Sumatriptan: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 13, 2023.

1. How it works

• Sumatriptan may be used to relieve symptoms of a migraine.
• Sumatriptan works by binding to serotonin 5‑HT1B/1D receptors and is thought to relieve migraine symptoms through inhibition of pro-inflammatory substances and a constriction of cranial blood vessels.
• Sumatriptan belongs to the class of medicines known as selective serotonin receptor agonists. Sumatriptan may also be called a triptan.

2. Upsides

• Effective for the acute treatment of migraine with or without aura in adults.
• In most people, sumatriptan works quickly, within 5 minutes for the injection or within 10 to 20 minutes with the tablets.
• Available as an oral tablet, a nasal spray, a nasal powder for inhalation, and in an injectable form. An auto-injection system is available for self-administration.
• Because sumatriptan works quickly and effectively, it may decrease the need for other pain-relieving medications and allow a person to quickly return to their normal routine.
• Generic sumatriptan is available.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Drowsiness or dizziness, fatigue, tingling or numbness in the fingers or toes, or a feeling of weakness.
• A sensation of tightness, pain, pressure, or heaviness in the throat, neck, jaw, or over the heart has been reported by some people after taking sumatriptan. This is a common occurrence and is usually not a sign of a heart problem. However, if you are at risk of heart problems, or if you are concerned in any way, you should see a doctor for an evaluation.
• Higher dosages carry a greater risk of side effects. Experts are unsure whether a 100mg dose of sumatriptan is any more beneficial than a 50mg dose.
• Should only be used if a clear diagnosis of a migraine headache has been established. The diagnosis of a migraine will need to be reconsidered if the migraine attack does not respond to the first dose of sumatriptan. Do not keep administering sumatriptan.
• Safety and effectiveness, when used for other headache disorders (such as cluster headaches), have not been established.
• Sumatriptan is not a preventive medicine and will not prevent future migraine attacks.
• Sumatriptan is not suitable for people with certain cardiovascular conditions including coronary artery disease, Prinzmetal’s angina, Wolff-Parkinson-White syndrome, a history of stroke or transient ischemic attack (TIA), uncontrolled high blood pressure, or peripheral vascular disease.
• Sumatriptan should also not be taken by people with a history of hemiplegic or basilar migraine, ischemic bowel disease, severe hepatic impairment, or who have recently taken certain medicines including ergotamine derivatives and monoamine oxidase inhibitors.
• Sumatriptan has been associated with an increased risk of stroke, hemorrhage, or TIA; however, it is not clear whether this is due to the presence of migraine, or people mistaking stroke symptoms for those of a migraine. Do not take sumatriptan if you have previously had a stroke or TIA.
• Sumatriptan tablets may also cause other serious side effects such as circulatory disturbances, vision loss, seizures, increased blood pressure, and allergic reactions.
• May interact with several drugs including ergot-containing drugs and those that increase serotonin (such as antidepressants, St Johns Wort, and antipsychotics).
• There is limited data regarding the use of sumatriptan during pregnancy. Reports on 1000 women who used sumatriptan during the first trimester have not shown an increased risk of congenital defects; however, data are insufficient to be conclusive. Animal studies have shown adverse effects on the fetus, such as fetal death, fetal abnormalities, and vascular defects. Use only if the risk outweighs the benefits. Use caution during breastfeeding. Minimize infant exposure by avoiding breastfeeding 8 to 12 hours after administering sumatriptan.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

• Sumatriptan may be used to quickly relieve the symptoms of a migraine but may not be suitable for everyone including those with pre-existing cardiovascular conditions.

5. Tips

• Start treatment as soon as you develop migraine symptoms or symptoms that typically occur with a migraine (such as nausea, vomiting, or sensitivity to light).
• A second dose may be administered if the migraine has not resolved within two hours of taking an initial dose of sumatriptan tablets, or if only a transient improvement in symptoms is noted. The second dose must be administered at least two hours after the first dose. Do not take more than 200mg of sumatriptan in 24 hours. See your doctor if you have more than four headaches in a 30-day period that require sumatriptan treatment.
• If the initial sumatriptan dose has been given by injection, and the migraine returns, sumatriptan tablets may be administered at two-hour intervals up to a maximum cumulative tablet dose of 100mg/day.
• Talk to your doctor if you have had more than four episodes of a migraine in 30-days for which you have taken sumatriptan for. Overuse of sumatriptan and other acute migraine drugs may lead to medication overuse headaches (symptoms include daily headaches or a marked increase in migraine frequency).
• Symptoms of a stroke or TIA may be easily mistaken for those of a migraine. A stroke tends to come on suddenly, whereas symptoms of a migraine with aura tend to evolve gradually over several minutes. The headache of a migraine also tends to intensify to a peak rather than instantaneously developing. Vision disturbances can be experienced during both a stroke and a migraine; however, other effects, such as flashing lights or zigzagging lines usually occur only with migraines. You may not realize your vision has been impaired with a stroke until you start bumping into things. It is rare for migraines to suddenly develop during adulthood; most people experience their first one in childhood. If you have any concerns at all that your symptoms may be those of a stroke, call 911 and seek immediate medical attention.
• There is a risk of serotonin syndrome developing if too high a dosage of sumatriptan is used or other drugs are taken that also increase serotonin levels in the body. Symptoms include hallucinations, agitation, fast heartbeat, nausea, vomiting, diarrhea, and incoordination. Talk to your doctor or pharmacist before taking any other medication or herbal product that may interact with sumatriptan. If you develop symptoms suggestive of serotonin syndrome, discontinue sumatriptan and talk to your doctor straight away.
• See your doctor if you experience any side effects of concern such as changes in the color or sensation in your fingers and toes, sudden or severe stomach pain, weight loss, bloody diarrhea, cramping, cold or hot feelings in parts of your body, hives, or swelling of your tongue, mouth, or throat.
• Either a migraine or treatment for a migraine, may cause drowsiness. Do not drive or operate machinery or perform other hazardous tasks if a migraine or its treatments make you drowsy.
• Do not drink alcohol if you have taken a dose of sumatriptan.
• Talk to your doctor if you are pregnant or intend to become pregnant before taking sumatriptan. The benefits of taking the drug need to be weighed up against the risks.

6. Response and effectiveness

• Sumatriptan oral tablets usually start working within 30 minutes, with the peak effect occurring within two to four hours. The effects of the injection are usually apparent within 5 minutes.
• Liver disease can dramatically shorten the time it takes for sumatriptan to act and the length of time it lasts in the body.

7. Interactions

Medicines that interact with sumatriptan may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with sumatriptan. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with sumatriptan include:

• 5-hydroxytryptophan
• bromocriptine
• antidepressants, such as citalopram, desvenlafaxine, duloxetine, fluoxetine, mirtazapine, or nefazodone
• methylene blue
• monoamine oxidase inhibitors, such as isocarboxazid, phenelzine, or selegiline
• ondansetron
• other migraine medications, such as dihydroergotamine, almotriptan, rizatriptan, or zolmitriptan
• opioids, such as buprenorphine, codeine, fentanyl, oxycodone, methadone, morphine, or codeine
• red yeast rice
• St John's wort
• tramadol
• venlafaxine.

Note that this list is not all-inclusive and includes only common medications that may interact with sumatriptan. You should refer to the prescribing information for sumatriptan for a complete list of interactions.

References

• Sumatriptan. Revised 02/2022. Bionpharma Inc. https://www.drugs.com/pro/sumatriptan.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use sumatriptan only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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