing your doctor:

Occurring more commonly at the site of injection

  • Bleeding
  • Blisters
  • Burning sensation
  • Coldness of the area
  • Discoloration of the skin around the site
  • Feeling of pressure being applied
  • Hives
  • Infection (will need to be treated)
  • Inflammation appearing red and puffy
  • Itching
  • Lumps around the injection site
  • Numbness or lack of feeling
  • Pain or general soreness
  • Rash with raised lesions
  • Redness
  • Scarring
  • Soreness or area
  • Stinging sensation
  • Swollen puncture point
  • Tenderness
  • Tingling sensation
  • Ulceration
  • Warmth expelled from injection site

Occurring more commonly

  • Burning or tingling sensation throughout body
  • Drowsiness or tiredness
  • Feeling that self or surroundings are constantly moving
  • Feeling of warmth
  • Redness of the face, neck, arms and upper chest
  • Relaxed and calm feeling
  • Sensation of spinning when stationary
  • Sleepiness

Occurring less commonly

  • Abdominal discomfort or pain in the stomach
  • Anxiousness
  • Bad, unusual, or unpleasant aftertaste following food consumption
  • Burning or tingling feelings in the skin
  • Change in color vision or appearance
  • Change in taste
  • Difficulty seeing in the dark
  • Difficulty in moving
  • Discomfort experienced in the jaw, nose or throat
  • False happiness or unusual sense of well-being
  • Feeling strange and unusual
  • Heartburn
  • Increased eye sensitivity to sunlight or electric lights
  • Joint pain or swelling and stiffness
  • Mental confusion and uncertainty
  • Muscle aching or cramping
  • Neck pain
  • Red eyes
  • Sore eyes
  • Swelling in the joints
  • Tearing up of the eyes
  • Thirstiness
  • Weakness

Occurring only rarely

  • Backache
  • Belching or burping
  • Bloated or full feeling when not full
  • Changes in speech pattern or rhythm
  • Cramping
  • Dry heaving
  • Excess gas building up in the stomach or intestines
  • Extreme thirstiness
  • Heavy bleeding
  • Hiccupping
  • Hunger or increased appetite
  • Increased thirst or increased fluid consumption
  • Muscle tiredness or weakness
  • Muscle twitching or jerking uncontrollably
  • Pain
  • Passing of gas
  • Reduced appetite or lack of hunger
  • Rhythmic movement of muscles
  • Severe pain in the stomach when vomiting
  • Tenderness of the skin and increased sensitivity

Frequency of occurrence unknown

  • Deafness or reduction in hearing
  • Panic or irrational fear
  • Severe sunburn when exposed to sunlight

Dosage

Sumatriptan can be given to patients to self-administer at home. If this is the case that it is important that you use it for only the type of headaches for which it was prescribed. If you experience headaches that are unusual then you should instead check with your doctor.

A dose of this medication should be taken as early as possible after the pain has begun. In cases where you get warning symptoms of a migraine, you should still wait until the pain of the migraine has begun to be felt before taking the medication.

When you receive a prescription of Sumatriptan you should discuss the use of other medications in conjunction with it if it fails to help. Other painkillers may interact with the medication, so you need to determine which should be taken in advance of taking Sumatriptan. If Sumatriptan has failed to take away the pain then you should consult your doctor as this pain may require alternative medication.

You should always wait for at least 1 hour between doses of Sumatriptan. You should, however, only use it as directed by your doctor. You should never use this medication in higher doses than was prescribed, nor more frequently than was prescribed. Overuse of Sumatriptan can intensify the already serious side effects that you may experience. Overuse may also stimulate the occurrence of new side effects that you had not experienced up to this point.

Never use more than two doses within a single 24 hour period.

This medication is to be taken subcutaneously as an injection underneath your skin. It would usually be administered to the stomach or thighs.

If you are to be given this medication to administer to yourself at home you will also be given guidance on how to correctly prepare and administer it.

You should make the injection into different locations on the body each time you take a dose of Sumatriptan. This rotation of injection points will help your body to recover from the injections and will help in the prevention of side effects that occur from use.

The subcutaneous Sumatriptan medicine can be administered in three different manners. These are as a single dose vial, prefilled syringe or autoinjector.

This medicine will turn dark in color or cloudy. These are signs that it has deteriorated and may be damaging.

Always make sure you dispose of the needles, cartridges and containers properly as instructed when you have finished administering the dose. These should never be left out even when empty. Remember to return needles to the container before they are discarded to help protect from injury. Autoinjector units should not be discarded as they can be refilled for use again.

Ensure that you read all of the patient information that you are given when you are prescribed this medication.

