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Sumatriptan is a selective agonist for 5-hydroxytryptamine1 (5-HT1B/1D) receptors. It is believed to exert its antimigraine effect by causing vasoconstriction of intracranial blood vessels, particularly those of the carotid circulation, which are dilated during a migraine attack. It may also inhibit the release of pro-inflammatory neuropeptides from trigeminal nerve endings.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Note: In rare cases, allergic reactions can be fatal.
Signs of high blood pressure, including:
+ Severe headache
+ Dizziness
+ Fainting
+ Changes in eyesight
Seizures
Loss of vision (which can be long-lasting)
Abnormal sensations, such as:
+ Burning
+ Numbness
+ Tingling
Discoloration of the skin, lips, nail beds, fingers, or toes (blue or gray)
Gastrointestinal issues, including:
+ Diarrhea
+ Constipation
+ Severe stomach pain
+ Bloody diarrhea
Other symptoms, such as:
+ Belly pain after meals
+ Fever
+ Weight loss
+ Leg cramps and pain
+ Heaviness or tightness in the leg muscles
+ Feeling cold
+ Burning or aching pain in the feet or toes

Serotonin Syndrome: A Potentially Life-Threatening Condition

There is a risk of developing serotonin syndrome, a severe and potentially deadly condition, especially when taking certain other medications. If you experience any of the following symptoms, contact your doctor immediately:

Agitation
Changes in balance
Confusion
Hallucinations
Fever
Fast or abnormal heartbeat
Flushing
Muscle twitching or stiffness
Seizures
Shivering or shaking
Excessive sweating
Severe diarrhea
Upset stomach
Vomiting
Severe headache

Brain Blood Vessel Problems: A Rare but Serious Risk

In rare cases, this medication has been associated with brain blood vessel problems, including stroke. If you experience any of the following symptoms, contact your doctor right away:

Weakness on one side of the body
Trouble speaking or thinking
Changes in balance
Drooping on one side of the face
Changes in eyesight

Other Side Effects

As with any medication, you may experience side effects. While many people have no side effects or only mild ones, it's essential to contact your doctor if you experience any of the following:

Dizziness
Drowsiness
Fatigue
Weakness
Flushing
Feeling of warmth
Upset stomach
* Vomiting

If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ High blood pressure
+ Liver disease
A history of specific health problems, such as:
+ Chest pain or pressure
+ Diseased arteries in the legs or arms
+ Heart attack
+ Heart disease
+ Poor blood flow in the heart, brain, bowel, or kidney
+ Stroke or transient ischemic attack (TIA)
+ Certain types of migraines, including hemiplegic or basilar migraines
+ Abnormal heart rhythms, such as Wolff-Parkinson-White syndrome
Recent use of certain antidepressant medications, including isocarboxazid, phenelzine, or tranylcypromine, within the last 14 days. Taking this medication within 14 days of these drugs can cause severe high blood pressure.
Concurrent use of another medication that contains the same active ingredient.
Use of other medications for migraines, such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, or zolmitriptan, within the last 24 hours.
* Use of ergotamine, methysergide, dihydroergotamine, or similar medications within the last 24 hours.

This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems. Ensure that it is safe to take this medication with your other medications and health conditions before starting, stopping, or changing the dose of any medication. Always consult your doctor before making any changes to your medication regimen.

Important Warnings and Cautions for Patients Taking This Medication

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This will help ensure your safety and prevent any potential interactions with other treatments.

Caution with Daily Activities
Until you understand how this medication affects you, avoid driving and engaging in activities that require alertness.

Monitoring Blood Pressure
High blood pressure has been reported in patients taking this medication. Follow your doctor's instructions for regular blood pressure checks to monitor your condition.

Medication Purpose and Usage
This medication is not intended to prevent or reduce the frequency of migraine headaches. If you experience a headache that is different from your typical migraine, consult your doctor before taking this medication.

