Sumatriptan SC injection
IMITREX
Pronunciation: soo-ma-TRIP-tan (IM-i-trex)
“Sumo tripped In my tracks”
What it isSubcutaneous 5-HT1B/1D agonist (IMITREX, 1992) causing cranial vasoconstriction; acute migraine and cluster headache.
Why this oneThe injection is the fastest triptan route, with relief possible within 10 minutes, and the only sumatriptan form also labeled for acute cluster headache.
What limits itCoronary vasospasm and chest symptoms preclude use in ischemic vascular disease; do not combine with ergot drugs.
FDA-approved for
- acute migraine (1992)
- acute cluster headache (1992)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acute treatment of migraine (with or without aura) | Adults | 4 mg or 6 mg subcutaneously (single dose) | 12 mg/24 h (two doses ≥1 h apart) | |
| Acute treatment of cluster headache | Adults | 6 mg subcutaneously (single dose) | 12 mg/24 h (two doses ≥1 h apart) |
Renal Undefined.
Hepatic Contraindicated in severe hepatic impairment.
Maximum 12 mg per 24 hours; separate injections by at least 1 hour; second dose only if some response to the first.
Instructions
- For subcutaneous use only; avoid intramuscular or intravascular delivery
- STATdose Pen available for 4 mg and 6 mg cartridges
- Needle shield contains dry natural rubber (latex)
Available strengths
- inj 3, 4, 6 mg/0.5 mL
- tab 25, 50, 100 mg
- powder 11 mg
- nasal spray 5, 10, 20 mg/spray
Contraindications
- Ischemic coronary artery disease or coronary vasospasm (including Prinzmetal's angina)
- Wolff-Parkinson-White syndrome or arrhythmias with other accessory conduction pathway disorders
- History of stroke/TIA, or hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent (within 24 h) use of ergotamine-type medication or another 5-HT1 agonist
- Concurrent or recent (within 2 weeks) use of an MAO-A inhibitor
- Severe hepatic impairment
Cautions
- Myocardial ischemia/infarction/Prinzmetal's angina
- Arrhythmias
- Chest/throat/neck/jaw tightness
- Cerebrovascular events
- Peripheral/GI vasospasm
- Medication overuse headache
- Serotonin syndrome
- Increased blood pressure
- Seizures
Adverse reactions
- Injection-site reactions
- Tingling
- Dizziness/vertigo
- Warm/hot sensation
- Burning sensation
- Feeling of heaviness/pressure
- Flushing
- Numbness
Pregnancy No detected increased frequency of birth defects; animal developmental toxicity.
Lactation Excreted in human milk; can minimize infant exposure by avoiding breastfeeding for 12 hours after a dose.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 3 mg/0.5 mL | inj | per unit | — | $384.09/mL | not offered |
| 4 mg/0.5 mL | inj | per unit | — | $463.07/mL | not offered |
| 6 mg/0.5 mL | inj | per unit | $15.00/mL | — | offered |
Other forms: Sumatriptan (IMITREX)
NO BOXED WARNINGS
Principal riskCoronary vasospasm; contraindicated in ischemic heart disease
Classes and tags
Clinical profile
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