5-HT1B/1D agonist (triptans)
Each tablet contains:
sumatriptan (as succinate) 50 and 100mg
Indication and dosage:
25mg, 50mg, or 100mg
Additional Dose: May administer a 2nd dose at least 2 hrs after 1st dose if migraine has not resolved or returns after transient improvement
Use After Inj: If migraine returns after initial treatment with inj, may give additional single tab (up to 100mg/day), with an interval of at least 2 hrs between tab doses
Max: 200mg/24 hrs
Mild to Moderate:
Max Tab Single Dose: 50mg
Start at lower end of dosing range
Pregnancy and breastfeeding:
Pregnancy category C.
Excreted in human milk , avoid breastfeeding for 12 hrs after administration.
Ischemic coronary artery disease (CAD) (eg, angina pectoris, history of MI, documented silent ischemia), coronary artery vasospasm (eg, Prinzmetal’s angina), Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders, history of stroke or transient ischemic attack, history of hemiplegic/basilar migraine, peripheral vascular disease, ischemic bowel disease, uncontrolled HTN.
hypersensitivity to sumatriptan.
severe hepatic impairment.
Recent use (within 24 hrs) of another 5-HT1 agonist, or of an ergotamine-containing or ergot-type medication (eg, dihydroergotamine, methysergide).
Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor.
Warning and precautions:
Serious cardiac adverse reactions (eg, acute MI) reported.
May cause coronary artery vasospasm. Perform cardiovascular (CV) evaluation in triptan-naive patients with multiple CV risk factors (eg, increased age, diabetes, HTN, smoking, obesity, strong family history of CAD) prior to therapy; if negative, consider administering 1st dose under medical supervision and perform an ECG immediately following administration.
Consider periodic CV evaluation in intermittent long-term users with multiple CV risk factors. Sensations of tightness, pain, pressure, and heaviness in the precordium, throat, neck, and jaw, usually noncardiac in origin, reported; perform cardiac evaluation if at high cardiac risk.
Life-threatening cardiac rhythm disturbances (eg, ventricular tachycardia, ventricular fibrillation leading to death) reported; discontinue if these occur.
Cerebral/subarachnoid hemorrhage and stroke reported; discontinue therapy if a cerebrovascular event occurs.
Patients with migraine may be at increased risk of certain cerebrovascular events.
Exclude other potentially serious neurological conditions prior to therapy in patients not previously diagnosed with migraine or in patients who present with atypical symptoms.
May cause noncoronary vasospastic reactions (eg, peripheral vascular ischemia, GI vascular ischemia/infarction, splenic infarction, Raynaud’s syndrome); rule out therapy-related vasospastic reactions before additional therapy is given.
May cause transient/permanent blindness and significant partial vision loss.
Overuse of acute migraine drugs may lead to exacerbation of headache; detoxification, including drug withdrawal, and treatment of withdrawal symptoms may be necessary.
Serotonin syndrome may occur; discontinue if suspected.
Significant elevation in BP, including hypertensive crisis with acute impairment of organ systems, reported.
Anaphylactic/anaphylactoid reactions may occur.
Seizures reported; caution with history of epilepsy or conditions associated with a lowered seizure threshold.
Paresthesia, warm/cold sensation, chest/neck/throat/jaw pain and other pressure sensations, malaise/fatigue.
Serotonin syndrome reported with SSRIs, SNRIs, TCAs, or MAOIs.
Store below 30°C, protect from light.
Keep out of reach of children.