Sumatriptan

Sumatriptan is a medicine to treat migraines and cluster headaches. It does not prevent these conditions.

It's not fully understood what causes migraines and cluster headaches, but it may be due to the temporary widening of blood vessels in your brain. Sumatriptan works by narrowing these blood vessels again.

You'll usually take or use sumatriptan once a migraine or cluster headache has started. It is not a painkiller but you can use this medicine if painkillers or non-steroidal anti-inflammatory drugs (NSAIDs) have not worked.

Sumatriptan comes as tablets, a nasal spray or injection. The nasal spray and injection are used to treat migraines and cluster headaches. The tablets are for migraines only.

Sumatriptan is available on prescription. You can also buy packs containing two, 50mg tablets from a pharmacy without a prescription, but only if you have previously been diagnosed with migraines.

Most adults can have sumatriptan tablets or injections. But the nasal spray is only officially approved for people under the age of 65.

Sumatriptan is not officially approved for children. However, a specialist doctor may sometimes prescribe it for a child aged 6 years or over.

Sumatriptan is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to sumatriptan or any other medicine
• have a heart problem such as coronary heart disease, chest pain (angina), heart rhythm problems (arrhythmia) or you've had a heart attack
• have circulation problems in your legs (peripheral vascular disease)
• have had a stroke or "mini stroke" (transient ischaemic attack)
• have liver disease or other liver problems
• have seizures or fits
• are trying to get pregnant, are already pregnant or breastfeeding
• are a heavy smoker or use nicotine replacement therapy (particularly if you've been through menopause, or if you're a man over the age of 40)
• have high blood pressure

You may be able to use sumatriptan if you've had high blood pressure in the past and it is now well controlled with treatment.

If you have a latex allergy, check with your doctor or a pharmacist before having sumatriptan injections. Some needle protectors may contain latex.

Sumatriptan comes as:

• 50mg and 100mg tablets
• 3mg and 6mg pre-filled syringes
• a 10mg and 20mg nasal spray

The usual dose for migraine is one 50mg tablet. Some people may need more (100mg tablet) for severe migraine relief.

Take your first dose as soon as the pain starts. Do not take it at the warning stage, before your migraine starts. This is when some people get symptoms of aura.

Tablets (for migraine only)

Swallow the tablet whole with a drink of water. Do not chew or crush it.

If you find tablets difficult to swallow, some sumatriptan tablets have a score line to help you break them in half. Check the information leaflet inside the medicine packet to see if you can do this with your medicine.

Tablets usually begin to work in 30 to 60 minutes. If your first sumatriptan tablet does not help, do not have another one for the same attack.

If your migraine improves but then comes back, you can take the same dose again after 2 hours. Do not take more than 300mg in 24 hours.

Injections (for migraine or cluster headache)

Check the instructions that come with your medicine to find out how to use the pre-filled syringe (auto-injector) or pen and how to get rid of it safely afterwards.

Use the pre-filled syringe to inject 1 dose. You'll usually inject it into your thigh.

The medicine generally works in 10 to 15 minutes.

If your headache improves but then comes back, you can inject another dose after 1 hour.

If the first sumatriptan injection does not help, do not have another one for the same attack.

Nasal spray (for migraine or cluster headache)

1. Blow your nose if it feels blocked or if you have a cold.
2. Place your finger over 1 nostril.
3. Spray the medicine into the other nostril and breathe in gently at the same time.

The nasal spray usually works within 15 minutes.

Each spray contains 1 dose (10mg or 20mg of sumatriptan). If your headache improves but then comes back, you can have another dose after 2 hours.

If the first dose of sumatriptan does not help, do not take another dose for the same attack.

Follow the instructions that come with your medicine to find out how to use the single-use nasal spray.

Do not have more than 2 injections, or 2 doses of nasal spray, or more than 300mg of tablets in 24 hours.

Do not take more than your prescribed amount in any 24-hour period. The maximum amount is 300mg of tablets, 12mg as injections or 40mg as a nasal spray.

