Formulary
Sumatriptan: Indications, Dosing, Side Effects and Interactions
Sumatriptan clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 5 min read
Sumatriptan: Indications, Dosing, Side Effects and Interactions
Sumatriptan clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Treatment of acute migraine**
- **Adult** (By Mouth): Initially 50-100 mg for 1 dose, followed by 50-100 mg after at least 2 hours if required, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack); maximum 300 mg per day.
- **Adult** (By Subcutaneous Injection): 18-65 years Initially 10-20 mg, to be administered into one nostril, followed by 10-20 mg after at least 2 hours if required, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack); maximum 40 mg per day.
**Treatment of acute cluster headache**
- **Adult** (By Subcutaneous Injection): 18-65 years Initially 10-20 mg, dose to be administered into one nostril, followed by 10-20 mg after at least 2 hours if required, to be taken only if headache recurs (patient not responding to initial dose should not take second dose for same attack); maximum 40 mg per day.
**Treatment of acute migraine for sumatriptan**
- **Child 6-9 years** (By mouth): Initially 25 mg for 1 dose, followed by 25 mg after at least 2 hours if required, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack).
- **Child 10-11 years** (By mouth): Initially 50 mg for 1 dose, followed by 50 mg after at least 2 hours, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack).
- **Child 12-17 years** (By mouth): Initially 50-100 mg for 1 dose, followed by 50-100 mg after at least 2 hours if required, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack).
- **Child 10-17 years** (By subcutaneous injection): Initially 6 mg for 1 dose, followed by 6 mg after at least 1 hour if required, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack), dose to be administered using an auto-injector; maximum 12 mg per day.
- **Child 12-17 years** (By intranasal administration): Initially 10-20 mg for 1 dose, followed by 10-20 mg after at least 2 hours if required, to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack); maximum 40 mg per day.
**Treatment of acute cluster headache for sumatriptan**
- **Child 10-17 years (under expert supervision)** (By subcutaneous injection): Initially 6 mg for 1 dose, followed by 6 mg after at least 1 hour if required, to be taken only if headache recurs (patient not responding to initial dose should not take second dose for same attack), dose to be administered using auto-injector; maximum 12 mg per day.
- **Child 12-17 years (under expert supervision)** (By intranasal administration): Initially 10-20 mg for 1 dose, followed by 10-20 mg after at least 2 hours if required, to be taken only if headache recurs (patient not responding to initial dose should not take second dose for same attack); maximum 40 mg per day.
Cautions
Conditions which predispose to coronary artery disease; elderly; history of seizures; mild, controlled hypertension; risk factors for seizures
Contraindications
Coronary vasospasm; ischaemic heart disease; mild uncontrolled hypertension; moderate and severe hypertension; peripheral vascular disease; previous cerebrovascular accident; previous myocardial infarction; previous transient ischaemic attack; Prinzmetal's angina
Side effects
General side-effects: Common or very common Asthenia; dizziness; drowsiness; dyspnoea; feeling abnormal; flushing; myalgia; nausea; pain; sensation abnormal; skin reactions; temperature sensation altered; vomiting Frequency not known Angina pectoris; anxiety; arrhythmias; arthralgia; colitis ischaemic; coronary vasospasm; diarrhoea; dystonia; hyperhidrosis; hypersensitivity; hypotension; myocardial infarction; nystagmus; palpitations; Raynaud's phenomenon; seizure; tremor; vision disorders Specific side-effects: Common or very common With intranasal use Epistaxis; nasal irritation; taste altered; throat irritation With subcutaneous use Haemorrhage; swelling Frequency not known With oral use Dysphagia Side-effects, further information Discontinue if symptoms of heat, heaviness, pressure or tightness (including throat and chest) occur.
Interactions
**Other interactions (5):**
- There is no evidence of interactions with propranolol, flunarizine, pizotifen or alcohol.
- The period of time that should elapse between the use of sumatriptan and ergotamine-containing preparations or another triptan/5-HT 1 receptor agonist is not known.
- It is advised to wait at least 24 hours following the use of ergotamine-containing preparations or another triptan/5-HT 1 receptor agonist before administering sumatriptan.
- Conversely, it is advised to wait at least 6 hours following use of sumatriptan before administering an ergotamine-containing product and at least 24 hours before administering another triptan/5-HT...
- There have been rare post-marketing reports describing patients with serotonin syndrome (including altered mental status, autonomic instability and neuromuscular abnormalities) following the use of...
Pregnancy
There is limited experience of using 5HT 1 -receptor agonists during pregnancy; manufacturers advise that they should be avoided unless the potential benefit outweighs the risk.
Breast feeding
Present in milk but amount probably too small to be harmful; withhold breast-feeding for 12 hours after treatment.
Hepatic impairment
Manufacturer advises caution (reduced pre-systemic clearance increases exposure); avoid in severe impairment (no information available). Dose adjustments With oral use: Manufacturer advises consider dose reduction to 25-50 mg in mild to moderate impairment.
Renal impairment
Use with caution. M
Medicinal forms
Tablet,Solution,Spray
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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