Sumatriptan

Notice! Sumatriptan is also effective against nausea and vomiting (and thus against the main accompanying symptoms of the migraine attack). Therefore, the additional intake of an antiemetic is not indicated when sumatriptan is used in acute attacks.

After oral administration, sumatriptan is rapidly absorbed and reaches maximum plasma concentrations after approx. 2 (0.5 to 5) hours. The absolute bioavailability after oral administration averages 14 percent. The elimination half-life is approximately 2 hours. Binding to plasma proteins is low (14 to 21 percent).

Extrarenal clearance corresponds to about 80 percent of total clearance, indicating that sumatriptan is mainly eliminated by oxidative metabolism controlled by monoamine oxidase A.

Tbl.: 50-100 mg p.o. during the acute attack (maximum daily dose: 100 mg).

Solution for injection: 6 mg (0.5 ml) s.c. during the acute pain attack (maximum daily dose 12 mg).

Suppositories: insert 1 suppository (25 mg) during the acute attack (maximum daily dose: 50 mg).

Nasal spray: apply 1 spray (10-20 mg) intranasally during an acute attack (maximum daily dose 20 mg).

Note! Exceeding the maximum daily dose is not associated with an increased analgesic effect!

Occasionally pain, tingling, hyperhidrosis, facial flushing, feeling of heat, heaviness, pressure or tightness in the chest or neck area, stiffness/pain in the neck.

Propranolol, flunarizine, pizotifen or alcohol

Ergotamine or other triptan/5-HT1 receptor agonists: Theoretically, there is an increased risk of coronary vasospasm: wait at least 24 hours before using sumatriptan; wait at least 6 hours after using sumatriptan before using an ergotamine-containing product and at least 24 hours before using another triptan/5-HT1 receptor agonist

MAO inhibitors:

SSRI and SNRI: risk of serotonin syndrome

Lithium: risk of serotonin syndrome

Imigran

The group of triptans also includes the following active ingredients:

• Eletriptan
• rizatriptan
• naratriptan
• almotriptan
• frovatriptan
• Zolmitriptan

General: It is advisable to give sumatriptan as soon as possible after the onset of the migraine headache. However, it is equally effective at any other stage during the migraine attack.

Sumatriptan should only be used in the case of a clearly diagnosed migraine.

Care must be taken to rule out other potentially serious neurological conditions before treating headaches.

Menstrual migraine: Sumatriptan is also effective in the treatment of menstrual migraine, i.e. migraine without aura occurring 3 days before and up to 5 days after the onset of menstruation. Sumatriptan should be taken as soon as possible after a migraine attack.

Excluded from the prescription requirement are for the acute treatment of the headache phase of migraine attacks with and without aura, after initial diagnosis of a migraine by a doctor:

• almotriptan in solid preparations for oral use in concentrations of 12.5 mg per divided form and in a total quantity of 25 mg per pack
• Naratriptan in solid preparations for oral use in concentrations of 2.5 mg per divided form and in a total quantity of 5 mg per package
• Sumatriptan in solid preparations for oral use in concentrations of 50 mg per divided form and in a total quantity of 100 mg per package

1. Wienholtz NKF et al. (2021) Infusion of Pituitary Adenylate Cyclase-Activating Polypeptide-38 in Patients with Rosacea Induces Flushing and Facial Edema that Can Be Attenuated by Sumatriptan. J Invest Dermatol 141:1687-1698.