Home Drug Guide Sumatriptan Succinate

Drug Guide

Generic Name

Sumatriptan Succinate

Brand Names Imitrex, Imitrex Statdose, Sumavel Dosepro, Alsuma, Zecuity, Onzetra Xsail, Zembrace Symtouch

Classification

Therapeutic: Antimigraine agent

Pharmacological: Serotonin (5-HT1) receptor agonist

FDA Approved Indications

Acute treatment of migraine with or without aura
Cluster headaches

Mechanism of Action

Selective agonist for serotonin (5-HT1) receptors, resulting in vasoconstriction of intracranial blood vessels and inhibition of pro-inflammatory neuropeptide release, thereby alleviating migraine symptoms.

Dosage and Administration

Adult: Typically 25-100 mg orally at the onset of migraine; may repeat after 2 hours if needed, not exceeding 200 mg/day.

Pediatric: Safety and effectiveness not established in children.

Geriatric: Use with caution due to increased cardiovascular risk; start at lower dose and titrate as needed.

Renal Impairment: Adjust dose; use with caution in severe impairment.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Rapid, peak plasma concentrations in about 2-4 hours (oral).

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Primarily hepatic via monoamine oxidase A (MAO-A).

Excretion: Renally excreted as metabolites.

Half Life: Approximately 2 hours.

Contraindications

Ischemic heart disease, history of stroke or transient ischemic attack, uncontrolled hypertension, peripheral vascular disease.
Use with monoamine oxidase inhibitors (MAOIs).

Precautions

Use cautiously in patients with risk factors for cardiovascular disease, uncontrolled hypertension, or cerebrovascular disease. Not recommended in hemiplegic or basilar migraine.

Adverse Reactions - Common

Sensations of tingling, warmth, or flushing (Common)
Dizziness or vertigo (Common)
Coronary artery vasospasm leading to chest pain (Serious)
Serious allergic reactions including anaphylaxis (Rare)

Adverse Reactions - Serious

Serious cardiac events (e.g., myocardial infarction, arrhythmias) (Rare)
Serotonin syndrome (when combined with other serotonergic drugs) (Rare)

Drug-Drug Interactions

Ergot-containing drugs, other 5-HT1 agonists (e.g., triptans), SSRIs, SNRIs, MAOIs, vasoconstrictors.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Evaluate for contraindications such as ischemic heart disease; monitor response and adverse effects.

Diagnoses:

Risk for decreased cardiac perfusion
Ineffective health management

Implementation: Administer as prescribed, monitor blood pressure and cardiovascular status, evaluate migraine relief.

Evaluation: Assess effectiveness of symptom relief and monitor for adverse reactions.

Patient/Family Teaching

Take at the first sign of migraine.
Report chest pain, dizziness, or unusual symptoms immediately.
Do not use jointly with other serotonergic drugs or ergotamines.

Special Considerations

Black Box Warnings:

Serious cardiovascular adverse events, including myocardial infarction and arrhythmias, may occur, especially in patients with risk factors.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Severe vasospasm, hypertension, chest pain, agitation, hallucinations.

Treatment: Supportive care, monitoring cardiac status, use of vasodilators if indicated, and symptomatic management.

Storage and Handling

Storage: Store at room temperature (20-25°C), away from light and moisture.

Stability: Stable for at least 2 years under recommended storage conditions.