Sumatriptan is a selective serotonin 5-hydroxytryptamine 1 (5-HT1) receptor agonist that works against receptors in intracranial blood vessels and the sensory nerves of the trigeminal system. Although the exact mechanism of action is not understood, broadly the drug works through rapid constriction of blood vessels in the brain during a headache event.1 The drug is also thought to act on trigeminal sensory nerve terminals within the cranial blood vessel, inhibiting the release of sensory neuropeptides that signal pain.2
Migraines: Sumatriptan is indicated for the treatment of migraines, either with or without an accompanying aura. The drug does not prevent or reduce the number of headaches.3
Cluster Headaches: Sumatriptan is also used to treat cluster headaches, sometimes called migrainous neuralgia.
Side Effects and Drug Interactions
Common side effects in patients taking sumatriptan include4:
Pressure or heavy feeling in body
Hot or cold sensations
Nausea or vomiting
Drooling or unusual taste after using nasal spray
Burning, numbness, or irritation in the nose or throat after using nasal spray
Warmth, redness, or tingling under the skin
Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Those who experience an allergic reaction (hives, trouble breathing, swelling of the face, lips, tongue, or throat) or pain or tightness in the jaw, neck, or throat, chest pain, pain spreading to the arm or shoulder, sweating, general malaise, sudden numbness or weakness, especially unilateral, sudden or severe headache, confusion, vision, speech or balance problems, sudden or severe stomach pain, bloody diarrhea, seizures, or numbness or tingling with pale or blue appearance in fingers or toes should contact their physician right away. Patients on antidepressants should also contact their physician right away if they experience agitation, hallucinations, fever, rapid heart rate, overactive reflexes, nausea or vomiting, diarrhea, loss of coordination, or fainting.
Patients who are allergic to sumatriptan should not take this drug. Patients who are taking ergot-containing drugs, monoamine oxidase-A inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, or other 5-HT1 inhibitors should not take this medication. This drug has not been studied in pregnant patients, and is secreted in breast milk.
Latest News and Research
Sumatriptan can be delivered subcutaneously, however most patients would like a simpler and non-invasive delivery system. Oral tablets so far have shown decreased effect on headaches. Additionally, migraines and other headaches can cause a patient to be nauseous and have gastrointestinal problems that preclude taking a pill by mouth. Nasal sprays offer another delivery route, but again with lower efficacy. Researchers are currently studying a breath-powered nasal sumatriptan delivery system.5.The system consists of a device with both a mouthpiece and a nosepiece designed to improve the extent of drug delivery while protecting against the risk of lung inhalation. Initial studies look promising.
A different iontophoretic transdermal system of delivery is also under study in Phase III clinical trials. Reports indicate that the drug is well-tolerated with only mild to moderate side effects.6
Given the efficacy of sumatriptan in treating migraines, the drug is now being studied in combination with naproxen sodium for use in children. The drug combination appears to be effective, with minimal side effects.7
“Improved Pharmacokinetics of Sumatriptan With Breath Powered™ Nasal Delivery of Sumatriptan Powder,” http://www.optinose.com/wp-content/uploads/2013/09/Improved-PK-Suma-Headache-2013.pdf ↩
“A Sumatriptan Iontophoretic Transdermal System for the Acute Treatment of Migraine,” June 12, 2013, http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2012.02198.x/abstract?userIsAuthenticated=false&deniedAccessCustomisedMessage= ↩
“Randomized Trial of Sumatriptan and Naproxen Sodium Combination in Adolescent Migraine ,” June 2012, http://pediatrics.aappublications.org/content/129/6/e1411.short ↩