Imitrex (Sumatriptan Succinate)

(soo ma trip' tan)

Sumatriptan nasal spray is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound and light). Sumatriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels around the brain, stopping pain signals from being sent to the brain, and blocking the release of certain natural substances that cause pain, nausea, and other symptoms of migraine. Sumatriptan does not prevent migraine attacks or reduce the number of headaches you have.

Sumatriptan comes as a spray to inhale through the nose. It is usually used at the first sign of a migraine headache. If your symptoms improve after you use sumatriptan but return after 2 hours or longer, you may use a second dose of sumatriptan. However, if your symptoms do not improve after you use sumatriptan, do not use a second dose without talking to your doctor. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use sumatriptan exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. You may use your first dose of sumatriptan nasal spray in a doctor's office or other medical facility where you can be monitored for serious reactions. Call your doctor if your headaches do not get better or occur more frequently after using sumatriptan nasal spray. If you use sumatriptan more often or for longer than the recommended period of time, your headaches may get worse or may occur more frequently. You should not use sumatriptan nasal spray or take any other headache medication for more than 10 days per month. Call your doctor if you need to use sumatriptan nasal spray to treat more than four headaches in 1-month period. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. To use the nasal spray, follow these steps:

• Read all of the manufacturer's instructions for using the nasal spray before you use your first dose.
• Blow your nose gently.
• Remove the protective cap from the sprayer.
• Hold the sprayer between your fingers and thumb, but be careful not to press the plunger.
• Use your other hand to block one nostril by pressing firmly on the side of your nose.
• Put the tip of the sprayer into your other nostril as far as feels comfortable (about one half inch). Keep your head upright and close your mouth. Be careful not to press the plunger or spray the medication in your eyes.
• Breathe in gently through your nose. At the same time, press the plunger firmly with your thumb.
• Keep your head level and remove the tip from your nose.
• Breathe gently in through your nose and out through your mouth for 10–20 seconds. Do not breathe in deeply. It is normal to feel liquid in your nose or the back of your throat.
• The sprayer only contains one dose of medication. After you have used it, dispose of it safely, so that is out of the reach of children and pets.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before using sumatriptan,
• tell your doctor and pharmacist if you are allergic to sumatriptan, any other medications, or any of the ingredients in sumatriptan nasal spray. Ask your pharmacist for a list of the ingredients.
• do not use sumatriptan nasal spray if you have taken any of the following medications in the past 24 hours: other selective serotonin receptor agonists such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or ergot-type medications such as bromocriptine (Parlodel), cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), ergotamine (Cafergot, Ergomar, Wigraine), methylergonovine (Methergine), methysergide (Sansert), and pergolide (Permax).
• do not use sumatriptan nasal spray if you are taking a monoamine oxidase A (MAO-A) inhibitor such as isocarboxazid (Marplan), phenelzine (Parnate), or tranylcypromine (Nardil) or if you have taken one of these medications in the past 2 weeks.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetaminophen (Tylenol); antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft); and selective serotonin/norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), sibutramine (Meridia), and venlafaxine (Effexor). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had heart disease; a heart attack; angina (chest pain); irregular heartbeats; stroke or 'mini-stroke'; or circulation problems such as varicose veins, blood clots in the legs, Raynaud's disease (problems with blood flow to the fingers, toes, ears, and nose), or ischemic bowel disease (bloody diarrhea and stomach pain caused by decreased blood flow to the intestines). Your doctor may tell you not to use sumatriptan nasal spray.
• tell your doctor if you smoke or are overweight; if you have or have ever had high blood pressure, high cholesterol, diabetes, seizures, or liver or kidney disease; if you have gone through menopause (change of life); or if any family members have or have ever had heart disease or stroke.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you plan to be sexually active while you are using this medication, talk to your doctor about effective methods of birth control. If you become pregnant while using sumatriptan nasal spray, call your doctor.
• you should know that sumatriptan nasal spray may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you.

Unless your doctor tells you otherwise, continue your normal diet.

Sumatriptan nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• sore or irritated nose
• sore throat
• dry mouth
• unusual taste in the mouth
• nausea
• tiredness
• dizziness
• weakness
• burning or tingling feeling
• sensitivity to loud noises

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• pain, tightness, pressure, or heaviness in the chest, throat, neck, or jaw
• slow or difficult speech
• faintness
• breaking out in a cold sweat
• change in vision
• weakness or numbness of an arm or leg
• fast, pounding, or irregular heartbeat
• bloody diarrhea
• vomiting
• sudden or severe stomach pain
• sudden weight loss
• paleness or blue color of the fingers and toes
• shortness of breath
• swelling of the eyes, face, lips, tongue, or throat
• difficulty breathing or swallowing
• rash
• hives
• hoarseness
• pain, burning, or tingling in the hands or feet
• seizures

Sumatriptan nasal spray may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor. Your blood pressure should be checked regularly. You should keep a headache diary by writing down when you have headaches and when you use sumatriptan nasal spray. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.