Taking too much sumatriptan may make you very ill. An overdose can cause fainting, slowed heart rate, vomiting, loss of bladder and bowel control, and sleepiness.

It can narrow your blood vessels, leading to heart problems such as chest pains, abnormal heart rhythm or a heart attack. It can also reduce the blood supply to other organs such as part of your large intestine. This can give you a severe stomach ache.

• you take more than your prescribed dose of sumatriptan

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the sumatriptan packet or leaflet inside it, any remaining medicine, and any other medicines you take.

These common side effects of sumatriptan happen in more than 1 in 100 people. They're usually mild and do not last long. Some of the side effects are similar to the symptoms of migraine or cluster headaches. There are things you can do to help cope with them:

These symptoms may be due to the migraine itself.

If you feel able to eat, stick to simple meals and do not eat rich or spicy food.

If you're being sick, try small frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

If you begin to feel dizzy, lie down so that you do not faint, then sit until you feel better. Do not drive or use tools or machines if you feel dizzy, unsteady or tired.

If this bothers you or does not go away, speak to your doctor.

This usually only lasts for a short time.

These nosebleeds will usually only last for a short time.

Seek immediate medical help if the bleeding does not stop after 10 to 15 minutes, especially if you're taking a medicine to prevent blood clots such as warfarin or rivaroxaban, or you have haemophilia or any other condition that means your blood cannot clot properly.

Try chewing sugar-free gum.

The injection may cause local reactions (the place where you injected yourself), such as pain, swelling, bleeding or bruising. This is usually mild and will go away after a few days.

See a doctor if it gets worse, becomes painful or inflamed or if it lasts for longer than a few days.

Talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or last more than a few days.

It happens rarely, but some people have serious side effects when taking sumatriptan.

Do not take any more sumatriptan and tell a doctor urgently, or call 111 straight away if you get continued or increasing:

• tightness or tingling in your face, arms, legs or chest
• unusual feelings of heaviness in your face, arms, legs or chest
• feelings of warmth or cold in your face, arms, legs or chest

These feelings usually do not last for long. If they continue, or become severe or intense, seek medical help straight away.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to sumatriptan.

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of sumatriptan. For a full list, see the leaflet inside your medicine packet.

Sumatriptan is not thought to be harmful during pregnancy. However, there is not enough research to say for certain.

Talk to a doctor about the benefits and possible harms of taking sumatriptan. Other medicines may be more suitable for you to take during pregnancy.

If your doctor or health visitor says your baby is healthy, it's OK to take sumatriptan while you're breastfeeding.

Only very small amounts of sumatriptan pass into breast milk and it's very unlikely to cause any problems for your baby.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy, has an upset stomach, or if you have any other concerns about your baby, speak to your doctor, pharmacist, midwife, or health visitor.

There's no evidence that sumatriptan affects fertility in men or women.

Speak to your doctor if you're trying to get pregnant or you're having problems getting pregnant while taking sumatriptan.

Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

There are some medicines that may affect the way sumatriptan works.

Tell your doctor if you're taking:

• other migraine or headache medicines (including ergotamine and other triptans)
• antidepressants, including SSRIs (selective serotonin reuptake inhibitors) or MAOIs (monoamine oxidase inhibitors)

If you're taking antidepressants, check with your doctor whether it's safe to take sumatriptan with your other medicines. Using sumatriptan with some types of antidepressants can increase your risk of a severe side effect called serotonin syndrome.

Symptoms of serotonin syndrome include:

• feeling confused or agitated
• muscle twitching
• high temperature, sweating or shivering
• increased heart rate
• diarrhoea

Tell a doctor immediately if you get any of these symptoms.

Taking sumatriptan with St John's wort, a herbal remedy for depression, can increase your risk of serotonin syndrome. Do not take St John's wort if you're taking or using sumatriptan.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with sumatriptan. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.