Sumatriptan (tablets)

What is sumatriptan?

Sumatriptan is used to ease the symptoms of migraine or cluster headaches. It works by releasing a natural chemical called serotonin, which causes the blood vessels around your brain to contract (narrow). This reverses the dilating (widening) of blood vessels that's believed to be part of the headache process. 

Sumatriptan only works when a migraine attack has already begun. It will not prevent a migraine. Do not take it before your headache begins, or during the aura phase, as it may be less effective. Read more about migraine headaches.

Sumatriptan belongs to a group of medicines called triptans. In New Zealand, sumatriptan is available as tablets (50 mg and 100 mg) and an injection. The information on this page is about sumatriptan tablets. The injection may be better if you are vomiting, or if you develop a sudden migraine. Read more about sumatriptan injection.  

Dose

• Take 1 tablet (50 or 100 milligrams) at the start of the migraine attack. It should work within 30 minutes.
• If your migraine improves but then comes back, wait at least 2 hours before taking another tablet (50 or 100 milligrams).
• Do not take more than 300 mg in 24 hours (6 of the 50 mg tablets or 3 of the 100 mg tablets).
• If the first sumatriptan dose does not relieve your symptoms or help your migraine, do not take another sumatriptan dose for this same attack. It is unlikely to work.

Monthly limit

Using sumatriptan too frequently can cause medication overuse headache or rebound headache. This headache is caused by overuse of painkillers to treat headache, including the use of triptans for migraine. The symptoms include a tension-type headache or migraine-like attack.

Headaches often improve within 7 to 10 days after sumatriptan has been stopped. Symptoms may be worse before an improvement is seen. To avoid this, do not use sumatriptan for more than 10 days per month.

How to take sumatriptan

• Timing: It is best to take sumatriptan as soon as you notice headache symptoms, but you can take it after a migraine has already begun. Sumatriptan tablets usually start to work within 30 minutes after taking the tablet.
• Swallow the tablet whole with a glass of water. Do not crush or chew sumatriptan tablets – it has a bitter taste.

Precautions before taking sumatriptan

• Do you have problems with your liver or kidneys?
• Do you have problems with high blood pressure (hypertension)?
• Have you had a heart attack or do you get angina (chest pain)?
• Have you had a stroke or do you get transient ischemic attacks?
• Are you pregnant?
• Are you breastfeeding?
• Are you taking medicine for depression?

If so, it’s important that you tell your doctor or pharmacist before you start sumatriptan. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

What are the side effects of sumatriptan (tablets)?

Like all medicines, sumatriptan can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Interactions

Sumatriptan interacts with a few medications and herbal supplements, so check with your doctor or pharmacist before starting sumatriptan or before starting any new medicines. It may also interact some cold and flu preparations containing dextromethorphan such as Benadryl®.

Learn more

The following links have more information on sumatriptan:

Sumatriptan New Zealand Formulary
Sumagran tablet Medsafe Consumer Information Sheet, NZ

References

1. Treatment of acute migraine NZ Formulary
2. Diagnosing and managing headache in adults in primary care BPAC, NZ, 2017 
3. The role of triptans in the treatment of migraine in adults BPAC, NZ, 2014

Additional resources for healthcare professionals

Sumatriptan NZ Formulary
Cerebrovascular events with sumatriptan Medsafe, NZ, 2002
The role of triptans in the treatment of migraine in adults  BPAC, NZ, 2014