Adult Dosing

Acute migraine attacks with or without aura

• 6.5mg/4hr
• No more than two transdermal systems should be used in any 24 hour period; second transdermal system should be used no sooner than 2 hours after activation of first.

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• Acute migraine attacks with or without aura

• Hypersensitivity to any of the ingredients of the product
• Wolff-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders
• Hx of stroke
• Hx of transient ischemic attack
• Hx of hemiplegic or basilar migraine
• Peripheral vascular disease
• Ischemic bowel disease
• Uncontrolled hypertension
• 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
• Severe hepatic impairment
• Allergic contact dermatitis

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Mild-moderate hepatic impairment: Dose adjustments not defined
• Severe hepatic impairment: Use contraindicated

• Transdermal patch contains metal parts which may cause injury during magnetic resonance imaging (MRI) procedure; hence must be removed before an MRI procedure
• Therapy may lead to allergic contact dermatitis (ACD). If ACD is suspected, therapy should be discontinued
• Erythema, erythematous plaque and/or erythemato-vesicular or erythemato-bullous eruptions may develop during therapy
• Patients sensitized from use of patch may develop systemic sensitization or other systemic reactions if sumatriptan-containing products are taken via other routes, e.g., orally or subcutaneously
• There have been rare reports of serious cardiac adverse reactions, including acute myocardial infarction, occurring within a few hours following administration of sumatriptan. Use is contraindicated in patients with ischemic or vasospastic CAD
• Before initiating therapy in triptan-naive patients who have multiple cardiovascular risk factors such as increased age, diabetes, hypertension, smoking, obesity, or strong family history of CAD, a cardiovascular evaluation should be performed
• Life-threatening disturbances of cardiac rhythm, including ventricular tachycardia and ventricular fibrillation leading to death, have been reported within a few hours following the administration of 5-HT1 agonists
• Sensations of tightness, pain, pressure, and heaviness in the chest, throat, neck, and jaw commonly occur after treatment with sumatriptan
• 5-HT1 agonists have been associated with cerebral hemorrhage, subarachnoid hemorrhage, and stroke
• 5-HT1 agonists, including sumatriptan, may cause non-coronary vasospastic reactions, such as peripheral vascular ischemia, gastrointestinal vascular ischemia and infarction (presenting with abdominal pain and bloody diarrhea), splenic infarction, and Raynaud’s syndrome
• 5-HT1 agonists may lead to transient and permanent blindness and significant partial vision loss
• Overuse may lead to exacerbation of headache
• During coadministration with selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and MAO inhibitors, serotonin syndrome characterized by symptoms such as mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea) may occur
• Rarely, 5-HT1 agonists have been associated with significant elevation in blood pressure, including hypertensive crisis with acute impairment of organ systems. Closely monitor blood pressure
• Anaphylactic/anaphylactoid fatal and life threatening reactions have occurred in patients receiving sumatriptan
• Seizures have been reported following administration of sumatriptan. Use cautiously in patients with a history of epilepsy or conditions associated with a lowered seizure threshold
• Patch should not be applied in areas near or over electrically-active implantable or body­-worn medical devices (e.g., implantable cardiac pacemaker, body-worn insulin pump, implantable deep brain stimulator)

Zecuity interacts with :

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

Pregnancy Category:C

Breastfeeding: It is not known whether sumatriptan is excreted in human milk following transdermal administration. Because many drugs are excreted in human milk, and because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

• NEURO: Cerebrovascular events, paresthesia
• DERM: Allergic contact dermatitis, pruritus
• CV: Increase in blood pressure, myocardial ischemia, myocardial infarction, and Prinzmetal’s angina, arrhythmias
• EENT: Chest, throat, neck, and/or jaw pain/tightness/pressure
• HYPERSENSITIVITY: Application site pain, anaphylactic/anaphylactoid reactions

• 5-HT1B/1D receptor agonist; binds to 5-HT1B/1D receptors located on intracranial blood vessels and activates vascular serotonin receptors; produces vasoconstriction
• Metabolized by MAO to inactive metabolites: indole acetic acid (IAA) or the IAA glucuronide
• Excretion: Urine (11%) and 69% in urine (IAA metabolite)
• Half-life: 3.1 hours

US Trade Name(s)

• Zecuity

US Availability

Zecuity

• TDP film: 6.5 mg/4 hr

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Analgesics

Antimigraine Agents

Triptans (5-HT1 Receptor Agonists)