What are the dosages for Sumatriptan (Imitrex)?

From the Guidelines

Sumatriptan dosages should be administered as 6 mg subcutaneously, repeated in one hour if necessary, with a maximum dosage of 12 mg per 24 hours, or 25 to 100 mg orally every two hours, with a maximum dosage of 200 mg per day, as this has been shown to be effective in 70 to 82 percent of patients 1. The dosage of sumatriptan varies by administration route, with subcutaneous injections typically being 6 mg, and oral tablets ranging from 25 to 100 mg at migraine onset.

• The maximum dosage for subcutaneous injections is 12 mg per 24 hours, with a minimum of one hour between doses.
• The maximum dosage for oral tablets is 200 mg per day, with a minimum of two hours between doses.
• Intranasal sumatriptan is also available, with a dosage of 5 to 10 mg (one to two sprays) in one nostril, and a maximum dosage of 40 mg per day. Sumatriptan works by activating serotonin receptors, causing vasoconstriction of dilated cerebral blood vessels and reducing inflammation associated with migraines, and its efficacy is supported by good evidence 1.
• Side effects may include chest tightness, flushing, dizziness, and injection site reactions.
• Sumatriptan should not be taken within 24 hours of other triptans or ergot medications, and is contraindicated in patients with cardiovascular disease, uncontrolled hypertension, or hemiplegic/basilar migraines. It is essential to note that if the first dose doesn't provide relief, a second dose generally won't help for the same attack, and patients should try a medication for two to three headache episodes before abandoning that line of therapy 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION 2. 1 Dosing Information The recommended dose of sumatriptan tablets is 25 mg, 50 mg, or 100 mg. The recommended dosages for sumatriptan are:

• 25 mg
• 50 mg
• 100 mg The maximum daily dose is 200 mg in a 24-hour period 2.

From the Research

Dosage Information for Sumatriptan

• The provided studies do not explicitly state the dosages for sumatriptan, but they discuss its use and efficacy in treating migraine attacks 3, 4, 5, 6, 7.
• Sumatriptan is a triptan, which is a type of medication that is effective in eliminating pain in 20% to 30% of patients by 2 hours, but it can have adverse effects such as transient flushing, tightness, or tingling in the upper body in 25% of patients 3.
• Triptans, including sumatriptan, are contraindicated in patients with cardiovascular disease and have warnings and precautions for those with cardiovascular risk factors 4, 6.
• The American Headache Society considers all triptans, including sumatriptan, to be effective for the treatment of acute migraine attacks, and they are recommended as first-line medications for moderate to severe attacks 7.

Administration and Usage

• The administration of sumatriptan should follow the concept of "stratified care", where the medication is chosen based on the severity of the migraine attack 7.
• For moderate to severe migraine attacks, oral or nasal spray triptans, including sumatriptan, are recommended and should be administered in the early stage of the attack 7.
• A combination of a triptan and a nonsteroidal anti-inflammatory drug (NSAID) may yield a better efficacy compared to either therapy alone 7.

Safety and Contraindications

• Sumatriptan is generally well-tolerated, but it can have adverse effects such as chest symptoms, which are usually nonserious and not attributed to ischemia 6.
• The incidence of serious cardiovascular adverse events associated with sumatriptan is extremely low, but they can occur in patients with significant cardiovascular risk or overt cardiovascular disease 6.
• Patients with cardiovascular disease or risk factors should avoid using triptans, including sumatriptan, due to their vasoconstrictive properties 3, 4, 6.