Maximum Weekly Sumatriptan 100mg Dosing
You can take a maximum of 4 doses of sumatriptan 100mg in one week (twice weekly dosing), which equals 400mg total weekly, to prevent medication-overuse headache. 1
Critical Weekly Limit Framework
Guideline societies mandate limiting acute migraine treatment to no more than twice per week to prevent transformation of episodic migraine into chronic daily headache from medication overuse. 1
This twice-weekly limit translates to approximately 8-9 treatment days per month, which equals roughly 2 treatment days per week when averaged. 1
The FDA specifies a maximum daily dose of 200mg in any 24-hour period, but this does NOT mean you can use this maximum dose daily. 2
Practical Weekly Calculation
Maximum allowable: 2 treatment days per week × 2 doses per attack (100mg each) = 4 doses of 100mg weekly (400mg total). 1, 2
Each 100mg dose must be separated by at least 2 hours if a second dose is needed for the same attack. 2
You cannot exceed 200mg (two 100mg tablets) within any single 24-hour period. 2
Critical Pitfall: Medication-Overuse Headache
Using triptans more frequently than twice weekly causes rebound headaches and transforms episodic migraine into chronic daily headache. 1
This risk applies regardless of whether you're taking 50mg or 100mg doses - the frequency of treatment days matters most. 1
Patients must explicitly understand this limitation when receiving their prescription to avoid inadvertent overuse. 1
Dosing Strategy Within Weekly Limits
If 100mg provides insufficient relief during a single attack, you may take a second 100mg dose after 2 hours (total 200mg for that attack), but this still counts as ONE treatment day toward your weekly limit. 2
Space your treatment days throughout the week rather than clustering them together. 1
If you need more than 2 treatment days per week consistently, you require preventive migraine therapy rather than increased acute treatment. 1
Alternative Approaches Before Increasing Frequency
Add an NSAID or acetaminophen to your 100mg sumatriptan dose rather than increasing triptan frequency if single doses are inadequate. 1
Trial sumatriptan for 2-3 different headache episodes before concluding it's ineffective, as response can vary between attacks. 3
If sumatriptan consistently fails, switch to a different triptan (almotriptan, eletriptan, rizatriptan, zolmitriptan) rather than increasing frequency, as different triptans work for different patients. 1, 3