The dose of this medication will be different for each patient and you should follow the instructions given to you by the doctor. Ensure that you follow your doctor’s instructions and follow the instructions on the label of the medicine at all times. If your prescribed dose is different to the following dosage information then you should continue to take the dose as directed by your doctor. The following is an average dose guidance only.

For migraine or cluster headaches in adults:

Alsuma™, Imitrex®, and Sumavel®

  • To be taken as either 4 or 6mg doses by injection under the skin.
  • If the headache returns, one further dose may be taken after one hour.
  • Do not exceed two doses of 6mg or 3 doses of 4mg injections.

Zembrace™ and Symtouch™

  • 3mg to be injected under the skin.
  • If the headache returns, one further dose may be taken after one hour.
  • Do not exceed four doses of 3mg in a 24 hour period.

For children, the use and dosage must be determined by a doctor.

Interactions

Sumatriptan has a wide range of interactions with other medications. Some medicines should not be used at all with Sumatriptan and others may require that the dosages are changed. The interactions listed herein have been selected for severity and do not necessarily include all interactions. Any medication that you take should be discussed with your doctor before you take Sumatriptan. This includes herbal remedies, prescription medication, over the counter medication and vitamin supplements.

You should also discuss with your doctor, in advance of taking Sumatriptan, what pain relief you should take if Sumatriptan fails to relieve your headache or migraine.

Use of Sumatriptan with any of the following medications is not recommended under any circumstances. If you are taking one of the following then your doctor may need to change it.

  • Almotriptan
  • Bromocriptine
  • Dihydroergotamine
  • Eletriptan
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Frovatriptan
  • Furazolidone
  • Iproniazid
  • Isocarboxazid
  • Linezolid
  • Methylene Blue
  • Methylergonovine
  • Methysergide
  • Moclobemide
  • Naratriptan
  • Phenelzine
  • Procarbazine
  • Rasagiline
  • Rizatriptan
  • Safinamide
  • Selegiline
  • Tranylcypromine
  • Zolmitriptan

Use of Sumatriptan with the following medications would not usually be recommended. In some cases, a doctor may prescribe both, but they may wish to adjust the dosage of one or other treatments to ensure they can be safely used in conjunction with one another. Always ensure that you closely follow the instructions for dosage as provided by your doctor.

  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Buprenorphine
  • Citalopram
  • Clomipramine
  • Dasabuvir
  • Desipramine
  • Desvenlafaxine
  • Dexfenfluramine
  • Dibenzepin
  • Dolasetron
  • Doxepin
  • Duloxetine
  • Escitalopram
  • Fentanyl
  • Fluoxetine
  • Fluvoxamine
  • Granisetron
  • Imipramine
  • Levomilnacipran
  • Lofepramine
  • Lorcaserin
  • Melitracen
  • Meperidine
  • Milnacipran
  • Mirtazapine
  • Nefazodone
  • Nortriptyline
  • Opipramol
  • Oxycodone
  • Palonosetron
  • Paroxetine
  • Protriptyline
  • Reboxetine
  • Sertraline
  • Sibutramine
  • St John's Wort
  • Tapentadol
  • Tianeptine
  • Tramadol
  • Trazodone
  • Trimipramine
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Ziprasidone

Interactions with other medicines can occur. Inform your doctor of all medication that you are taking.

Interactions can also occur with medical problems that you have. In some cases, the presence of medical problems can prohibit the use of Sumatriptan. It is important that you tell your doctor about all medical conditions from which you suffer. This is especially important in the following cases:

This medication should not be used in patients suffering from the following conditions:

  • Chest pains or Angina
  • Arrhythmia
  • Basilar migraines (migraines accompanied by hearing and vision problems)
  • Heart attack history
  • Heart disease
  • Blood vessel disease
  • Hemiplegic migraine (migraine experienced with paralysis)
  • Hypertension
  • Ischemic bowel disease
  • Severe liver disease
  • Cirrhosis
  • Peripheral vascular disease
  • Stroke
  • Transient ischemic attack
  • Wolff-Parkinson-White syndrome

The following conditions may be impacted. Use caution in patients with the following conditions:

  • Bleeding problems
  • Irregular heart rate
  • Epilepsy
  • Seizures
  • Stomach bleeding
  • Intestinal bleeding

Patients suffering from the following conditions may be at increased risk of serious side effects:

  • Raynaud’s syndrome
  • Coronary artery disease
  • Diabetes
  • Hypercholesterolemia
  • Hypertension
  • Obesity

Interactions with other medical conditions may also occur. Inform your doctor of all conditions that you have.

Sumatriptan can also interact with medicines that may be administered in emergency situations. If you are to receive any further treatment inform your doctor that you are receiving treatment with Sumatriptan.

