Sumatriptan

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What is a Migraine?

A migraine is a severe, throbbing headache. It is a common condition, affecting approximately 20% of women and 7% of men. Migraine headaches can occur on one or both sides of the head and are often accompanied by other symptoms e.g. nausea/vomiting or sensitivity to light/noise.

Why do migraines occur?

Why some people have migraines is not clear. It is assumed that migraines occur when blood vessels around the brain widen.

Some patients experience migraine with aura, which means they also have symptoms such as problems with vision, numbness of face or limbs, problems with speech or dizziness. We strongly advise if you have any aura symptoms that you see your GP to ensure that they are due to the migraine alone and that there is no other cause for them.

Migraines can also be caused by trigger factors for some people. Triggers can be all sorts of things. For example:

Diet: Dieting too fast, irregular meals, cheese, chocolate, red wines, citrus fruits.

Environmental: Smoking and smoky rooms, glaring light, VDU screens or flickering TV sets, loud noises, strong smells.

Psychological: Stress, anxiety, anger, tiredness, etc.

Other: Periods (menstruation), shift work, different sleep patterns, the menopause, some medicines e.g. the Pill.
It may helpful to keep a migraine diary. Note down when and where each migraine attack started, what you were doing, and what you had eaten that day. A pattern may emerge, and it may be possible to avoid one or more things that may trigger your migraine attacks.

Sumatriptan Vs Imigran

Imigran is the more expensive branded form of the generic medicine Sumatriptan. Both medicines have EXACTLY the same active ingredient and will work in EXACTLY the same way.
Generic medicines are always better value for money.

When drug companies first make a medicine, they have a certain period of time where they exclusively hold the licence for that product (and therefore have a monopoly on the medicine and its price). This can help them to recoup the cost of the research and development of the medicine in the first instance.

However, once this licence expires, other drug manufacturers are able to make the same product (the generic) which opens the market up to competition and prices for the medicine tend to be reduced.

What is Sumatriptan?

Sumatriptan (otherwise know under the brand name Imigran) is a popular treatment for migraines and belongs to a class of medicines known as ‘triptans.’  Triptans work differently to painkillers as they work by stimulating 5HT (serotonin) receptors in the brain to reverse the temporary widening of the blood vessels there which are though to contribute to a migraine attack. As well as treating the cause of the migraine, they also help to reduce associated symptoms such as headache, nausea, vomiting and sensitivity to light or sound.

Sumatriptan should be taken when lifestyle changes and analgesics such as paracetamol, aspirin, ibuprofen, (or those analgesics combined with codeine) haven’t worked. It cannot be used to prevent a migraine, only to treat one.

How to take Sumatriptan (Imigran)

Sumatriptan is for use in patients aged between 18-65. Take one tablet as soon as possible after the first signs of a migraine. The recommended dose of Sumatriptan is 50mg, however some patients may require 100mg.

If you respond to the first dose but symptoms recur, a second dose may be given, provided that there is a minimum interval of two hours between the two doses. If you don’t respond to the first dose, then do not take a second dose.

The tablets should be swallowed whole with water. Patients with swallowing difficulties may choose to disperse a tablet in a small amount of water before administration. Sumatriptan dispersed in water has a bitter taste.

Side Effects

Common side effects (affecting up to 1 in 10 people) include:

Pain, heaviness, pressure or tightness in the chest, throat or other parts of the body, or unusual sensations, including numbness, tingling and warmth or cold. These effects may be intense but generally pass quickly. If these effects continue or become severe (especially the chest pain): get medical help urgently. In a very small number of people these symptoms can be caused by a heart attack.

Other common side effects include:

• Feeling sick (nausea) or being sick (vomiting), although this may be due to the migraine itself
• Tiredness or drowsiness
• Dizziness, feeling weak, or getting hot flushes
• Temporary increase in blood pressure
• Shortness of breath
• Aching muscles

If you experience any of the following symptoms with your migraines, please contact us in the pharmacy to consult with our pharmacist or prescribers:

• If your headaches normally last for more than 24 hours
• If your normal pattern of migraine symptoms has changed
• If your attacks are more frequent, last longer or are more severe
• If you don’t fully recover from your attacks
• If you have four or more migraine attacks each month
• If you are over 50 years and this is the first time you are experiencing migraine symptoms
• If your symptoms include weakness on one side of your body, double vision, clumsy movements, ringing in the ears, reduced level of consciousness, fit-like movements, a recent rash with a headache
• If you are a woman who has had the menopause, or a man over 40 years
• If you have high cholesterol
• If you smoke regularly, or use Nicotine Replacement Therapy (NRT)
• If you are very overweight
• If you have diabetes or a family history of early heart disease

Other Important Information

Driving and using machines: This medicine or your migraine may make you feel sleepy or affect your vision. You should not drive or use machines until you are sure you are not affected.
Other medical tests: If you have any blood tests, or an ‘ECG’ (to check the rhythm and working of your heart), it is important to tell the doctor that you are taking this medication.
Giant cell arteritis: This is a condition which can affect 1/4500 people in the UK each year, usually those over 50. Symptoms include a sudden change to your migraine such as vision loss, jaw muscle pain while eating or aching temples. If this happens to you, please see your doctor urgently as giant cell arteritis needs to be treated immediately with steroids.

It is always important to tell your GP what medicine you are taking so they can see a full and accurate picture of your health. In addition, always read the patient leaflet which comes with your medication to make sure you understand which risks and side effects your medication can cause and contact us in the pharmacy on 01625 460621 if you would like to speak to our pharmacist or prescribers.

What is a ‘Rebound’ or ‘Overuse’ Headache?

This is caused by the overuse of drugs to treat migraines- including painkillers and Sumatriptan. If you have more than 4 episodes per month then you should speak to your doctor to discuss a regular preventative treatment for migraine.

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