Sumatriptan is a generic prescription drug that quickly ends migraine headaches. It reverses some of the mechanisms that cause migraine headaches: nerve signals, dilation of the arteries in the head, and inflammation of the membranes that surround and protect the brain. Sumatriptan nasal spray is not often prescribed, but has a swift onset of action.
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Imitrex, Onzetra Xsail, Tosymra
Sumatriptan
Treats active migraines
Antimigraine, migraine abortive, selective serotonin 1B/1D receptor agonist
Nasal spray, nasal powder
Into the nose
The FDA has approved sumatriptan as a treatment for acute migraines in adults. Sumatriptan does not prevent migraines. Healthcare professionals prescribe sumatriptan off-label to manage cyclic vomiting syndrome or to treat children or teens with acute migraine headaches.
Nasal spray (sumatriptan)
5 mg
10 mg
20 mg
Nasal powder (sumatriptan succinate)
22 mg
Find more detailed information about sumatriptan dosage, forms, and strengths here.
For active migraine in adults:
Nasal spray: 5–20 mg single nasal spray or one 5 mg spray in each nostril followed by a second dose if necessary, no sooner than one hour (Tosymra only) or two hours (all other nasal sprays) after the first dose
Nasal powder: Two 11 mg nosepieces, one in each nostril, followed by a second 22 mg dose, if necessary, no sooner than two hours after the first dose
For active migraine in adults: 6 mg subcutaneous injection followed by a second dose, if necessary, no sooner than one hour after the first dose
SUMAtriptan
1 solution inhaler
SUMAtriptan
20mg/act solution
SUMAtriptan
5mg/act solution
Follow all the prescriber’s instructions when taking sumatriptan. Do not take more than prescribed or exceed the maximum daily dosage.
The first dose may need to be taken in a doctor’s office or clinical setting.
Only take a sumatriptan dose when you experience a migraine or cluster headache. Sumatriptan does not prevent migraine or cluster headaches.
If the initial dose does not provide any relief, do not take a second dose without talking to a doctor or other healthcare provider.
If the first dose provides some but not enough relief or the migraine returns, wait for at least one hour (injection) or two hours (tablets or nasal formulations) before taking a second dose.
Consult with the prescriber if you need to treat more than four headaches in any 30-day period.
How to administer sumatriptan nasal spray:
The instructions for administering a dose may vary by product. Please read the Instructions for use included in the package.
Sumatriptan nasal spray comes in single-dose spray devices in portable plastic packs.
The medicine is sprayed into one nostril only.
Do not test the device before using it.
Gently blow your nose before administering the spray.
Keep your head upright with one finger closing the other nostril and your mouth closed when giving a dose.
Keeping the head upright, gently breathe in and out of the nose for 10 to 20 seconds.
Immediately dispose of the empty single-dose sprayer.
Store sumatriptan nasal spray at room temperature. Do not refrigerate or freeze.
How to administer sumatriptan nasal powder (Onzetra Xsail):
Carefully follow the instructions on the package insert or have a healthcare professional demonstrate how to use the dosing device.
The powder is delivered through a device with a mouthpiece and an insertable nosepiece.
The nosepiece contains the medicine.
Sumatriptan nasal powder is administered into both nostrils using two dosing nosepieces.
Insert the nosepiece into the device.
Insert the nosepiece deeply into one nostril.
Rotate the device so that the mouthpiece can be placed in the mouth.
Blow into the mouthpiece for two to three seconds as if you were blowing up a balloon for two to three seconds.
Remove and immediately dispose of the used nosepiece.
Insert a new nosepiece and repeat the process in the other nostril.
Remove and discard the used nosepiece.
Store Onzetra Xsail at room temperature. Do not refrigerate or freeze.
A missed dose can be taken at any time if pain and symptoms persist.
The next dose cannot be taken until two hours later (for migraines) or one hour later (for cluster headaches).
This medicine is not right for everyone.
Do not use it if you had an allergic reaction to sumatriptan or if you have:
Serious coronary artery disease, including angina or a history of heart attack
Certain types of heart rhythm abnormalities
History of stroke or transient ischemic attack (TIA)
Peripheral vascular disease
Intestinal injuries due to compromised blood flow (ischemic bowel disease)
High blood pressure not controlled by blood pressure medications
Severe liver disease
Tell any healthcare provider who treats you that you are using this medicine.
The prescriber may need regular visits or lab tests to monitor the effectiveness and side effects of this treatment. Keep all appointments.
Tell the prescriber if you are pregnant, breastfeeding, or have:
Kidney disease
Liver disease
Diabetes
A history of seizures
High blood pressure
High cholesterol
A family history of heart disease
Eye or vision problems
Tell the prescriber if you smoke or are overweight. Both are risk factors for heart disease.
Sumatriptan can cause serious side effects, including:
Increased risk of heart problems, heart attack, or chest pain
Increased risk of stroke
Blood vessel problems
High blood pressure
Do not breastfeed for 12 hours after you take a dose of sumatriptan.
This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Your headaches may become worse if you use headache medicine for 10 or more days per month. Call your doctor if your symptoms do not improve or if they get worse.
Do not use this medicine if you have used an MAO inhibitor in the past two weeks. You can find a list of MAO inhibitors here.
Never combine sumatriptan with certain types of migraine treatments:
Other triptans
Migraine drugs called ergots such as cafergot, ergomar, migergot, or Migranal (dihydroergotamine)
To avoid drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements being taken before starting sumatriptan.
Tell the prescriber about any depression medications being taken, particularly selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs).
Find more detailed information about sumatriptan interactions to avoid here.
Immediately stop using sumatriptan and get medical attention if you experience:
Persistent or repeating chest discomfort, chest tightness, chest pain, arm pain, shoulder pain, back pain, neck pain, shortness of breath, lightheadedness, cold sweats
Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:
Sudden severe headache (other than the one being treated), problems with vision, speech, or walking
Severe stomach pain, bloody diarrhea, nausea, vomiting, fever
Vision changes that are not part of a usual migraine
Numbness, tingling, cramps, unexplained pain in your legs or feet, numbness or weakness in your arm or leg or on one side of your body
Color changes and cold feeling in your toes or fingers
Pain in your lower leg (calf)
Seizures
Fast, pounding, or uneven heartbeat
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, throat tightness, trouble breathing
Bad or unusual taste in your mouth
Dizziness or vertigo
Tingling or numbness in the fingers and toes
Burning or tingling feeling in your nose (nasal spray or powder)
Injection site reactions (injections)
Imitrex drug summary, Prescriber’s Digital Reference (PDR)
Imitrex sumatriptan spray, DailyMed (NIH National Library of Medicine)
Onzetra Xsail sumatriptan succinate capsule prescribing information, DailyMed (NIH National Library of Medicine)
Sumatriptan, StatPearls
Tosymra sumatriptan spray prescribing information, DailyMed (NIH National Library of Medicine)
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