From the Guidelines
Imitrex (sumatriptan) should be avoided in patients with uncontrolled hypertension due to the risk of further increasing blood pressure and potentially causing cardiovascular complications. According to the study published in the American Family Physician in 2002 1, triptans, including sumatriptan, are contraindicated in patients with uncontrolled hypertension or significant cardiovascular disease. This is because triptans work by constricting blood vessels in the brain, which can temporarily increase blood pressure and worsen hypertension.
The study also notes that if one triptan is ineffective in a patient, a different triptan should be tried, and patients should try a medication for two to three headache episodes before abandoning that line of therapy 1. However, in the case of uncontrolled hypertension, the risk of using triptans may outweigh the potential benefits.
Another study published in 2003 1 also supports this recommendation, stating that triptans should not be used in patients with uncontrolled hypertension or basilar or hemiplegic migraine, or who are at risk for heart disease.
Key points to consider when evaluating the use of Imitrex in patients with hypertension include:
- The patient's blood pressure should be well-controlled before considering the use of Imitrex
- The patient should not have a history of heart disease or be at risk for cardiovascular complications
- Alternative treatments, such as preventive medications, non-triptan acute treatments, or non-pharmacological approaches, should be considered for patients with hypertension who suffer from migraines
- Patients should discuss their complete medical history with their healthcare provider before starting or stopping any medications, especially when dealing with conditions like hypertension.
From the FDA Drug Label
Sumatriptan tablets are contraindicated in patients with uncontrolled hypertension. Significant elevation in blood pressure, including hypertensive crisis with acute impairment of organ systems, has been reported on rare occasions in patients treated with 5-HT1 agonists, including patients without a history of hypertension. Monitor blood pressure in patients treated with sumatriptan.
Imitrex (sumatriptan) should not be used in patients with uncontrolled hypertension. However, for patients with controlled hypertension, the decision to use Imitrex should be made with caution and under close monitoring of blood pressure 2. It is essential to weigh the benefits of using Imitrex against the potential risks, especially in patients with a history of hypertension.
- Key considerations:
- Monitor blood pressure closely in patients with hypertension who are treated with sumatriptan.
- Use sumatriptan with caution in patients with controlled hypertension.
- Avoid using sumatriptan in patients with uncontrolled hypertension. 2
From the Research
Imitrex and Hypertension
- Imitrex, also known as sumatriptan, is a medication used to treat migraine headaches 3.
- There is evidence to suggest that people with hypertension may be less responsive to triptan therapy, including sumatriptan, than those without hypertension 4.
- A study found that sumatriptan was effective in treating migraine headaches in people with hypertension, but the response rate was lower compared to those without hypertension 4.
- Another study found that the combination of sumatriptan and naproxen was effective in treating migraine headaches, including in people with hypertension, and had a lower risk of cardiovascular side effects compared to triptans alone 5, 6.
Safety and Efficacy
- The safety and efficacy of sumatriptan in people with hypertension have been evaluated in several studies, and the results suggest that it is generally well-tolerated and effective in treating migraine headaches 3, 6.
- However, people with hypertension may need to be monitored more closely when taking sumatriptan, as they may be at higher risk for cardiovascular side effects 4.
- The use of sumatriptan in combination with other medications, such as naproxen, may be a viable option for people with hypertension who experience migraine headaches 5, 6.
Comparison with Other Treatments
- Sumatriptan has been compared to other treatments for migraine headaches, including lasmiditan, rimegepant, and ubrogepant, and the results suggest that it is generally more effective in treating migraine headaches, but may have a higher risk of side effects 7.
- The choice of treatment for migraine headaches in people with hypertension should be individualized and based on the specific needs and medical history of the patient 4, 7.