Sumatriptan: Difference between revisions
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{{MedTemplate | {{MedTemplate | ||
| generic | | generic = Sumatriptan (succinate) | ||
| brand | | brand = Imitrex (oral, injectable, nasal), Tosymra (nasal spray), Onzetra Xsail (nasal powder), Zembrace SymTouch (low-dose autoinjector), Sumavel DosePro (needle-free SC) | ||
| structure | | structure = | ||
| classes | | classes = [[:Category:Triptans|Triptan (5-HT1B/1D agonist)]], [[:Category:Antimigraine medicines|Antimigraine medicine]], [[:Category:Analgesics|Analgesic]] | ||
| uses = <vote slug="acute-migraine-use">Acute migraine with or without aura (FDA)</vote>, <vote slug="cluster-headache-use">Cluster headache (FDA; subcutaneous and nasal formulations specifically)</vote> | |||
| uses | | starting_dose = Oral: 50-100 mg at migraine onset, may repeat in 2 hours if needed. SC: 6 mg, may repeat in 1 hour. Nasal: 5-20 mg per nostril, may repeat in 2 hours | ||
| starting_dose | | preparations = Oral tablets 25, 50, 100 mg; SC injection 4, 6 mg autoinjector; needle-free SC 6 mg (Sumavel); nasal spray 5, 20 mg; nasal powder 22 mg (Onzetra Xsail); low-dose autoinjector 3 mg (Zembrace SymTouch) | ||
| preparations | | fda_max = 200 mg/day (oral); 12 mg/day (SC); 40 mg/day (nasal spray); 44 mg/day (Onzetra) | ||
| fda_max = | | pill_id = | ||
| routes | | routes = Oral, subcutaneous, intranasal | ||
| onset | | onset = 10 minutes (SC); 15-30 minutes (nasal); 30-60 minutes (oral) | ||
| duration | | duration = 2-4 hours; headache recurrence rate ~20-30% within 24 hours | ||
| halflife | | halflife = 2 hours<ref name="imitrex-label">FDA Prescribing Information, Imitrex (sumatriptan succinate), GSK, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020132s029,020626s025,020080s055lbl.pdf</ref> | ||
| bioavailability = ~14% (oral; substantial first-pass); ~97% (subcutaneous); ~17% (nasal)<ref name="imitrex-label" /> | |||
| pregnancy = Limited human data; pregnancy registry data have been broadly reassuring relative to baseline malformation rates.{{citation needed}} | |||
| legal = [[USLegal:Prescription only|Rx-only]] in US | |||
| | | mechanism = <vote slug="sumatriptan-mech-claim">Selective 5-HT1B and 5-HT1D receptor agonist. The 5-HT1B effect on cranial blood vessels produces vasoconstriction that reverses the neurogenic vasodilation of migraine; the 5-HT1D effect inhibits CGRP and other vasoactive neuropeptide release at trigeminal nerve terminals, blunting the neuroinflammatory cascade that drives migraine pain.</vote> '''Contraindicated''' in coronary artery disease, vasospastic angina (Prinzmetal), uncontrolled hypertension, history of ischemic stroke, and hemiplegic or basilar migraine. Serotonin syndrome risk with SSRIs and SNRIs has FDA labeling but the clinical incidence is debated. Should not be combined with ergot derivatives within 24 hours. '''Medicine-overuse headache''' is the major chronic-use complication, with the threshold of ≥10 days of triptan use per month<ref name="imitrex-label" />. | ||
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== References == | |||
<references /> | |||
[[Category:Triptans]] | |||
[[Category:Antimigraine medicines]] | |||
[[Category:Analgesics]] | [[Category:Analgesics]] | ||