Dosage and Administration
Taking more of this medication than prescribed by your doctor (higher dose, more frequent) may worsen your headaches. Use caution when taking this medication, especially if you have risk factors for heart disease, such as:

High blood pressure
High cholesterol
Overweight
High blood sugar or diabetes
Cigarette smoking
Male older than 40 years of age
Family history of early heart disease
Female after menopause

Discuss your individual risk factors with your doctor.

Cardiovascular Risks
Rare but serious heart problems, including heart attack and abnormal heartbeat, have occurred within a few hours of taking this medication. Seek immediate medical attention if you experience:

Chest, throat, neck, or jaw tightness, pain, pressure, or heaviness
Cold sweat
Shortness of breath
Rapid heartbeat
Abnormal heartbeat
Severe dizziness or fainting

Special Considerations

Older Adults (65 and older): Use this medication with caution, as you may be more susceptible to side effects.
Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Your doctor will discuss the benefits and risks of taking this medication with you.
* Children: This medication is not approved for use in children. However, your doctor may decide that the benefits outweigh the risks. If your child has been prescribed this medication, ask your doctor about the benefits and risks, and discuss any questions or concerns you may have.

• Monoamine Oxidase Inhibitors (MAOIs) or within 2 weeks of discontinuing MAOIs
• Ergotamine-containing drugs or ergot-type drugs (e.g., dihydroergotamine) within 24 hours
• Other 5-HT1 agonists (triptans) within 24 hours

• Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) - increased risk of serotonin syndrome
• Cimetidine - may increase sumatriptan levels (minor clinical significance for oral sumatriptan)

• St. John's Wort - theoretical increased risk of serotonin syndrome

• Alcohol - may exacerbate migraine or interact with sumatriptan side effects

• Chest pain or tightness
• Neck or jaw pain/tightness
• Dizziness or vertigo
• Paresthesias (tingling, numbness)
• Flushing
• Warm sensation
• Fatigue
• Nausea/vomiting
• Serotonin syndrome symptoms (agitation, hallucinations, rapid heart beat, fever, overactive reflexes, nausea, vomiting, diarrhea, incoordination)

Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited human data suggest no increased risk of major birth defects, but animal studies show some developmental toxicity at high doses.

Sumatriptan is excreted into human breast milk. The amount ingested by an infant is small. Consider pumping and discarding breast milk for 12 hours after a dose to minimize infant exposure, or use with caution and monitor the infant for adverse effects.

Oral tablets are not recommended for patients under 18 years of age due to lack of established efficacy and safety. Nasal spray and subcutaneous injection forms are approved for adolescents (12-17 years) for acute migraine.

Use with caution. Elderly patients may be at higher risk for cardiovascular adverse events due to a greater likelihood of underlying cardiovascular disease. Consider lower initial doses and careful monitoring.

• Sumatriptan is for acute treatment of migraine or cluster headache, not for prevention.
• Do not use in patients with a history of ischemic heart disease, uncontrolled hypertension, or hemiplegic/basilar migraine.
• Advise patients to take the medication at the first sign of a migraine attack, but not during the aura phase if it precedes the headache.
• Warn patients about the potential for 'triptan sensations' (e.g., chest pressure, neck tightness, tingling), which are usually transient and not indicative of cardiac ischemia, but should be reported if severe or persistent.
• Ensure a 24-hour interval between sumatriptan and ergotamine-containing medications or other triptans to avoid additive vasoconstrictive effects.

• Other triptans (e.g., zolmitriptan, rizatriptan, eletriptan, frovatriptan, naratriptan)
• CGRP receptor antagonists (e.g., rimegepant, ubrogepant)
• NSAIDs (e.g., ibuprofen, naproxen)
• Acetaminophen
• Ergot alkaloids (e.g., ergotamine, dihydroergotamine - generally less preferred due to side effects)
• Anti-emetics (e.g., metoclopramide, prochlorperazine - often used adjunctively)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide information about the medication taken, the amount, and the time it happened.