Adult Dosing

Acute migraine attacks (with or without aura)

• 25-100 mg PO x 1
• May repeat q2 hrs if headache recurs
• Max: 200 mg/24 hrs

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Acute migraine attacks with or without aura

• Hypersensitivity to any of the ingredients of the product
• Underlying or significant cardiovascular disease
• Uncontrolled hypertension
• Ischemic heart disease (angina, Hx of MI)
• Coronary artery vasospasm
• Cerebrovascular disease
• Peripheral vascular disease
• Ischemic bowel disease
• Basilar migraine
• Hemiplegic migraine
• Severe hepatic impairment
• Concurrent (or within 24 hr) use of other 5-HT1 agonists, ergotamine, or ergot-type medications
• Concurrent (or within 2 wk) use of MAO inhibitors
• Safety and effectiveness of oral tablets have not been established for cluster headache, which is present in an older, predominantly male population

• N/A

Renal Dose Adjustment

• Renal impairment: Use with caution; dose adjustments not defined

Hepatic Dose Adjustment

• Mild to moderate impairment: Max: 50 mg/dose
• Severe impairment: Contraindicated

• Sumatriptan should be given only if a clear diagnosis of migraine has been established
• If the patient does not respond to the first dose, reconsider diagnosis of migraine headache before administration of a second dose
• Sumatriptan is not indicated for prophylaxis of migraine or for use in the management of hemiplegic or basilar migraine
• Safety and effectiveness have not been established for cluster headache
• Sumatriptan should not be given when risk factors for ischemic, cerebrovascular, or peripheral vascular syndromes are present. Unrecognized coronary artery disease (CAD) is predicted by the presence of risk factors e.g. hypertension, hypercholesterolemia, smoking, obesity, diabetes, strong family history of CAD, female with surgical or physiological menopause, or male over 40 years of age. Do not use unless a cardiovascular evaluation establishes that the patient does not have CAD
• Serious adverse cardiac events, including acute MI, arrhythmias, and death, have been reported within a few hours following administration
• It may cause coronary vasospasm in patients with history of coronary artery disease (CAD)
• Cerebral hemorrhage, subarachnoid hemorrhage, stroke, and other cerebrovascular events have occurred with 5-HT1 agonists
• Intermittent long term users should undergo periodic cardiovascular evaluation
• Monitor BP at baseline, cardiovascular evaluation at baseline, then periodically during long-term treatment if risk factors present

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Diabetes Mellitus
• Concomitant use with SSRI's possible serotonin syndrome
• Hypertension (due to possibility of unrecognised CAD)
• Cardiac risk factors
• Hx of seizure disorder
• Geriatric population (due to presence of risk factors for hypertension, hypercholesterolemia, possibility of unrecognized CAD)

Imitrex interacts with :

	Cafergot
	D.H.E. 45
	Dihydroergotamine
	Ergomar
	Ergotamine
	Methysergide
	Migranal
	Sansert

Pregnancy Category:C

Breastfeeding: Sumatriptan is excreted in breastmilk in low levels. It has poor oral bioavailability, thus would not be expected to cause any adverse effects in most breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 28 August2010). Manufacturer advises caution.

• CV: Chest pain/pressure/tightness/heaviness, hypertension, palpitations, coronary artery vasospasm, transient myocardial ischemia, myocardial infarction, ventricular tachycardia, ventricular fibrillation, arrhythmias, hypertensive crisis
• CNS: Dizziness, drowsiness, somnolence, insomnia, vertigo, cerebral hemorrhage, subarachnoid hemorrhage
• NEURO: Hyperesthesia, paresthesia, cerebrovascular accident
• EENT: Neck/jaw/throat pain/tightness/pressure, nasal irritation, throat discomfort, vision loss
• DERM: Burning sensation
• GI: Nausea/vomiting, abdominal pain, dysphagia, bad/unusual test
• MUSC: Myalgias, myasthenia
• MISC: Hypersensitivity reactions, asthenia, sweating, feeling of heaviness, pain, fatique

• 5-HT1B/1D receptor agonist; activates vascular serotonin receptors; produces vasoconstriction
• Extensively metabolized by liver; CYP450: Unknown
• Renally excreted: 60% (3% unchanged); feces: 40%
• Half-life: 2.5 hrs

