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EspañolSumatriptan succinate (brand names: Imitrex, Onzetra Xsail) is a generic prescription drug that relieves acute migraine headache and cluster headache. Sumatriptan belongs to a class of drugs called 5-HT receptor agonists, or “triptans” for short. Because many migraine symptoms are caused by the sudden widening of blood vessels in the head, sumatriptan relieves those symptoms by stimulating those blood vessels to contract. Sumatriptan is taken on an as-needed basis and is available in a variety of formats.
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Sumatriptan forms and strengths
Sumatriptan can be taken in several ways: tablets, nasal spray, nasal powder, subcutaneous auto-injections, or subcutaneous needle and syringe injections.
Tablets: 25 milligrams (mg), 50 mg, 100 mg
Nasal spray: 5 mg, 10 mg, 20 mg
Nasal powder: 11 mg
Auto-injection: 3 mg, 4 mg, 6 mg
Injection (vial): 6 mg per 0.5 milliliters (mL)
Sumatriptan dosage for adults
| Sumatriptan dosage chart | ||||
|---|---|---|---|---|
| Indication | Form | Starting dosage | Standard dosage | Maximum dosage |
| Migraine | Tablet | 25–100 mg | 25–100 mg tablet followed by a second dose if necessary no sooner than 2 hours after the first dose | 200 mg in 24 hours |
| Nasal spray | 5–20 mg | 5–20 mg single nasal spray or one 5 mg spray in each nostril followed by a second dose if necessary no sooner than 2 hours after the first dose | 40 mg in 24 hours | |
| Nasal powder | 22 mg | Two 11 mg nosepieces, 1 in each nostril, followed by a second 22 mg dose if necessary no sooner than 2 hours after the first dose | 44 mg in 24 hours | |
| Injection | 3–6 mg | 3–6 mg subcutaneous injection followed by a second dose if necessary no sooner than 1 hour after the first dose | 12 mg in 24 hours | |
| Cluster headache | Injection | 6 mg | 6 mg subcutaneous injection followed by a second dose if necessary no sooner than 1 hour after the first dose | 12 mg every 24 hours |
Sumatriptan dosage for migraine
All forms of sumatriptan can be used for acute treatment of migraine headaches with or without aura (symptoms like visual disturbances that occur before the migraine starts). The dosage forms will vary in their therapeutic effects. While nearly all the sumatriptan in an injection enters the bloodstream and begins working in minutes, less than 20% of the sumatriptan in a tablet or nasal dose enters the bloodstream. Nasal sumatriptan, however, begins working faster than tablets, and injected sumatriptan works the quickest. All forms of sumatriptan have been shown to provide effective pain relief.
Standard dosage for migraine (tablets): 25–100 mg dose tablet followed by a second dose if necessary no sooner than two hours later
Standard dosage for migraine (nasal spray): 5–20 mg dose followed by a second dose if necessary no sooner than two hours later
Standard dosage for migraine (nasal powder): 22 mg dose (one 11 mg nosepiece in each nostril) followed by a second dose if necessary no sooner than two hours later
Standard dosage for migraine (injection): 3–6 mg dose followed by a second dose if necessary no sooner than one hour later
Maximum dosage for migraine (tablets): 200 mg per 24-hour period
Maximum dosage for migraine (nasal spray): 40 mg per 24-hour period
Maximum dosage for migraine (nasal powder): 44 mg per 24-hour period
Maximum dosage for migraine (injection): 12 mg per 24-hour period
Sumatriptan dosage for cluster headache
Only sumatriptan subcutaneous injections are FDA-approved to treat acute cluster headaches. Several generic manufacturers offer sumatriptan auto-injectors, helping to make self-dosing easier and less prone to failure. Sumatriptan is also provided in single-dose vials for use with traditional syringe needles.
Standard dosage for cluster headache (injection): 6 mg followed by a second dose if necessary no sooner than one hour later
Maximum dosage for cluster headache (injection): 12 mg per 24-hour period
Sumatriptan dosage for children
Sumatriptan is not FDA-approved for use in children and adolescents under 18 years old. Some healthcare professionals do, however, use it off-label to treat migraine attacks in children as young as 6. Sumatriptan in combination with naproxen (Treximet) can be used in children aged 12 or older.
Sumatriptan dosage restrictions
For many, sumatriptan can be an effective way to stop migraine attacks after they happen. On the other hand, some people have medical conditions that may be seriously aggravated by sumatriptan, so the medication is never used by those people. Contraindications include:
A history of heart problems (ischemic coronary artery disease, heart attack, chest pain, palpitations, arrhythmias)
A history of cerebrovascular problems such as stroke or transient ischemic attacks (TIA, or mini-strokes)
Narrowing of blood vessels to the arms, legs, kidneys, or stomach (peripheral vascular disease)
Uncontrolled hypertension (high blood pressure)
Hemiplegic or basilar migraines (rare forms of migraines that increase stroke risk)
Ischemic bowel disease
Severe liver problems (severe hepatic impairment)
Allergy (hypersensitivity) to sumatriptan
People with risk factors for heart disease—high blood pressure, high cholesterol, diabetes, family history of heart disease—will not be prescribed sumatriptan until a complete heart examination has been performed.
