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Sumatriptan

1. About

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

It belongs to a group of medicines called triptans, or serotonin (5-HT1) agonists.

You take 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 used for migraines only.

Sumatriptan tablets, nasal spray and injections are 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.

2. Key facts

  • Take sumatriptan as soon as a migraine or cluster headache starts.
  • The tablets usually work within 30 to 60 minutes. The spray and injection work quicker.
  • Common side effects include feeling or being sick, feeling sleepy or dizzy.
  • Do not take migraine medicines such as ergotamine or other triptans when taking sumatriptan.
  • Sumatriptan is also known by the brand names Imigran, Migraitan and Boots Migraine Relief 50mg Tablets.

3. Who can and cannot take sumatriptan

Most adults with migraines 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 over the age of 6 years.

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

  • have had an allergic reaction to sumatriptan or any other medicine in the past
  • 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.

Important

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

4. How and when to take it

Always follow your doctor's instructions when taking this medicine.

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 come with a line in the middle 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.

The usual dose is 50mg. But some people may be prescribed 100mg.

The tablets should work in 30 to 60 minutes. If your migraine improves but then comes back, you can take the same dose again after 2 hours.

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

Injections (migraine or cluster headache)

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

Use the pre-filled syringe to inject 1 dose. This contains 6mg of sumatriptan. 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.

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

Nasal spray (migraine or cluster headache)

Read the instructions that come with your medicine to find out how to use the single-use nasal spray. Each spray contains 1 dose (10mg or 20mg of sumatriptan).

  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.

If your headache improves but then comes back, you can have another dose after 2 hours.

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

Important

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

What if I take too much?

Do not take more than the 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.

Urgent advice: Contact 111 for advice now if:

  • you take too much sumatriptan

Go to 111.nhs.uk or call 111

If you need to go to hospital, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the sumatriptan packet or leaflet inside it plus any remaining medicine with you.

5. Side effects

Like all medicines, sumatriptan can cause side effects. However, many people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and short lived. Some of the side effects are similar to the symptoms of migraine or cluster headaches.

Talk to your doctor or pharmacist if these side effects bother you or last more than a few days:

  • feeling or being sick (nausea or vomiting)
  • feeling dizzy, unsteady on your feet or tired
  • feeling hot or cold, face flushes red

With the nasal spray:

  • irritation or burning in your nose or throat
  • nosebleeds
  • bad taste in your mouth

With the injections:

  • bruising or swelling where you gave yourself the injection
  • bleeding where you gave yourself the injection

Serious side effects

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

Do not take any more sumatriptan and tell a doctor 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 don't 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.

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having 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 medicines packet.

Information:

You can report any suspected side effect to the UK safety scheme.

6. How to cope with side effects

What to do about:

  • feeling or being sick (nausea or vomiting) – these side effects 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.
  • feeling dizzy, unsteady on your feet or tired – 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 or a bit shaky.
  • feeling hot or cold, face flushes red – if this bothers you or does no't go away, speak to a GP.
  • irritation or burning in your nose or throat – this usually only lasts for a short time.
  • nosebleeds – these 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 blood-thinning medicine such as warfarin or rivaroxaban, or you have haemophilia or any other condition that means your blood cannot clot properly.
  • bad taste in your mouth – try chewing sugar-free gum.
  • bruising or swelling (where you gave yourself the injection) – this is usually mild and will go away after 1 to 3 days. See a doctor if it gets worse, becomes painful or inflamed or if it lasts for longer than a few days.
  • bleeding (where you gave yourself the injection) – this should only last a short time. Seek immediate medical help if the bleeding does not stop after 10 to 15 minutes, especially if you're taking a blood-thinning medicine such as warfarin or rivaroxaban, or you have haemophilia or any other condition that means your blood can't clot properly.

7. Pregnancy and breastfeeding

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

Talk to a doctor about the benefits and possible harms of taking sumatriptan. There may be other medicines that are safer for you.

Find out more about how sumatriptan can affect you and your baby during pregnancy by Best Use of Medicines in Pregnancy (BUMPS).

Sumatriptan and breastfeeding

It's usually safe to take sumatriptan if you're breastfeeding. Only small amounts of the medicine get into breast milk and so it's not enough to cause any problems for your baby.

However, speak to a doctor if your baby was premature or has any health problems.

Important

Tell a doctor if you're trying to get pregnant, you are already pregnant or if you're breastfeeding.

8. Cautions with other medicines

There are some medicines that may interfere with the way sumatriptan works.

Tell your doctor before you take sumatriptan if you're already taking:

  • other migraine or headache medicines (including ergotamine and other triptans)
  • antidepressants called MAOIs (monoamine oxidase inhibitors
  • antidepressants

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 seretonin sydrome 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.

Mixing sumatriptan with herbal remedies or supplements

Taking sumatriptan with St John's wort (hypericum perforatum) can increase your risk of serotonin syndrome. Do not take St John's wort if you're using sumatriptan.

