Sumatriptan

• Sumatriptan is used to treat migraines. It helps to relieve headache, pain, and other migraine symptoms (including nausea, vomiting and sensitivity to light/sound). Prompt treatment helps you return to your normal routine and may decrease your need for other pain medications.
• Sumatriptan belongs to a class of drugs known as triptans. It affects a certain natural substance (serotonin) that causes narrowing of blood vessels in the brain. It may also relieve pain by affecting certain nerves in the brain.
• Sumatriptan works by narrowing blood vessels in the head, stopping pain signals from being sent to the brain, and blocking the release of certain natural substances that cause pain, nausea and other symptoms of migraine.
• Sumatriptan does not prevent future migraines or lessen how often you get migraine attacks.
• There are many more serious causes of headache that mimic a migraine. You should seek medical care if your headache is different than your typical migraine.
• You should not "assume" your headache is a migraine until you have been formally diagnosed with migraines and this is the same headache as your past migraines.

• Migraines are usually (POUND)

  • (P) Pulsatile
  • (O) One day duration (4-72 hours if untreated or successfully treated)
  • (U) Unilateral headache
  • (N) Nausea or vomiting
  • (D) Disabling intensity of headache

• Because Sumatriptan constricts your blood vessels you should tell your medical provider if you have or have ever had:

  • Heart disease
  • A heart attack
  • Angina (chest pain)
  • Irregular heartbeats
  • Stroke or 'mini-stroke'
  • Circulation problems such as varicose veins or blood clots in the legs
  • Raynaud's disease (problems with blood flow to the fingers, toes, ears and nose)
  • Ischemic bowel disease (bloody diarrhea and stomach pain caused by decreased blood flow to the intestines)
  • If you have had any of these conditions, your medical provider may tell you not to take Sumatriptan.

• Sumatriptan comes as a tablet to take by mouth. It is usually taken at the first sign of a migraine headache.
• Follow the directions on your prescription label carefully, and ask your medical provider or pharmacist to explain any part you do not understand. Take Sumatriptan exactly as directed. Do not take more or less of it or take it more often than prescribed by your medical provider.
• Read the Patient Information Leaflet if available from your pharmacist before you start taking Sumatriptan and each time you get a refill. If you have any questions, ask your medical provider or pharmacist.
• Take this medication by mouth with or without food as directed by your medical provider, at the first sign of a migraine.
• The dosage is based on your medical condition and response to treatment. If there is no improvement in your symptoms, do not take more doses of this medication before talking to your medical provider. If your symptoms are only partly relieved, or if your headache comes back, you may take another dose at least two hours after the first dose. Do not take more than 200 milligrams in a 24-hour period.
• This medication may also be used as a backup for Sumatriptan injection. If your symptoms are only partly relieved or your headache comes back, you may take a dose of Sumatriptan by mouth at least two hours after the injection, up to a maximum of 100 milligrams in a 24-hour period.
• If you have a higher risk for heart problems (see “Precautions to be aware of”), your medical provider may perform a heart exam before you start taking Sumatriptan. They may also direct you to take your first dose of this medication at an in-person clinic or medical provider's office to monitor for serious side effects (such as chest pain). Talk to your medical provider for details.
• If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Request a callback from your medical provider if you need to use this medication more often, if the medication is not working as well or if your headaches get worse.

• Flushing, feelings of tingling/numbness/prickling/heat, tiredness, weakness, drowsiness, dizziness, upset stomach, diarrhea, nausea or muscle cramps may occur. If any of these effects are severe, do not go away or get worse, go to your patient dashboard and request a callback or talk to your pharmacist promptly.
• Remember that this medication has been prescribed because your medical provider has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
• This medication may raise your blood pressure. Check your blood pressure regularly and request a callback if the results are high.

• Tell your medical provider right away if you have any serious side effects, including:

  • Blue fingers, toes or nails
  • Cold hands or feet
  • Hearing changes
  • Mental/mood changes

• Sumatriptan can cause chest pain, which should be evaluated right away by a medical provider. Heart attacks, heart disease and cardiac arrest have been reported as a result of taking this medication. Get medical help right away if the following side effects occur:

  • Chest/jaw/neck tightness
  • Shortness of breath
  • Unusual sweating
  • Fast or irregular heartbeat
  • Fainting
  • Severe stomach or abdominal pain
  • Bloody diarrhea
  • Signs of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes or confusion)

• This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your medical provider or pharmacist about all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms:

  • Fast heartbeat
  • Hallucinations
  • Loss of coordination
  • Rigidity
  • Severe dizziness
  • Severe nausea, vomiting or diarrhea
  • Twitching muscles
  • Unexplained fever
  • Unusual agitation or restlessness

• A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • Rash
  • Itching or swelling (especially of the face, tongue or throat)
  • Severe dizziness
  • Trouble breathing