People with kidney problems (renal impairment) or on dialysis can take sumatriptan without any dose adjustment, as can seniors. In people with mild to moderate liver disease (hepatic impairment), the dose of sumatriptan tablets should not exceed 50 mg.
How to take sumatriptan
There are many ways to take sumatriptan. Dosing formats will vary in how fast and how effectively the medicine works, so talk to a doctor or other healthcare professional about which dosing format best fits your medical situation.
General instructions
Read and follow the patient instructions that are packaged with the medicine. Some have detailed step-by-step instructions with illustrations to help with taking doses.
You should only take this medication if you get a migraine or cluster headache. Sumatriptan is not meant to be taken daily and does not prevent migraine attacks.
If you do not get any relief from the first dose, do not take a second dose without first talking to a doctor or other healthcare provider.
If you get some relief from the first dose, but not enough, or the migraine returns, wait for at least one hour (injection) or two hours (tablets or nasal formulations) before taking a second dose.
Do not take more than the maximum daily dose in a single 24-hour period. If the medicine still does not provide sufficient relief, ask a doctor or other healthcare professional for medical advice.
Sumatriptan tablets
Sumatriptan tablets can be taken with or without food
Swallow the tablets whole with a glass of water or other liquid
Sumatriptan nasal spray
Sumatriptan nasal spray is always packaged in single-dose units
Sumatriptan nasal spray is administered into one nostril only
Follow the package insert instructions on how to use the nasal spray
Sumatriptan (Onzetra Xsail) nasal powder
The device’s nosepiece contains the medication
Onzetra Xsail nasal powder is administered into both nostrils using two dosing nosepieces
Carefully follow the instructions on the package insert or have a healthcare professional demonstrate the way to use the powder
Sumatriptan injections
An auto-injector cartridge or vial contains one dose
A healthcare professional will demonstrate how to give an injection using the auto-injector or a standard subcutaneous needle and syringe and where on
the body shots can be given
Use a new needle and syringe each time you inject your medicine
Sumatriptan dosage FAQs
How long does it take sumatriptan to work?
How long it takes for sumatriptan to start working depends on how it’s taken. Sumatriptan injections start having an effect in about six minutes. Nasal sprays take about 15 minutes, but tablets can take anywhere from 30–60 minutes to start working depending on whether delayed stomach emptying (gastroparesis) is associated with the migraine attack. Sumatriptan injections take about one hour to reach their full effect, and tablets and nasal sprays take about two hours.
How long does sumatriptan stay in your system?
Sumatriptan is a short-acting medication that is rapidly cleared from the body. No matter how it’s taken, a single dose of sumatriptan has a half-life of around two hours. The amount of medication in the body begins to decrease about then. Migraines, though, can persist for hours, so often a second dose may be needed two or more hours after the first tablet or nasal dose.
What happens if I miss a dose of sumatriptan?
Sumatriptan is intended to be taken at the onset of a migraine or cluster headache. If a dose isn’t taken right away, it can be taken at any time while experiencing a migraine or cluster headache.
How do I stop taking sumatriptan?
Used as directed, sumatriptan can be safely discontinued at any time. Sumatriptan does not cause physical or psychological dependence.
Sumatriptan can safely treat up to four headaches per month. However, sumatriptan overuse can result in medication-overuse headache (MOH), a condition in which the frequency and intensity of headaches increases when using headache medications. If you need to take this medicine more than four times a month, talk to your healthcare provider.
A doctor or other healthcare professional may choose to stop giving sumatriptan at any sign of cardiovascular problems, circulation problems, stroke, or allergic reactions.
What is the maximum dosage for sumatriptan?
The maximum dose for sumatriptan depends on the dosing format. No more than 200 mg of sumatriptan tablets, 44 mg of sumatriptan nasal powder, 40 mg of sumatriptan nasal spray, or 12 mg of sumatriptan injections can be taken in a 24-hour period.
What interacts with sumatriptan?
Some drug interactions with sumatriptan can cause serious adverse reactions by raising drug levels in the body and increasing the risk of side effects. Some reactions may be life-threatening, such as dangerously high blood pressure or blood vessel contractions (vasospasms). Because of the risk for life-threatening adverse effects, sumatriptan is never taken with
MAO inhibitors (MAOIs), a small class of drugs that includes some antidepressants, antibiotics, and Parkinson’s disease medications
Other triptans (migraine medications) such as Amerge (naratriptan), Axert (almotriptan), Maxalt (rizatriptan), or Zomig (zolmitriptan)
Another class of migraine drugs called ergots, such as Cafergot (ergotamine with caffeine) or Migranal (dihydroergotamine)
People taking sumatriptan may also experience another serious side effect called serotonin syndrome if they’re also taking antidepressants like SSRIs (selective serotonin reuptake inhibitors such as fluoxetine) or SNRIs (serotonin and norepinephrine reuptake inhibitors such as venlafaxine).
Is it safe to take sumatriptan during pregnancy or while nursing?
Sumatriptan is prescribed to pregnant women, but there is limited data about how the drug affects an unborn baby. In observational and population studies, there was no increased risk of birth defects among women who took sumatriptan during pregnancy. During lactation, sumatriptan does pass into breast milk. Again, there is no certainty that the drug won’t harm a baby who is breastfeeding. Nursing women should not breastfeed an infant for at least 12 hours after taking a sumatriptan dose.
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