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Sumatriptan Side Effects

Medically reviewed by Drugs.com. Last updated on Aug 10, 2024.

For healthcare professionals

Applies to sumatriptan: nasal capsule, nasal spray, oral tablet, subcutaneous kit, subcutaneous solution, transdermal film extended release.

General

The more commonly observed adverse reactions have included those of pressure sensation, flushing, tingling, dizziness/vertigo, warm/hot sensation, burning sensation, flushing, and numbness; formulation specific events including injection site reactions, application site pain, and nasal discomfort have been reported.[Ref]

Cardiovascular

Life-threatening disturbances of cardiac rhythm, such as ventricular tachycardia and ventricular fibrillation leading to death, and rare reports of acute myocardial infarction, have been reported within a few hours after administration of 5-HT1 agonists.

Chest discomfort is usually noncardiac in origin. A survey of 453 migraine patients found chest symptoms occurred in up to 58% of patients in at least some attacks and in up to 42% of patients in all attacks.

One study of 735 consecutive migraine patients reported that chest symptoms are frequent, but rarely important adverse effects of (primarily subcutaneous) sumatriptan. The risk of chest symptoms was reported to be patient dependent and not related, even opposite, to cardiovascular disease. This report contradicts the hypothesis that chest symptoms after sumatriptan are caused by cardiac ischemia.

Another study of 125 patients concluded that panic-like symptoms may explain the chest pain and related side effects after sumatriptan administration in patients with high levels of anxiety.[Ref]

Nervous system

Cerebral hemorrhage, subarachnoid hemorrhage, and stroke have occurred with 5-HT1 treatment; some have resulted in fatalities. One case of sumatriptan-induced cortical stroke has been reported in a patient with sagittal sinus thrombosis. In some cases, it appears possible that the cerebrovascular events were primary, and the 5-HT1 agonist administered in the belief that presenting symptoms were due to migraine when they were not. Patients with migraine may also be at an increased risk of certain cerebrovascular events such as stroke, hemorrhage, and transient ischemic attacks.

Medication overuse headache may present as migraine-like headaches or as a marked increase in frequency of migraine attacks.

Serotonin syndrome is characterized by 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). The onset of symptoms generally occurs within minutes to hours of receiving a new or a greater dose of a serotoninergic medications.

Seizures have been reported in patients with either a history of seizures or concurrent conditions predisposing to seizures and also in patients where no such predisposing factors are apparent.[Ref]

Gastrointestinal

It is unclear whether the nausea and vomiting is related to sumatriptan therapy or to the underlying condition.

One report has suggested that "throat tightness" and chest pain associated with sumatriptan may sometimes be attributable to changes in esophageal motility.[Ref]

Other

Dermatologic

Burns and scars have been reported on the skin where the transdermal iontophoretic transdermal system has been worn. These reports describe severe redness, pain, skin discoloration, blistering, and cracked skin. On June 13, 2016, the manufacturer of the patch suspended sales and distribution of the patch to investigate the cause of these reports.[Ref]

Endocrine

Genitourinary

Hematologic

Hepatic

Hypersensitivity

Immunologic

Local

Postmarketing reports:

Following subcutaneous administration: Contusion, induration, lipoatrophy, lipohypertrophy, pain, redness, stinging, subcutaneous bleeding, swelling[Ref]

Local irritative symptoms were reported in clinical trials with sumatriptan nasal spray in approximately 5% of patients, and were severe in about 1% of cases. Symptoms were noted as being transient and generally resolved in less than 2 hours.[Ref]

Metabolic

Musculoskeletal

Ocular

Loss of vision included reports of permanent defects. Causality has not been established as visual disorders may occur during a migraine attack itself.[Ref]

Oncologic

Psychiatric

Renal

Respiratory

The consequences of repeated and prolonged use of the nasal spray on nasal and/or respiratory mucosa have not been established.[Ref]

References

1. Welch KM (1993) "Drug therapy of migraine." N Engl J Med, 329, p. 1476-83

2. (1991) "Treatment of migraine attacks with sumatriptan. the subcutaneous sumatriptan international study group." N Engl J Med, 325, p. 316-21

3. (2001) "Product Information. Imitrex (sumatriptan)." Glaxo Wellcome

4. Schoenen J, Bulcke J, Caekebeke J, Dehaene I, Dekeyser J, Hildebrand G, Joffroy A, Laloux P, Louis P, Monseu G, Pierre P, Vander (1994) "Self-treatment of acute migraine with subcutaneous sumatriptan using an auto-injector device - comparison with customary treatment in an open, longitudinal study." Cephalalgia, 14, p. 55-63

