Sumatriptan


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Migraine >18 yr: 50-100 mg, repeat 2 hrly if migraine recurs. Max: 300 mg/24 hr. SC Migraine; Cluster headache >18 yr: 6 mg as a single dose, repeat at least 1 hr after the 1st dose if needed. Max: 12 mg/24 hr. Nasal Migraine 12-17 yr: 10 mg into 1 nostril, max: 20 mg/24 hr; >18 yr: 20 mg into 1 nostril, max: 40 mg/24 hr. May repeat dose at least 2 hr after the 1st dose if needed.
Dosage Details
Nasal
Migraine
Adult: 12-17 yr: 10 mg into 1 nostril, repeated at least 2 hr after the 1st dose if symptoms recur. Max: 20 mg/24 hr. >18 yr: 20 mg into 1 nostril, repeated at least 2 hr after the 1st dose if symptoms recur. Max: 40 mg/24 hr.

Oral
Migraine
Adult: >18 yr: 50-100 mg repeated at 2-hr intervals if migraine recurs. Max: 300 mg/24 hr.

Subcutaneous
Migraine, Cluster headache
Adult: >18 yr: 6 mg as a single dose inj, repeated at least 1 hr after the 1st dose if symptoms persist. Max: 12 mg/24 hr.
Hepatic Impairment
Nasal:
Dose reduction needed.
Oral:
Max single dose: 50 mg.
Subcutaneous:
Dose reduction needed.
Administration
May be taken with or without food.
Contraindications
Not to be used prophylactically and in patients with basilar or hemiplegic or ophthalmoplegic migraine. History of MI or stroke, severe hepatic impairment, ischaemic heart disease, uncontrolled hypertension, peripheral vascular disease, hypersensitivity to sulfonamides.
Special Precautions
Conditions predisposing to seizures, presence of coronary risk factors, cardiac arrhythmias, renal or hepatic impairment, elderly, pregnancy, lactation.
Adverse Reactions
Transient hypertension, hypotension, dizziness, flushing, fatigue, drowsiness, weakness, seizures, nausea and vomiting, heat, tightness in any part of body, paraesthesia, seizures, inj site reactions, irritation of nasal mucosa and epistaxis. Rebound headache with frequent use.
Potentially Fatal: Cardiac arrhythmias, MI.
IM/IV/Nasal/Parenteral/PO/SC: C
Drug Interactions
Concurrent use increased risk of vasospastic reaction with ergotamine and related compounds.
Potentially Fatal: Increased risk of serotonin syndrome with concurrent use of SSRI, MAOIs or within 14 days of stopping MAOIs. Admin of ergotamine or related compounds within the previous 24 hr.
Food Interaction
Increased serotonergic effects and adverse events with concurrent use of St John's Wort.
Action
Description: Sumatriptan is a selective serotonin agonist that acts at 5-HT1 receptors. It causes vasoconstriction of cranial arteries and/or inhibition of neurogenic inflammatory processes in the CNS. A small but significant delay in gastric emptying also occurs.
Onset: Oral: 30 min; Intranasal: 15 min; subcutaneous: 10-15 min.
Pharmacokinetics:
Absorption: Rapidly but incompletely absorbed from the GIT (oral); peak plasma concentrations reached in 2 hr (oral), 25 min (subcutaneous), 1.5 hr (intranasal). Bioavailability for oral is 14%, subcutaneous 96% and intranasal is 16% of that achieved in subcutaneous.
Distribution: Enters breast milk. Protein-binding: 14-21%.
Metabolism: Extensive first-pass metabolism by MAO type A.
Excretion: Mainly via urine (as inactive indole acetic acid derivative and its glucuronide), via faeces (as unchanged drug and metabolites). Elimination half-life: 2hr.
Storage
Nasal:
Store below 30°C. Do not freeze.
Oral:
Store below 30°C.
Subcutaneous:
Store below 30°C.
Disclaimer: This information is independently developed by MIMS based on Sumatriptan from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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