• Some side effects can be serious. There have been reports linking this medication to brain hemorrhage (bleeding in the brain). This drug can also cause permanent or temporary blindness, so seek in-person evaluation for loss or change in vision, eye pain, redness, etc. If you experience any of the following symptoms, contact your medical provider immediately or get emergency medical treatment:

  • Sudden tingling, weakness, numbness or paralysis of the face, arm or leg, particularly on one side of the body
  • Headache
  • Confusion
  • Dizziness
  • Seizures
  • Loss of vision or difficulty seeing
  • Loss of balance or coordination
  • Stiff neck and sensitivity to light
  • Abnormal or slurred speech
  • Difficulty reading, writing or understanding speech
  • Change in level of consciousness or alertness, lack of energy, sleepiness or coma
  • Trouble breathing and abnormal heart rate
  • Pain, tightness, pressure, or heaviness in the chest, throat, neck, and/or jaw
  • Slow or difficult speech
  • Faintness
  • Breaking out in a cold sweat
  • Shortness of breath
  • Sudden or severe stomach pain
  • Bloody diarrhea
  • Nausea and vomiting
  • Sudden or severe stomach pain
  • Sudden weight loss
  • Paleness or blue color of the fingers and toes
  • Difficulty breathing or swallowing
  • Redness, swelling, or itching of the eyes, face, lips, or throat
  • Rash
  • Hives

• This is not a complete list of possible side effects. If you notice other effects not listed above, request a callback for medical advice. You may also report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

• Before using Sumatriptan, tell your medical provider or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

• Before using this medication, tell your medical provider or pharmacist your medical history, especially of:

  • Blood circulation problems (for example, in your legs, arms/hands or stomach)
  • Certain types of headaches (hemiplegic or basilar migraine)
  • Heart problems (such as chest pain, irregular heartbeat or previous heart attack)
  • Liver disease
  • Seizure
  • Stroke or "mini-stroke" (transient ischemic attack)

• Certain conditions can increase your risk for heart problems. Tell your medical provider if you have any of these conditions, including:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Family history of heart disease
  • Overweight
  • Smoker
  • Postmenopausal (women)
  • Age more than 40 years (men)
• Tell your medical provider if you smoke or are overweight; if you have or have ever had high blood pressure, high cholesterol, diabetes, seizures or liver or kidney disease; if you have gone through menopause (change of life); or if any family members have or have ever had heart disease or stroke.
• This medication has been reported to cause certain serious arrhythmias that can lead to death. Tell your medical provider if you have history of a prolonged QT interval on EKG, have a genetic heart condition, low heart rate, any type of arrhythmia, have any electrolyte abnormalities, including low calcium, potassium or magnesium.
• This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your medical provider if you are using marijuana (cannabis).
• Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs and herbal products).
• The risk of heart disease, liver disease and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.
• Tell your medical provider if you are pregnant, plan to become pregnant, or are breastfeeding. If you plan to be sexually active while you are using this medication, talk to your medical provider about effective methods of birth control. If you become pregnant while taking Sumatriptan, contact your medical provider.
• During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your OB/GYN.
• This drug passes into breast milk in small amounts. Consult your child’s pediatrician or OB/GYN before breastfeeding.

• Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.
• Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your medical provider and pharmacist.
• Do not start, stop or change the dosage of any medicines without your medical provider's approval.
• Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any MAO inhibitors (Isocarboxazid, Linezolid, Metaxalone, Methylene blue, Moclobemide, Phenelzine, Procarbazine, Rasagiline, Safinamide, Selegiline or Tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your medical provider when to start or stop taking this medication.
• The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort and certain antidepressants (including SSRIs such as Fluoxetine/Paroxetine, SNRIs such as Duloxetine/Venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
• If you also take any ergotamine medication (such as Dihydroergotamine) or other "triptan" drugs (such as Zolmitriptan or Rizatriptan), you will need to separate your Sumatriptan dose from your dose of these other medications to lessen the chance of serious side effects. Ask your medical provider how long you should wait between your doses of these drugs.
• This drug has an interaction with the dopamine receptor agonist Bromocriptine.

• If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. If symptoms from taking this medication are less severe, call your local poison control center at 1-800-222-1222 right away.

• Do not share this medication with others.
• Certain foods, beverages, or food additives (such as red wine, cheese, chocolate and monosodium glutamate) as well as lifestyle patterns such as irregular eating/sleeping habits or stress may bring on a migraine headache. Avoiding these "triggers" may help lessen migraine attacks. Consult your medical provider for more details.
• Laboratory and/or medical tests (such as blood pressure) may be performed periodically to monitor your progress or check for side effects. Consult your medical provider for more details.

Not applicable. (See How to take Sumatriptan section.)

• Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand or ask your pharmacist.
• Keep all medications away from children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.