Sumatriptan Succinate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Apr 10, 2023

Warnings

Sumatriptan Succinate (Imitrex) Risks, Warnings, and Complications

Sumatriptan (Imitrex) tablets can cause serious problems in some people. Talk to your doctor or pharmacist about other treatment options for your headaches if you are at increased risk of complications from sumatriptan use.

CHEST/THROAT/NECK/JAW PAIN, TIGHTNESS, PRESSURE OR HEAVINESS: Sumatriptan can cause pain, pressure, tightness or heaviness in the chest, neck, throat, or jaw. These symptoms usually go away on their own. However, they can also be signs of a heart attack. If you notice worsening or persistent symptoms, get emergency medical help.
SERIOUS CARDIOVASCULAR EVENTS: Sumatriptan can cause serious problems like cerebral hemorrhage (brain bleeds), transient ischemic attack, stroke, irregular heartbeats, and high blood pressure. Significant elevation in blood pressure can be dangerous, especially in people with pre-existing heart disease. Risk factors for these adverse reactions include people over the age of 65 years and those with high blood pressure, diabetes, obesity, tobacco use, or a family history of heart disease. Before starting sumatriptan, tell your doctor if you have a history of heart problems, heart rhythm abnormalities, brain bleeds, or stroke. If you develop serious side effects on this medicine, your doctor may ask you to stop taking it.
MEDICATION OVERUSE HEADACHE: Taking sumatriptan for more than 10 days a month to treat migraines can cause rebound headaches or medication overuse headaches. Tell your healthcare provider if you need to take sumatriptan more than 4 times a month, if you’re not getting relief from sumatriptan, or if you have worsening or more frequent headaches. Detoxification may be necessary by discontinuing the medicine for some time.
SEROTONIN SYNDROME: Sumatriptan can interact with a serotonergic medication, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs), which are antidepressants. This can lead to dangerously high levels of serotonin in the body. Get emergency medical help if you develop serotonin syndrome symptoms such as sudden confusion, hallucinations, mental status changes, nausea, diarrhea, or muscle tightness.
SEIZURES: Sumatriptan can increase the risk of seizures, especially in people who have epilepsy. Seizures can also happen in people who have never had them before. Before starting sumatriptan, tell your healthcare provider if you have a history of seizures or epilepsy. Seek emergency medical care if you have a seizure while on this medicine.
SEVERE BLOOD VESSEL NARROWING: Patients treated with sumatriptan can develop severe narrowing of blood vessels, which can cause sensations of hot or cold in the hands and feet, significant partial vision loss, or transient and permanent blindness. Stop taking sumatriptan and get immediate medical help if you notice vision changes, hot or cold sensations, or any other symptoms that are unusual.
ALLERGIC REACTIONS: Rarely, taking sumatriptan can lead to potentially life-threatening allergic reactions. Get emergency medical attention if you develop a skin rash, hives, difficulty breathing or swallowing, or swelling of the face, eyes, lips, tongue, or throat.

Precautions Before Starting Sumatriptan Succinate (Imitrex)

Tell your doctor if you are allergic to sumatriptan, any of the active or inactive ingredients in sumatriptan formulations, any other triptans, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions.

Give your doctor a complete medical history. Sumatriptan may not be right for people with certain medical conditions such as heart disease, heart attack, angina, irregular heartbeat, mini strokes (transient ischemic attacks or TIAs), stroke, blood clots, circulation problems, peripheral vascular disease, varicose veins in the legs, Raynaud’s phenomenon, ischemic bowel disease, severe hepatic impairment, uncontrolled hypertension, or hemiplegic or basilar migraine. Also, tell your doctor if you have high blood pressure, high cholesterol, obesity or overweight, diabetes, liver disease, kidney disease, seizures, are postmenopausal, are a smoker, or if someone in your family has a history of heart disease or stroke.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding. If you are sexually active, discuss appropriate birth control with your provider before starting sumatriptan.

Precautions During Use of Sumatriptan Succinate (Imitrex)

Keep all your medical appointments while on sumatriptan. Your doctor may adjust your dose based on your response to the medicine. They will also monitor you for side effects and medication overuse headache.

Sumatriptan can cause drowsiness and dizziness. Do not drive or do anything that requires your full concentration until you know how this medicine affects you.

Tell your doctor if you become pregnant while on sumatriptan.

Sumatriptan Succinate (IMITREX) Drug Interactions

Certain other drugs can affect how sumatriptan works. Possible interactions between sumatriptan and other medicines can increase the risk of severe adverse effects.

Do not take sumatriptan if you have taken any of these medications within the last 24 hours:

Other triptans (selective serotonin receptor agonists) such as eletriptan (Relpax), naratriptan (Amerge), frovatriptan (Frova), almotriptan (Axert), zolmitriptan (Zomig), or rizatriptan (Maxalt).
Ergot-type medications such as ergotamine (Cafergot, Wigraine, Ergomar), dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), methylergonovine (Methergine), pergolide (Permax), methysergide (Sansert), bromocriptine (Parlodel), and cabergoline.
Do not take sumatriptan if you have taken monoamine oxidase inhibitors such as phenelzine (Nardil), isocarboxazid (Marplan), or tranylcypromine (Parnate) in the past 2 weeks.

The following medications can also have drug interactions with sumatriptan:

Acetaminophen (Tylenol).
Aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin).
Tricyclic antidepressants such as amitriptyline (Elavil), nortriptyline (Aventyl, Pamelor), clomipramine (Anafranil), amoxapine (Asendin), doxepin (Adapin, Sinequan), desipramine (Norpramin), imipramine (Tofranil), trimipramine (Surmontil), and protriptyline (Vivactil).
Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem, in Symbyax), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and fluvoxamine.
Serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor), desvenlafaxine (Pristiq), sibutramine (Meridia), and duloxetine (Cymbalta).

The above list may not describe all the other medicines that can have interactions with sumatriptan. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC medications, dietary supplements, and herbal remedies. Also, tell your doctor or pharmacist if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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