Sumatriptan Treatment Indications
Sumatriptan is a prescription medication used to treat acute migraine headaches with or without aura in adults. 1
Primary Indication
- Sumatriptan treats acute migraine attacks, providing relief from headache pain and associated symptoms including nausea, photophobia, and phonophobia 2, 1
- The medication is specifically indicated for the abortive treatment of established migraine attacks, not for prevention or prophylaxis 1, 3
Mechanism of Action
- Sumatriptan works as a selective serotonin 5-HT1B/1D receptor agonist, causing cranial vessel constriction and inhibiting pro-inflammatory neuropeptide release in the trigeminal system 1
- This dual mechanism addresses both the vascular and neurogenic components of migraine pathophysiology 1
Available Formulations and Efficacy
- Oral sumatriptan is available in 25 mg, 50 mg, and 100 mg doses, with the 100 mg dose showing the highest efficacy (pain-free at 2 hours in approximately 59% of patients versus 18% with placebo) 2, 3
- Subcutaneous sumatriptan 6 mg provides the most rapid onset of action (approximately 15 minutes) and highest efficacy rates (70-82% headache relief within 15 minutes) 4, 5
- Intranasal sumatriptan (5-20 mg) is particularly useful for patients with significant nausea or vomiting 2, 4
What Sumatriptan Does NOT Treat
- Sumatriptan is not used to treat hemiplegic or basilar migraines, as these are contraindications 1
- Sumatriptan is not indicated for cluster headache treatment in the oral formulation, though subcutaneous sumatriptan has shown efficacy for this indication 1, 6
- Sumatriptan does not prevent migraines or decrease the frequency of attacks—it only treats acute episodes 1
- Sumatriptan is not used for other types of headaches such as tension-type headaches 1
Critical Contraindications
- Patients with ischemic heart disease, coronary artery disease, or history of myocardial infarction should not receive sumatriptan 1
- Uncontrolled hypertension is an absolute contraindication 1
- Sumatriptan cannot be used within 24 hours of ergotamine-containing medications or other triptans 1
Important Clinical Considerations
- Headache recurrence occurs in 21-57% of patients who initially respond to sumatriptan, but most respond well to a second dose given at least 2 hours after the first 7, 5
- Maximum daily dose is 200 mg for oral sumatriptan 1
- Medication overuse headache can develop if sumatriptan is used more than twice weekly, requiring limitation of use frequency 4, 1