From the FDA Drug Label
The safety of treating an average of more than 4 headaches in a 30-day period has not been established. The recommended frequency of sumatriptan use is not explicitly stated in terms of days, but it is limited to treating no more than 4 headaches in a 30-day period. This implies that the medication should not be used for more than 4 days in a 30-day period, assuming one dose per headache. However, the exact number of days is not directly specified, and the limitation is based on the number of headaches treated rather than the number of days. 1
- The maximum daily dose is 200 mg in a 24-hour period.
- A second dose may be administered at least 2 hours after the first dose if the migraine has not resolved or returns after a transient improvement.
From the Research
Sumatriptan should not be used more than 2-3 days per week or 9-10 days per month for migraine treatment. The standard adult dose of oral sumatriptan is typically 25-100 mg at headache onset, which can be repeated after 2 hours if needed, not exceeding 200 mg in a 24-hour period 2. For the injectable form, the standard dose is 6 mg subcutaneously, while the nasal spray is available in 5-20 mg strengths. Exceeding the recommended frequency can lead to medication overuse headache (MOH), a condition where frequent use of acute headache medications paradoxically increases headache frequency and intensity. This occurs because regular triptan use can cause changes in pain pathways and receptors, creating a cycle of dependency. If you're needing triptans more frequently than recommended, consult your healthcare provider about preventive migraine treatments, which might include daily medications, lifestyle modifications, or non-pharmacological approaches to reduce your reliance on acute medications.
Some key points to consider when using sumatriptan include:
- The efficacy of sumatriptan in relieving migraine symptoms, including pain, nausea, photophobia, and phonophobia, has been established in numerous studies 3, 4, 5, 6.
- The optimal dosage of sumatriptan may vary depending on individual patient needs, but the 50 mg and 100 mg doses have been shown to be more effective than the 25 mg dose in some studies 3.
- Sumatriptan has been compared to other treatments, including other triptans, paracetamol, acetylsalicylic acid, non-steroidal anti-inflammatory drugs (NSAIDs), and ergotamine combinations, and has been found to be effective in relieving migraine symptoms 2.
- The use of sumatriptan has been associated with increased adverse events, including transient and mild events, with a clear dose-response relationship 2.
It is essential to follow the recommended usage guidelines for sumatriptan to minimize the risk of MOH and other adverse effects. If you have any concerns or questions about using sumatriptan or other migraine treatments, consult your healthcare provider for personalized advice.