US Trade Name(s)

• Imitrex

US Availability

sumatriptan (generic)

• TABS: 25, 50, 100 mg

Imitrex

• TABS: 25, 50, 100 mg

Canadian Trade Name(s)

• Imitrex DF

Canadian Availability

sumatriptan (generic)

• TABS: 25, 50, 100 mg

Imitrex DF

• TABS: 25, 50, 100 mg

UK Trade Name(s)

• Imigran
• Imigran Radis
• Imigran Recovery
• Migraleve Ultra

UK Availability

sumatriptan (generic)

• TABS: 50, 100 mg

Imigran, Imigran Radis

• TABS: 50, 100 mg

Imigran Recovery, Migraleve ultra

• TABS: 50 mg

Australian Trade Name(s)

• Imigran
• Imigran FDT
• Sumagran
• Sumatab
• Suvalan

Australian Availability

sumatriptan (generic)

• TABS: 50 mg

Imigran

• TABS: 50, 100 mg

Imigran FDT

• FDT (fast disintegrating tablets): 50, 100 mg

Sumagran, Sumatab, Suvalan

• TABS: 50, 100 mg

[Outline]

Analgesics

Antimigraine Agents

Triptans (5-HT1 Receptor Agonists)

Neurologic

Antimigraine Agents

Triptans (5-HT1 Receptor Agonists)

Pricing data from www.DrugStore.com in U.S.A.

• SUMAtriptan Succinate 50 MG TABS [Box] (RANBAXY PHARMACEUTICALS)
  9 mg = $199.99
  27 mg = $569.97
• Imitrex 25 MG TABS [Box] (GLAXO SMITH KLINE)
  9 mg = $272.65
  27 mg = $791.5
• Imitrex 50 MG TABS [Box] (GLAXO SMITH KLINE)
  9 mg = $268.99
  27 mg = $780.99
• Imitrex 100 MG TABS [Box] (GLAXO SMITH KLINE)
  9 mg = $255
  27 mg = $754

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Imitrex 100 MG Oral Tablet (GlaxoSmithKline LLC)
• Imitrex 25 MG Oral Tablet (GlaxoSmithKline LLC)
• Imitrex 50 MG Oral Tablet (GlaxoSmithKline LLC)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (American Health Packaging)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Aurobindo Pharma Limited)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Cobalt Laboratories Inc.)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Dispensing Solutions Inc.)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Dr Reddy's Laboratories Limited)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Dr. Reddy's Laboratories Limited)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Greenstone LLC)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Hikma Pharmaceutical)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Mylan Pharmaceuticals Inc.)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Physicians Total Care, Inc.)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Ranbaxy Pharmaceuticals Inc.)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (SUN PHARMACEUTICAL INDUSTRIES LIMITED)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Stat Rx USA)
• Sumatriptan 100 MG (sumatriptan succinate 140 MG) Oral Tablet (Teva Pharmaceuticals USA)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (American Health Packaging)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Aurobindo Pharma Limited)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Cobalt Laboratories Inc.)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Dr Reddy's Laboratories Limited)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Dr. Reddy's Laboratories Limited)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Greenstone LLC)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Hikma Pharmaceutical)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Mylan Pharmaceuticals Inc.)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Ranbaxy Pharmaceuticals Inc.)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (SUN PHARMACEUTICAL INDUSTRIES LIMITED)
• Sumatriptan 25 MG (sumatriptan succinate 35 MG) Oral Tablet (Teva Pharmaceuticals USA)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (American Health Packaging)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Aurobindo Pharma Limited)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Cobalt Laboratories Inc.)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Dispensing Solutions Inc.)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Dr Reddy's Laboratories Limited)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Dr. Reddy's Laboratories Limited)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Greenstone LLC)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Hikma Pharmaceutical)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Mylan Pharmaceuticals Inc.)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Physicians Total Care, Inc.)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Ranbaxy Pharmaceuticals Inc.)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (SUN PHARMACEUTICAL INDUSTRIES LIMITED)
• Sumatriptan 50 MG (sumatriptan succinate 70 MG) Oral Tablet (Teva Pharmaceuticals USA)