9. Common questions

How does sumatriptan work?

Sumatriptan belongs to a group of medicines called triptans, or serotonin (5-HT1) agonists.

We do not yet understand what causes migraines and cluster headaches. However, your symptoms may be due to the temporary widening of blood vessels in your head.

Sumatriptan works on the serotonin (or 5-HT) receptors located on blood vessels in your brain. This causes them to narrow.

This helps take away the headache and eases other symptoms such as feeling or being sick and sensitivity to light and sound.

How long does it take to work?

Sumatriptan tablets should work within 30 to 60 minutes. The injections start to work within 10 to 15 minutes and the nasal spray works in about 15 minutes.

Is it safe to take for a long time?

It's important not to use sumatriptan too often. See your doctor if your headache does not go away, or if you have frequent migraines or cluster headaches.

Sumatriptan is used to treat migraine or cluster headaches once the pain has started, but there are other medicines available that may help to reduce the number and frequency of attacks. Talk to your doctor about these.

Taking too many migraine medicines or taking them too often is linked to something called "medication overuse headaches". This is when medicines make your headaches worse. Your headaches may be more severe and you may get them more often.

If you're worried that you may have medication overuse headaches, make an appointment to see your doctor.

How does it compare with other migraine medicines?

Your choice of migraine treatment will usually depend on how well a treatment has worked for you in the past and how severe your headaches are.

Migraine headaches can often be treated with paracetamol (preferably soluble) or ibuprofen. Alternatively you can take aspirin (again, preferably soluble) if you are aged 16 or older.

There are also medicines that help you stop feeling or being sick when you have a headache. These are called antiemetics.

If painkillers or anti-inflammatories do not help a migraine, then a specific antimigraine medicine such as a triptan (serotonin 5-HT1-receptor agonist) may work.

Ergotamine tartrate (a type of medicine called an ergot) is rarely used for migraine because of its side effects. Ergots and opioids (such as codeine and morphine) are not recommended for treating migraines.

How does it compare with other medicines for cluster headaches?

Ordinary painkillers do not help with cluster headaches because they take too long to work. The headache is often gone before the painkiller starts to take effect.

Cluster headaches are usually treated with oxygen therapy, either on its own or together with a triptan (such as sumatriptan or zolmatriptan).

Sumatriptan comes as injections or a nasal spray for cluster headaches and zolmatriptan comes as a nasal spray. The tablets and capsules will not work for cluster headaches.

Opioids (such as codeine and morphine) or ergots (such as ergotamine) are not recommended for treating cluster headaches.

Will I need to stop sumatriptan before surgery?

Tell your doctor that you use sumatriptan if you're going to be put to sleep (having a general anaesthetic), or you're having any kind of operation.

Your doctor may advise you to stop taking sumatriptan for 24 hours before surgery.

Can I drink alcohol with it?

Alcohol does not affect how sumatriptan works.

However, it's best not to drink alcohol during a headache attack.

Migraines and cluster headaches can sometimes be triggered by alcohol.

Is there any food or drink I need to avoid?

You can eat and drink normally while taking sumatriptan.

However it's best to avoid drinking alcohol during a headache attack.

There are many possible migraine triggers including eating cheese, chocolate, red wine citrus fruits, foods containing an additive called tyramine (such as smoked salmon and salami) and not drinking enough water.

Keeping a migraine diary may help you work out what your triggers are. Recor when and where each migraine attack started, what you were doing at the time, and what you ate that day.

Eating a healthy, balanced diet and avoiding trigger foods or drinks may help if you have migraines or cluster headaches.

Will it affect my contraception?

Sumatriptan will not stop your contraception working.

However the combined pill is not usually recommended if you have migraines with symptoms called an aura.

Talk to your doctor if you have migraines and take (or want to take) a hormonal contraceptive.

Will it affect my fertility?

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

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

Do I need to avoid playing sports?

You do not need to stop playing sports if you take sumatriptan.

However, be careful playing sports if you get migraine aura that affect your sight and reactions.

If you have taken sumatriptan, some of the side effects may have an impact on you when you're playing sport. These include dizziness, tiredness, feeling sick or weak and shortness of breath.

Can I drive or ride a bike?

You can feel very dizzy or tired when you take sumatriptan. Migraines can also have this effect.

If you feel this way, do not drive a car, ride a bike or operate machinery until you feel OK again.

Can lifestyle changes help?

There are steps you can take to help prevent severe headaches.

This includes working out what things trigger an attack so you can avoid them. Keeping a migraine diary can help.

If you smoke, it's a good idea to quit. People who smoke seem to have a higher risk of getting cluster headaches.

Eating a healthy, balanced diet and avoiding trigger foods or drinks can also help.

Page last reviewed: 18 October 2019
Next review due: 18 October 2022