Sumatriptan — uses, dosing, side effects & the brands that sell it · pharmaranks
Sumatriptan: uses, dosing, side effects & brands
Sumatriptan is a serotonin-1b and serotonin-1d receptor agonist sold in the U.S. under 7 brand and generic names, for cluster headache and migraine disorders. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
By the pharmaranks editorial team·Reviewed against the FDA (openFDA label, NDC Directory & Enforcement) sources·How we research
Key facts
Drug class
Serotonin-1b and Serotonin-1d Receptor Agonist
Treats
Cluster Headache and Migraine Disorders
Available as
Injectable · Tablet · Capsule · Spray/Inhaler · System
Sold as
7 products — Imitrex, Alsuma and Onzetra Xsail, and others
Prescription?
Prescription only
Generic available?
Yes
Typical price
about $482 for a 30-count supply
How sumatriptan is dosed
From the FDA label for Imitrex (application NDA020626). Other sumatriptan products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
The recommended adult dose of Sumatriptan Nasal Spray for the acute treatment of migraine is 5 mg, 10 mg, or 20 mg. The 20-mg dose may provide a greater effect than the 5-mg and 10-mg doses, but may have a greater risk of adverse reactions [see Clinical Studies ( 14 )] . The 5-mg and 20-mg doses are given as a single spray in 1 nostril. The 10-mg dose may be achieved by the administration of a single 5-mg dose in each nostril. If the migraine has not resolved by 2 hours after taking Sumatriptan Nasal Spray, or returns after a transient improvement, 1 additional dose may be administered at least 2 hours after the first dose. The maximum daily dose is 40 mg in a 24-hour period. The safety of treating an average of more than 4 headaches in a 30‑day period has not been established. • Single dose of 5 mg, 10 mg, or 20 mg of nasal spray. ( 2 ) • A second dose should only be considered if some response to the first dose was observed. Separate doses by at least 2 hours. ( 2 ) • Maximum dose in a 24-hour period: 40 mg. ( 2 )
Sumatriptan side effects
The following adverse reactions are discussed in more detail in other sections of the prescribing information: • Myocardial ischemia, myocardial infarction, and Prinzmetal’s angina [see Warnings and Precautions ( 5.1 )] • Arrhythmias [see Warnings and Precautions ( 5.2 )] • Chest, throat, neck, and/or jaw pain/tightness/pressure [see Warnings and Precautions ( 5.3 )] • Cerebrovascular events [see Warnings and Precautions ( 5.4 )] • Other vasospasm reactions [see Warnings and Precautions ( 5.5 )] • Medication overuse headache [see Warnings and Precautions ( 5.6 )] • Serotonin syndrome [see Warnings and Precautions ( 5.7 )] • Increase in blood pressure [see Warnings and Precautions ( 5.8 )] • Local irritation [see Warnings and Precautions ( 5.9 )] • Hypersensitivity reactions [see Contraindications ( 4 ), Warnings and Precautions ( 5.10 )] • Seizures [see Warnings and Precautions ( 5.11 )] Most common adverse reactions (≥1% and >placebo) were burning sensation, disorder/discomfort of nasal cavity/sinuses, throat discomfort, nausea and/or vomiting, bad/unusual taste, and dizziness/vertigo. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Prasco Laboratories at 1-866-525-0688 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical…
Every sumatriptan product we track (7)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
Sumatriptan Nasal Spray contains sumatriptan, a selective 5-HT 1B/1D receptor agonist. Sumatriptan is chemically designated as 3-[2-(dimethylamino)ethyl]-N-methyl-indole-5-methanesulfonamide, and it has the following structure: The empirical formula is C 14 H 21 N 3 O 2 S, representing a molecular weight of 295.4. Sumatriptan is a white to off-white powder that is readily soluble in water and in saline. Each Sumatriptan Nasal Spray contains 5 or 20 mg of sumatriptan in a 100-mcL unit dose aqueous buffered solution containing monobasic potassium phosphate NF, anhydrous dibasic sodium phosphate USP, sulfuric acid NF, sodium hydroxide NF, and purified water USP. The pH of the solution is approximately 5.5. The osmolality of the solution is 372 or 742 mOsmol for the 5- and 20-mg Sumatriptan Nasal Spray, respectively. Sumatriptan chemical structure
What kind of drug is sumatriptan?
The FDA classifies sumatriptan as a serotonin-1b and serotonin-1d receptor agonist. These migraine drugs (triptans) switch on serotonin 5-HT1B/1D receptors: they tighten the dilated blood vessels around the brain and quiet the trigeminal nerve pathway, blocking the release of pain-signaling molecules that drive a migraine attack. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take sumatriptan with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run sumatriptan against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is sumatriptan sold under?
We track 7 sumatriptan-containing products in the U.S.: Imitrex, Alsuma, Onzetra Xsail, Sumatriptan Succinate, Sumavel Dosepro, Tosymra and Zecuity. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does sumatriptan come in?
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Who shouldn’t take sumatriptan
Sumatriptan Nasal Spray is contraindicated in patients with: • Ischemic coronary artery disease (CAD) (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal’s angina [see Warnings and Precautions ( 5.1 )] • Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders [see Warnings and Precautions ( 5.2 )] • History of stroke, transient ischemic attack (TIA), or history of hemiplegic or basilar migraine because these patients are at a higher risk of stroke [see Warnings and Precautions ( 5.4 )] • Peripheral vascular disease [see Warnings and Precautions ( 5.5 )] • Ischemic bowel disease [see Warnings and Precautions ( 5.5 )] • Uncontrolled hypertension [see Warnings and Precautions ( 5.8 )] • Recent use (i.e., within 24 hours) of ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide), or another 5-hydroxytryptamine 1 (5-HT 1 ) agonist [see Drug Interactions ( 7.1 , 7.3 )] • Concurrent administration of a monoamine oxidase (MAO)-A inhibitor or recent (within 2 weeks) use of an MAO-A inhibitor [see Drug Interactions ( 7.2 ), Clinical Pharmacology ( 12.3 )] • Hypersensitivity to sumatriptan (angioedema and anaphylaxis seen) [see Warnings and Precautions ( 5.10 )] • Severe hepatic impairment [see Clinical…
Sumatriptan drug interactions
Ergot-Containing Drugs Ergot-containing drugs have been reported to cause prolonged vasospastic reactions. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) and Sumatriptan Nasal Spray within 24 hours of each other is contraindicated. 7.2 Monoamine Oxidase-A Inhibitors MAO-A inhibitors increase systemic exposure by up to 7-fold. Therefore, the use of Sumatriptan Nasal Spray in patients receiving MAO-A inhibitors is contraindicated [see Clinical Pharmacology ( 12.3 )] . 7.3 Other 5-HT 1 Agonists Because their vasospastic effects may be additive, coadministration of Sumatriptan Nasal Spray and other 5-HT 1 agonists (e.g., triptans) within 24 hours of each other is contraindicated. 7.4 Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during coadministration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [see Warnings and Precautions ( 5.7 )] .
Across the brands we track, sumatriptan is currently marketed as injectable, tablet, capsule, spray/inhaler and system, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic sumatriptan?
Yes. Our catalog lists 1 generic sumatriptan product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.