Warnings

When you are prescribed Sumatriptan it is important that you check in with your doctor regularly so that they can ensure the medication is working properly, assess side effects and determine whether or not you should continue use of the medication.

You should inform your doctor immediately if the treatment stops working for pain relief, if your pain becomes worse or if they start occurring more regularly than they did when you first received Sumatriptan as a treatment.

You should not use this medicine if you have in the previous two weeks received medicine in the group MAO inhibitors. Examples of these include:

  • Phenelzine
  • Tranylcypromine

Do not use this medication if you have previously used other medicines in the triptan group. Some examples of these medicines are:

  • Almotriptan
  • Eletriptan
  • Naratriptan
  • Zolmitriptan

This medication has serious side effects and can increase your risk of serious medical conditions. When using Sumatriptan you will be at greater risk of suffering:

  • Irregular heart rhythms
  • Heart attack
  • Angina
  • Stroke

The risk of these conditions is also further increased in those who have family members with a history of heart disease. Risks are also increased in those with diabetes, smokers and those with high blood pressure.

You should seek emergency medical attention if you experience any symptoms of a heart problem when taking this medication. The following symptoms will require emergency medical attention:

  • Chest pain
  • Tight chest
  • Irregular heartrate
  • Vomiting
  • Nausea
  • Pain in shoulders
  • Sore arms
  • Sore jaw
  • Pain in back
  • Pain in neck
  • Difficulty breathing
  • Sweating

You should also seek emergency medical attention if you experience symptoms of a stroke. The following symptoms will require emergency medical attention:

  • Confusion
  • Difficulty communicating
  • Double vision
  • Headaches
  • Loss of movement of arms and/or legs
  • Loss of use of facial muscles
  • Inability to speak
  • Slow or slurring speech

If you experience changes in vision during treatment then you should consult your doctor. In this case, you may be referred to an ophthalmologist.

You should not use Sumatriptan for more than 10 days in a month. Use at this frequency can lead to a worsening of headaches. You should keep a record of use to share with your doctor.

Anaphylaxis may occur when you first take this medication. Anaphylaxis is a severe allergic reaction that will require immediate medical attention.

Alcohol consumption can make headaches and migraines worse. Sufferers should avoid consumption of alcohol, particularly during times of headache occurrence.

In some cases, this medication can make a patient dizzy and slow reactions. In these cases, the patient should not drive until normal responsiveness has returned.

No adequate studies in pregnant women have been carried out in relation to the use of Sumatriptan. You should inform your doctor if you are pregnant before you take Sumatriptan. If you become pregnant during use you should also inform your doctor before using the treatment again.

Studies in women have shown minimal risk for breastfeeding infants when using this medication. Discuss breastfeeding with your doctor before taking the medication.

Storage

This medication should be stored in a sealed container at room temperature. Do not allow the medication to freeze and keep away from moisture, heat and direct light at all times.

Always keep medication away from children and dispose of empty syringes properly. Syringes should always be placed in a hard sealed container that the needles cannot poke through before they are disposed of. Ask your doctor how you should dispose of spent medication.

Summary

Sumatriptan is a member of the group of medicines Triptans.

Sumatriptan is used in the treatment of cluster headaches and migraines in adults. This medication is not a pain reliever. Instead, it interacts with the brain to relieve pain caused by headaches. This medication will not work on other forms of pain.

Sumatriptan is injected subcutaneously under the skin and is available in both kits and as a solution. Patients are able to self-administer this medication when abiding by strict dosage guidelines and following doctor’s instructions. If you are prescribed this medication you will be instructed on how to administer the dose to yourself.

Sumatriptan should not be used more than 10 times in a month as this can lead to a worsening of headaches and migraines.

Sumatriptan is a very serious medication and comes with some very serious side effects. Chiefly among these is the increased risk of heart attack, stroke, heart disease and blood vessel disease. Other factors including diabetes, obesity, smoking and a family propensity to heart disease can all contribute towards increased risks. You should discuss the risks of the use of this drug with your doctor before you begin treatment.

Sumatriptan interacts with a wide range of medications. You should inform your doctor of all medications that you are taking before you start use of this treatment. This includes all herbal remedies, over the counter medicines, prescribed medicines and vitamin supplements that you take.

Sumatriptan should also be used with caution when you have other medical conditions. Some conditions will prohibit the use of this treatment and others will require greater caution to be taken. Heart problems, in particular, indicate that you should not use this medication. Discuss all conditions that you have and any family history of medical conditions with your doctor.

This medication can be hugely helpful in the treatment of cluster headaches and migraines, allowing patients to go about their normal lives in comfort. Consider the risks in relation to the benefits of use with your doctor before taking this treatment.

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Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
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