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Generic Name: sumatriptan (oral/nasal) (soo ma TRIP tan)
Brand Names: Imitrex, Imitrex Nasal, Onzetra Xsail

What is Imitrex?

Imitrex (sumatriptan) is a headache medicine that narrows blood vessels around the brain. Sumatriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Imitrex is used to treat migraine headaches. Imitrex will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Imitrex should not be used to treat a common tension headache or a headache that causes loss of movement on one side of your body. Use this medicine only if your condition has been confirmed by a doctor as migraine headaches.

Important information

You should not use Imitrex if you have uncontrolled high blood pressure, heart problems, certain heart rhythm disorders, a history of heart attack or stroke, or circulation problems that cause a lack of blood supply within the body.

Do not use Imitrex if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Before using Imitrex, tell your doctor if you have liver or kidney disease, seizures, high blood pressure, a heart rhythm disorder, or coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

Also tell your doctor if you are taking an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Imitrex will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

After taking a tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 200 mg of sumatriptan in 24 hours.

Before taking this medicine

You should not use Imitrex if you are allergic to sumatriptan, or if you have:

  • coronary artery disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;

  • a heart disorder called Wolff-Parkinson-White syndrome;

  • a history of heart disease, heart attack, or stroke, including "mini-stroke";

  • untreated or uncontrolled high blood pressure;

  • severe liver disease;

  • circulation problems affecting your intestines; or

  • a headache that seems different from your usual migraine headaches.

Do not use Imitrex if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure Imitrex is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • epilepsy or other seizure disorder;

  • high blood pressure, a heart rhythm disorder; or

  • risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

It is not known whether Imitrex will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Sumatriptan can pass into breast milk and may harm a nursing baby. Do not breast-feed within 12 hours after using Imitrex. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.

This medicine is not approved for use by anyone younger than 18 years old.

How should I use Imitrex?

Use Imitrex exactly as prescribed by your doctor. Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to quickly treat any serious side effects that occur.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Use Imitrex as soon as you notice headache symptoms.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Take one Imitrex tablet whole with a full glass of water. Do not split the tablet.

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet 2 hours after the first. Do not take more than 200 mg of Imitrex oral tablets in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

After using the nasal spray: If your headache does not completely go away, call your doctor before using a second spray of Imitrex. If your headache goes away and then comes back, you may use a second spray if it has been at least 2 hours since you used the first spray. Do not use more than 40 mg of Imitrex nasal spray in 24 hours. If your symptoms do not improve, contact your doctor before using any more sprays.

Do not take the nasal capsule by mouth. It is for use only in the disposable nosepiece and special inhaler device that comes with this medicine.

After using one nasal capsule in each nostril: If your headache does not completely go away, or goes away and comes back, you may use a second dose (1 capsule per nostril) if it has been at least two hours since you used the first capsules. Do not use more than two doses (4 nosepieces) in 24 hours. If your symptoms do not improve, contact your doctor before using any more Imitrex nasal capsules.

Call your doctor if your headache does not go away at all after using the first dose.

Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse.

Contact your doctor if you have more than four headaches in one month (30 days). Tell your doctor if this medicine seems to stop working as well in treating your migraine attacks.

Store Imitrex at room temperature away from moisture, heat, and light.

Imitrex dosing information

Usual Adult Dose for Migraine:

Use only after a clear diagnosis of migraine has been established

Oral:
Initial dose: 25 mg, 50 mg, or 100 mg orally, once
-If some response to first dose occurs, a second dose may be administered at least 2 hours after first dose if needed
-Oral doses of 50 and 100 mg may provide greater relief than 25 mg; however, a 100 mg dose may not provide greater effect than a 50 mg dose
Maximum dose: 200 mg per 24 hours

Intranasal:
Nasal spray: Initial dose: 5 mg, 10 mg, or 20 mg into one nostril, once
-Administer the 5 and 20 mg doses as a single spray in 1 nostril; the 10 mg dose may be administered as 5 mg into each nostril
-If some response to first dose occurs, a second dose may be administered at least 2 hours after first dose if needed
Maximum dose: 40 mg per 24 hours

Nasal capsule/powder: Initial dose: 11 mg into each nostril via Xsail (R) breath-powered delivery device once
-If symptoms have not resolved in 2 hours, or return after transient improvement a second dose may be administered at least 2 hours after the first dose
Maximum dose: 2 doses (44 mg/4 nosepieces) per 24 hours

Comments:
-Treatment should be started at the first sign of a migraine headache, or associated symptoms such as nausea, vomiting, or photophobia; this drug should not be used for migraine prophylaxis.
-Higher doses may have a greater effect, but also carry a greater risk of adverse reactions.
-The safety of treating an average of more than 4 headaches in a 30 day period has not been established.

Use: For the acute treatment of migraine with or without aura.

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Since Imitrex is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using this medicine.

After taking an Imitrex tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 200 mg of sumatriptan tablets in 24 hours.

After using Imitrex nasal spray, you must wait two (2) hours before using a second spray. Do not use more than 40 mg of sumatriptan nasal spray in 24 hours.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include tremors or shaking, skin redness, breathing problems, blue-colored lips or fingernails, vision problems, watery eyes or mouth, weakness, lack of coordination, or seizure (convulsions).

What should I avoid while using Imitrex?

Do not use Imitrex within 24 hours before or after using another migraine headache medicine, including:

  • sumatriptan injection, almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or zolmitriptan (Zomig); or

  • ergot medicine - dihydroergotamine, ergotamine, ergonovine, methylergonovine.

Imitrex may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Imitrex side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Imitrex and call your doctor if you have:

  • sudden and severe stomach pain and bloody diarrhea;

  • severe headache, pounding in your neck or ears, severe chest pain, shortness of breath, irregular heartbeats;

  • a seizure (convulsions);

  • blood circulation problems - cramps in your hips or legs, tight or heavy feeling in your legs, numbness or tingling in your legs, muscle weakness, burning pain in your feet, pale or blue-colored appearance in your toes;

  • heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

  • signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance; or

  • high levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Common Imitrex side effects may include:

  • pain or tight feeling in your chest, throat, or jaw;

  • pressure or heavy feeling in any part of your body;

  • numbness or tingling, feeling hot or cold;

  • dizziness, drowsiness, weakness;

  • unusual or unpleasant taste in your mouth after using the nasal medicine;

  • burning, numbness, pain or other irritation in your nose or throat after using the nasal medicine; or

  • runny or stuffy nose after using the nasal medicine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Imitrex?

Using Imitrex while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:

  • medicine to treat depression;

  • medicine to treat a psychiatric disorder;

  • a narcotic (opioid) medication; or

  • medicine to prevent nausea and vomiting.

This list is not complete. Other drugs may interact with sumatriptan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about Imitrex.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Imitrex only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2016 Cerner Multum, Inc. Version: 14.02.

Date modified: November 03, 2016
Last reviewed: October 03, 2016

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