Sumatriptan (Imitrex) for Acute Migraine Treatment

Sumatriptan (brand name: Imitrex) is a prescription medication that is used to treat acute migraine headaches. Please continue reading to learn more about this medicine.

What is a migraine headache?

A migraine headache is a pulsing or throbbing pain of severe intensity that is typically one-sided, taking place in the forehead, neck, or face. It is typically accompanied by other symptoms, such as nausea and sensitivity to light and noise. Some people have migraine with aura, which is a warning sign such as flashing lights, tingling in the face or hands, and blind spots before the headache begins. Acute migraine attacks can last for hours or even days. Prompt treatment can reduce migraine pain intensity. Medications can also help to reduce the frequency of chronic migraine attacks and improve a person’s quality of life.

What is sumatriptan (Imitrex)?

Sumatriptan succinate belongs to a group of drugs called selective serotonin receptor agonists or triptans. It causes the narrowing of blood vessels in the brain, blocks pain signals, and reduces the release of certain natural chemicals that cause the hallmark symptoms of migraine, such as nausea, migraine pain, and sensitivity to light and sound.

Dosage forms of sumatriptan for migraine treatment include an oral tablet taken by mouth, pre-filled auto-injectors for subcutaneous injection, a nasal spray, and nasal powder.

Remember that sumatriptan injection should only be administered subcutaneously (under the skin). This medication should not be administered intravenously. The U.S. FDA has classified the intravenous administration of sumatriptan as a contraindication because of its potential to cause coronary vasospasm. On the contrary, another class of migraine medications called dihydroergotamine can be given by intravenous administration (into the vein) at an infusion center or hospital to treat migraine headaches.

How effective is Imitrex for migraine attacks?

Sumatriptan is a rescue medication for the acute treatment of a migraine attack. It can provide quick relief from severe pain and associated symptoms such as severe nausea and light or noise sensitivity. However, the effects of sumatriptan wear off in a few hours. Even though sumatriptan provides sustained headache relief, this medication is not approved to prevent migraine or reduce the frequency of migraine attacks. The peak effects of sumatriptan are between 2 and 4 hours, and in the event that your headaches improve temporarily but come back later, you can take the same dose after 2 hours.

Studies on relative efficacy have found that sumatriptan is more effective than some other migraine medications. However, each person’s response to a drug is different. Also, sumatriptan may not be right for everyone, for example, people with uncontrolled hypertension (high blood pressure), ischemic heart disease, or severe hepatic impairment (liver disease). Your healthcare professional will help you choose the best medication and dosage form depending on your symptoms, response, side effects, cost factors, etc.

How quickly does sumatriptan work for acute migraine attacks?

Sumatriptan provides quick pain relief from an acute migraine attack, typically within 10 minutes of receiving a dose of subcutaneous sumatriptan injection, 15 minutes after using intranasal sumatriptan, and 30 minutes after receiving oral sumatriptan for severe headaches. Many migraine sufferers find that the maximum benefit is seen 2-4 hours after an injection, spray, or oral dose of sumatriptan.

When should I take Imitrex for migraine headache pain?

You should take Imitrex at the first sign of a migraine attack (for example, as soon as you experience an aura or warning sign). The sooner you take the medicine, the more effectively it will relieve pain. You can take a second dose of oral sumatriptan after 2 hours if your symptoms improve but come back. Do not take more than one dose at a time if your symptoms do not improve. Your doctor will tell you how many Imitrex you can take in 24 hours. The usual dosage is as follows:

Oral dosage form: Take a 25 mg, 50 mg, or 100 mg tablet at the first sign of migraine for initial treatment. Do not exceed 100 mg/dose. Repeat oral doses every 2 hours as needed. Do not exceed 200 mg per day of oral formulations.
Nasal spray: Use the 5 mg, 10 mg, or 20 mg nasal spray as prescribed in one or both nostrils for abortive treatment of migraine headaches. Repeat a second dose 2 hours after the initial dose if your symptoms improve but come back. Take a third dose one hour after the second one if needed. Do not exceed 40 mg in 24 hours.
Sumatriptan injection: Use the auto-injector for a single dose, which contains 6 mg of sumatriptan. You can repeat a dose 1 hour after the first dose. Do not exceed 12 mg in 24 hours.

Read the patient information leaflet and prescription label carefully and take sumatriptan exactly as prescribed.

Why do I feel strange effects after taking Imitrex?

Like most medications, Imitrex (sumatriptan) can cause side effects that can make you feel strange. Common side effects of sumatriptan include drowsiness, dizziness, tingling, feeling cold or warm, flushing, weakness, stomach cramps, nausea, diarrhea, upset stomach, and muscle cramps. In addition, subcutaneous sumatriptan may cause an injection site reaction, and intranasal sumatriptan may cause nasal discomfort.

Tell your doctor if the side effects are severe or do not go away. Sometimes, the side effects are dose-dependent, and lowering the dose may help.

Some of the adverse effects of sumatriptan are more serious. Call your doctor immediately or seek emergency medical attention if you develop the following signs and symptoms:

Chest pain, pressure, or tightness
Shortness of breath or difficulty breathing or swallowing
Fast, pounding, or irregular heartbeat
Fainting
Slowed or difficult speech
Cold sweats
Numbness or weakness in an arm or leg
Sudden severe stomach pain, bloody diarrhea, vomiting, sudden weight loss
Bluish coloration or paleness of the fingers and toes
Rash, hives, itching of the skin
Redness, swelling, or itching of the face, eyes, lips, or throat
Vision changes
Seizures

What are the risks of taking sumatriptan?

Some of the risks and potential adverse events associated with taking sumatriptan to treat episodic migraine include:

Medication overuse headache (if you take sumatriptan for 10 or more days a month, it can lead to an increase in headache frequency)
Increased risk of heart problems and stroke, especially in people with a history of coronary artery disease or risk factors such as age over 65, obesity, smoking, high blood pressure, or diabetes
Increased risk of seizures
Serotonin syndrome due to very high levels of a natural chemical called serotonin in the brain
Problems due to narrowing of blood vessels in the eyes, stomach, hands and feet, and spleen, especially in people with pre-existing conditions such as peripheral vascular disease or ischemic bowel disease
Life-threatening allergic reactions (your doctor may ask you to take the first dose in a medically supervised setting)
Drug interactions with other medications can cause severe side effects or health complications. Give your doctor a complete list of all your medications before starting sumatriptan treatment.