5. Boyd IW, Rohan AP (1994) "Sumatriptan-induced chest pain." Lancet, 344, p. 1704-5

6. (1995) "Drugs for migraine." Med Lett Drugs Ther, 37, p. 17-20

7. (2022) "Product Information. Imitrex Nasal (SUMAtriptan)." Glaxo Wellcome

8. Cerner Multum, Inc. "Australian Product Information."

9. (2014) "Product Information. Alsuma (sumatriptan)." Pfizer U.S. Pharmaceuticals Group

10. (2014) "Product Information. SUMAtriptan Succinate (sumatriptan)." Bedford Laboratories

11. (2016) "Product Information. Zecuity (sumatriptan)." Teva Pharmaceuticals USA

12. (2016) "Product Information. Onzetra Xsail (sumatriptan)." Avanir Pharmaceuticals, Inc

13. Willett F, Curzen N, Adams J, Armitage M (1992) "Coronary vasospasm induced by subcutaneous sumatriptan." BMJ, 304, p. 1415

14. Ottervanger JP, van Witsen TB, Valkenburg HA, Stricker BH (1993) "Postmarketing study of cardiovascular adverse reactions associated with sumatriptan." BMJ, 307, p. 1185

15. Curtin T, Brooks AP, Roberts JA (1992) "Cardiorespiratory distress after sumatriptan given by injection." BMJ, 305, d713-4

16. Ottervanger JP, Paalman HJ, Boxma GL, Stricker BH (1993) "Transmural myocardial infarction with sumatriptan." Lancet, 341, p. 861-2

17. MacLean MR, Smith GC, Templeton AG (1993) "Adverse reactions associated with sumatriptan." Lancet, 341, p. 1092

18. Ottervanger JP, Vanwitsen TB, Valkenburg HA, Grobbee DE, Stricker BHC (1994) "Adverse reactions attributed to sumatriptan - a postmarketing study in general practice." Eur J Clin Pharmacol, 47, p. 305-9

19. Dachs R, Vitillo J (1995) "Angioedema associated with sumatriptan administration." Am J Med, 99, p. 684-5

20. Mueller L, Gallagher RM, Ciervo CA (1996) "Vasospasm-induced myocardial infarction with sumatriptan." Headache, 36, p. 329-31

21. Visser WH, Devriend RHM, Jaspers NMWH, Ferrari MD (1996) "Sumatriptan in clinical practice: a 2-year review of 453 migraine patients." Neurology, 47, p. 46-51

22. Visser WH, Jaspers NMWH, Devriend RHM, Ferrari MD (1996) "Chest symptoms after sumatriptan: a two-year clinical practice review in 735 consecutive migraine patients." Cephalalgia, 16, p. 554-9

23. Morgan DR, Trimble M, McVeigh GE (2000) "Atrial fibrillation associated with sumatriptan." Br Med J, 321, p. 275

24. Luman W, Gray RS (1993) "Adverse reactions associated with sumatriptan." Lancet, 341, p. 1091-2

25. Cavazos JE, Caress JB, Chilukuri VR, Devlin T, Gray L, Hurwitz BJ (1994) "Sumatriptan-induced stroke in sagittal sinus thrombosis." Lancet, 343, p. 1105-6

26. Loi V, Lai M, Pisano MR, Delzompo M (1996) "Sumatriptan and panic-like symptoms." Am J Psychiatry, 153, p. 1505

27. Lopezalemany M, Ferrertuset C, Bernaceralpera B (1997) "Akathisia and acute dystonia induced by sumatriptan." J Neurol, 244, p. 131-2

28. Spierings EL (2001) "Intracranial hemorrhages associated with sumatriptan." Neurology, 57, p. 2322

29. Doctor's Guide to Medical & Other News (2001) AAN meeting: sumatriptan linked to life-threatening intestinal condition. http://www.pslgroup.com/dg/f9902.htm

30. (2022) "Product Information. Imitrex (SUMAtriptan)." GlaxoSmithKline

31. US Food and Drug Administration (2016) FDA Drug Safety Communication: FDA evaluating the risk of burns and scars with Zecuity (sumatriptan) migraine patch. http://www.fda.gov/Drugs/DrugSafety/ucm504588.htm

32. US Food and Drug Administration (2016) Zecuity (sumatriptan) Migraine Patch: Drug Safety Communication - FDA Evaluating Risk of Burns and Scars. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm504736.htm

33. Franceschini R, Cataldi A, Garibaldi A, Cianciosi P, Scordamaglia A, Barreca T, Rolandi E (1994) "The effects of sumatriptan on pituitary secretion in man." Neuropharmacology, 33, p. 235-9

34. (1991) "Treatment of acute cluster headache with sumatriptan. the sumatriptan cluster headache study group." N Engl J Med, 325, p. 322-6

35. Chiari M, Manzoni GC, Vandegeijn EJ (1994) "Ischemic optic neuropathy after sumatriptan in a migraine with aura patient." Headache, 34, p. 237-8

Frequently asked questions

Further information

Sumatriptan side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.