Sumatriptan

Brand names

• Imitrex

Usage

For the acute treatment of migraine headaches, with or without aura.

How it works

Sumatriptan appears to activate chemical messengers that cause blood vessels in the brain to constrict, thus lessening the effects of a migraine. It not only relieves the pain, but also nausea, vomiting, sensitivity to sound and light, and other symptoms associated with migraines.

Side effects

Serious

Chest pain (mild to severe) or feeling of heaviness or pressure in the chest; wheezing or shortness of breath, and rapid, shallow, or irregular breathing; puffiness or swelling of the eyelids, face or, lips; hives; intense itching.

Common

Pain, burning, or redness at injection site; a general feeling of warmth or heat; a feeling of numbness, tightness, or tingling; mild pain of the jaw, mouth, tongue, throat, nose, or sinuses; dizziness; drowsiness; feeling cold or weak; feeling flushed or lightheaded; muscle aches, cramps, or stiffness; nausea or vomiting.

Less common

Mild chest pain, heaviness or pressure in the chest or neck, anxiety, feeling tired or ill, vision changes.

Possible interactions

Other medicaments:

Sumatriptan taken concurrently with:

• citalopram (Celexa) may lead to loss of coordination and excessive reflex response.
• ergotamine-containing preparations may result in additive vasospasm (prolonged constriction of the blood vessels)-these medicines should not be taken within 24 hours of any sumatriptan dose. There is a case report of heart attack after sumatriptan was combined with methysergide.
• fluoxetine (Prozac) may result in coordination problems.
• fluvoxamine (Luvox) and other SSRIs may result in coordination problems.
• monoamine oxidase (MAO) inhibitors may result in toxic levels of sumatriptan-MAO inhibitors and sumatriptan should never be combined. It is important that 14 days go by after your last dose of an MAO inhibitor before you take any form of sumatriptan.
• naratriptan (Amerge) or other 5HT1 agonists may lead to prolonged spasm of the blood vessels.
• paroxetine (Paxil) may result in coordination problems.
• sertraline (Zoloft) may result in coordination problems.
• sibutramine (Meridia) may increase risk of serotonin syndrome.
• venlafaxine (Effexor) may result in coordination problems.

Foods:

No restrictions; however, some foods or additives such as monosodium glutamate or chocolate may be a risk factor for migraines. Skipping meals can also be a risk factor for migraines. Keeping a migraine diary can help identify triggers.

Herbal medicines or minerals:

Using St. John's wort, ma huang or kola while taking this medicine may trigger a migraine. Trigger compounds must be individually identified. Since part of how ginseng works (mechanism of action) may involve an MAO inhibitor, combination with sumatriptan is not recommended. Using ma huang or ephedrine-like compounds may result in additive and undesirable vasoconstriction. If you are allergic to plants in the Asteraceae family (aster, chrysanthemum, daisy or ragweed), you may also be allergic to Echinacea, chamomile, feverfew and St. John's wort. St. John's wort can cause changes in the liver enzymes that help remove this medicine.

Alcohol:

May cause additive sedation. Alcohol may also be a precipitating factor for migraine.

Marijuana smoking:

May cause additive dizziness, drowsiness and lethargy; may cause additive increases in blood pressure.

Exposure to cold:

Use caution until tolerance is determined. Cold may enhance sumatriptan vasoconstriction.

Heavy exercise or exertion:

Strenuous exercise can be a risk factor for migraines in some patients.

Special storage instructions:

Keep this medicine out of reach of children. Store at room temperature in a room where the temperature will not exceed 86 degrees F (30 degrees C). Keep away from heat and light.

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