top of page

Sumatriptan: A Prominent Acute Migraine Treatment in General Practice


Migraine is a prevalent neurological disorder that affects millions of individuals worldwide. It is characterized by severe headaches, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. In the general practitioner (GP) setting, the treatment of acute migraines often involves the use of medications such as sumatriptan. In this blog, we will explore the role of sumatriptan and its dosages in the management of acute migraines in a primary care setting.

Understanding Sumatriptan

Sumatriptan is a medication classified as a selective serotonin receptor agonist, specifically targeting the 5-HT1B and 5-HT1D receptors. It is available in various formulations, including tablets, nasal sprays, and injections. Sumatriptan works by constricting blood vessels and reducing inflammation in the brain, effectively relieving the pain and other symptoms associated with migraines.

The Role of Sumatriptan in Acute Migraine Treatment

Sumatriptan is considered a first-line treatment for acute migraines in the GP setting due to its proven efficacy and safety profile. It is most effective when taken at the onset of a migraine attack or during the prodromal phase, before the headache becomes severe. Sumatriptan helps alleviate the pain, nausea, and sensitivity to light and sound associated with migraines, allowing individuals to resume their daily activities more comfortably.

Dosage Recommendations The dosage of sumatriptan may vary depending on the formulation and individual patient factors. Here are some common dosage recommendations for different sumatriptan formulations:

1. Sumatriptan Tablets: The recommended starting dose is 50 mg. If the migraine symptoms persist or recur, a second dose may be taken after at least two hours. The maximum daily dose should not exceed 200 mg.

2. Sumatriptan Nasal Spray: The recommended initial dose is 10 mg. If the symptoms persist or recur, a second dose may be administered after at least two hours. The maximum daily dose should not exceed 40 mg.

3. Sumatriptan Injections: The recommended dose is 6 mg injected subcutaneously. If the symptoms persist or recur, a second dose may be administered after at least one hour. The maximum daily dose should not exceed 12 mg.

It is important to note that these dosage recommendations are general guidelines, and individual patient factors, such as age, overall health, and response to treatment, should be considered. It is always advisable to consult with a GP or healthcare professional for personalized dosage recommendations.

Considerations and Precautions

While sumatriptan is generally well-tolerated, it may not be suitable for everyone. Individuals with certain medical conditions, such as uncontrolled hypertension, cardiovascular disease, or a history of stroke, may need to avoid or use sumatriptan with caution. Additionally, potential side effects of sumatriptan may include chest tightness, flushing, dizziness, and fatigue. If any concerning side effects occur, it is important to seek medical advice promptly.

Sumatriptan plays a crucial role in the management of acute migraines in the GP setting. Its ability to relieve pain and associated symptoms makes it an effective treatment option for many individuals. However, it is essential to follow the recommended dosages and consult with a healthcare professional for personalized advice. By understanding the role of sumatriptan and its appropriate use, GPs can provide effective relief to patients experiencing acute migraines, improving their quality of life and overall well-being.

References

Ahonen, K., Hamalainen, M. L., Rantala, H., & Hoppu, K. (2004). Nasal sumatriptan is effective in treatment of migraine attacks in children: A randomized trial. Neurology, 62(6), 883–887. https://doi.org/10.1212/01.wnl.0000115105.05966.a7 Bates, D., Ashford, E., Dawson, R., Ensink, F-B. M., Gilhus, N. E., Olesen, J., Pilgrim, A. J., & Shevlin, P. (1994). Subcutaneous sumatriptan during the migraine aura. Neurology, 44(9), 1587–1587. https://doi.org/10.1212/wnl.44.9.1587 Brandes, J. L., Kudrow, D., Stark, S. R., O’Carroll, C. P., Adelman, J. U., O’Donnell, F. J., Alexander, W. J., Spruill, S. E., Barrett, P. S., & Lener, S. E. (2007). Sumatriptan-Naproxen for Acute Treatment of Migraine: A Randomized Trial. JAMA, 297(13), 1443–1454. https://doi.org/10.1001/jama.297.13.1443 Cady, R. K. (1991). Treatment of Acute Migraine With Subcutaneous Sumatriptan. JAMA: The Journal of the American Medical Association, 265(21), 2831. https://doi.org/10.1001/jama.1991.03460210077033 Cady, R., Sheftell, F. D., Lipton, R. B., O’Quinn, S., Jones, M., D. Gayla Putnam, Crisp, A., Metz, A., & McNeal, S. (2000). Effect of early intervention with sumatriptan on migraine pain: Retrospective analyses of data from three clinical trials. 22(9), 1035–1048. https://doi.org/10.1016/s0149-2918(00)80083-1 Ferrari, M. D., & Saxena, P. R. (1992). Clinical effects and mechanism of action of sumatriptan in migraine. Clinical Neurology and Neurosurgery, 94 Suppl, S73-77. https://doi.org/10.1016/0303-8467(92)90028-2 Hansen, J. M., Goadsby, P. J., & Charles, A. (2015). Reduced efficacy of sumatriptan in migraine with aura vs without aura. Neurology, 84(18), 1880–1885. https://doi.org/10.1212/wnl.0000000000001535 Humphrey, P. P. A., & Feniuk, W. (1991). Mode of action of the anti-migraine drug sumatriptan. Trends in Pharmacological Sciences, 12, 444–446. https://doi.org/10.1016/0165-6147(91)90630-b Pilgrim, A. J. (1991). Methodology of Clinical Trials of Sumatriptan in Migraine and Cluster Headache. European Neurology, 31(5), 295–299. https://doi.org/10.1159/000116757 Smith, T. R., Sunshine, A., Stark, S. R., Littlefield, D. E., Spruill, S. E., & Alexander, W. J. (2005). Sumatriptan and Naproxen Sodium for the Acute Treatment of Migraine. Headache: The Journal of Head and Face Pain, 45(8), 983–991. https://doi.org/10.1111/j.1526-4610.2005.05178.x Treatment of Migraine Attacks with Sumatriptan. (1991). New England Journal of Medicine, 325(5), 316–321. https://doi.org/10.1056/nejm199108013250504 Ueberall, M. A., & Wenzel, D. (1999). Intranasal sumatriptan for the acute treatment of migraine in children. Neurology, 52(7), 1507–1507. https://doi.org/10.1212/wnl.52.7.1507

4 views0 comments

Comentarios


bottom of page