What is the use of Sumatriptan (Imitrex)?

From the Guidelines

Sumatriptan is a medication primarily used to treat migraine headaches, and it should be taken at the first sign of a migraine, but not during the aura phase or for prevention, as recommended by studies such as 1 and 1. The standard dose for adults is typically 50-100mg taken orally at the onset of migraine symptoms, with a maximum daily dose of 200mg. Sumatriptan is also available as a nasal spray (5-20mg per nostril), injection (6mg subcutaneously), or as a needle-free injection system. Some key points to consider when using sumatriptan include:

• It belongs to the triptan class of drugs and works by narrowing blood vessels in the brain and blocking pain pathways.
• Side effects may include chest tightness, flushing, dizziness, and fatigue.
• Sumatriptan is contraindicated in patients with heart disease, uncontrolled hypertension, or those who have taken MAO inhibitors within 14 days.
• It works by activating serotonin receptors (5-HT1B/1D), which constricts cranial blood vessels and inhibits the release of inflammatory neuropeptides, effectively stopping the migraine process.
• Patients should not take other triptans within 24 hours of using sumatriptan to avoid serotonin syndrome, as noted in studies such as 1 and 1. Overall, sumatriptan is an effective treatment for migraine headaches, but it should be used with caution and under the guidance of a healthcare professional, as recommended by studies such as 1 and 1.

From the FDA Drug Label

Sumatriptan tablets, USP are a serotonin (5-HT1B/1D) receptor agonist (triptan) indicated for acute treatment of migraine with or without aura in adults. Limitations of Use: Use only if a clear diagnosis of migraine headache has been established. Not indicated for the prophylactic therapy of migraine attacks Not indicated for the treatment of cluster headache.

The use of Sumatriptan (Imitrex) is for the acute treatment of migraine with or without aura in adults, but only if a clear diagnosis of migraine headache has been established. It is not indicated for:

• prophylactic therapy of migraine attacks
• treatment of cluster headache 2

From the Research

Use of Sumatriptan (Imitrex)

Sumatriptan, also known as Imitrex, is a medication used to treat migraine headaches. The following are some key points about its use:

• Sumatriptan is a selective serotonin 5-hydroxytryptamine (5-HT1B/1D) agonist that relieves migraine attacks by causing cranial vasoconstriction and peripheral and central neural inhibition 3.
• It is available in various forms, including oral, subcutaneous, intranasal, and rectal, and is effective in relieving pain, nausea, photophobia, phonophobia, and functional disability associated with migraine attacks 4, 5, 6.
• The oral dose of sumatriptan is generally effective for migraine without aura attacks of both moderate and severe intensity, with a recommended dose of 50 mg or 100 mg 7, 5.
• Subcutaneous administration of sumatriptan is the most effective route, with pain reduced from moderate or severe to none by two hours in almost 6 in 10 people taking 6 mg sumatriptan 6.
• The most commonly used doses of oral, rectal, and intranasal sumatriptan also provide clinically useful pain relief, with the oral 50 mg dose providing complete relief of pain in almost 3 in 10 people compared to about 1 in 10 after placebo 6.
• Adverse events associated with sumatriptan are generally of mild or moderate severity, of short duration, and more common with subcutaneously administered sumatriptan and higher doses of oral and intranasal sumatriptan 4, 5, 6.

Efficacy of Sumatriptan

The efficacy of sumatriptan in treating migraine attacks is well established, with the following key points:

• Sumatriptan is effective in relieving pain, nausea, photophobia, phonophobia, and functional disability associated with migraine attacks 3, 4, 5, 6.
• The number needed to treat (NNT) for pain-free at two hours with sumatriptan 50 mg is 6.1, and with sumatriptan 100 mg is 4.7 5.
• The NNT for headache relief at two hours with sumatriptan 50 mg is 7.5, and with sumatriptan 100 mg is 6.8 5.
• Subcutaneous administration of sumatriptan provides more rapid pain relief than the other routes, with an NNT of 2.3 for pain-free at two hours 6.

Safety and Tolerability of Sumatriptan

The safety and tolerability of sumatriptan are generally good, with the following key points:

• Adverse events associated with sumatriptan are generally of mild or moderate severity, of short duration, and more common with subcutaneously administered sumatriptan and higher doses of oral and intranasal sumatriptan 4, 5, 6.
• The most common adverse events associated with sumatriptan include nausea, vomiting, malaise, fatigue, and dizziness 4.
• Sumatriptan is contraindicated in patients with ischemic heart disease, previous myocardial infarction, Prinzmetal (variant) angina, and uncontrolled hypertension 4.