Sumatriptan Tablets

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure how to use this medicine.

The recommended dose in adults:

A single dose should be taken for a migraine attacks. It is recommended that a dose is taken as early as possible after the onset of migraine headache.

If symptoms recur after initial relief, a second dose may be taken in the next 24 hours, providing there is an interval of at least 2 hours between the 2 doses.

No more than 2 doses to be taken in any 24 hour period.

If the first dose does not provide relief, a second dose must not be taken for the same attack, however can be taken for subsequent attacks. The use of paracetamol, aspirin or non-steroidal anti-inflammatory drugs may be appropriate.

Dose adjustment to 100mg is made by the prescriber. Always contact them for further information.

If you take more Sumatriptan than you should

Contact your doctor or local A&E immediately.

Like all medicines, this medicine can cause side effects, although not everybody gets them. Some of the side effects are temporary with continued treatment or disappeared when treatment is stopped.

Side Effects

Common

• Sensations such as tingling, prickling and numbness of the hands or feet (paraesthesia), decreased feeling or sensitivity especially (hypoesthesia) of the skin or feeling warmth or cold, pain, heaviness, pressure or tightness which can affect any part of the body including the throat and chest
• Feeling flushed (sudden reddening of the face (often cheeks), neck or upper chest), dizzy or drowsy
• Tiredness, weakness, but these effects should pass
• Increased blood pressure
• Nausea or vomiting
• Shortness of breath (dyspnoea)
• Muscle pain, muscle tenderness or weakness, not caused by exercise (myalgia)

Rare 

• Breast pain

Very rare

• Changes in your liver test results (this may show up in blood tests)

Frequency Not Known

• Problems with your eyes or eyesight such as flickering, double vision, reduced vision, spot-like reduced vision (visual field defect), loss of vision, which could be permanent. You may also experience repetitive, involuntary to-and-fro oscillations of the eye (nystagmus)
• Twisting and repetitive movements or abnormal postures (dystonia)
• Tremors
• Anxiety
• Irregular such as slow or rapid heartbeat, changes in heart rhythm or beating (this may show up in ‘ECG’ tests used to monitor the electrical activity of the heart), palpitations
• Spasms of the blood vessels supplying the heart, which can cause chest pain
• Low blood pressure
• Diarrhoea
• Raynaud’s phenomenon which causes pale skin and numbness or pain in the fingers and toes when you are cold
• Neck stiffness
• Painful, swollen joints (arthralgia)
• Excessive sweating (hyperhidrosis)
• Difficulty swallowing
• If you had a recent injury or if you have inflammation (like rheumatism or inflammation of the colon) you may experience pain or pain worsening at the site of injury or inflammation

Serious Side Effects

Some of the side effects reported may be associated side effects of migraine.

If you experience any of the following side effects, stop taking this medicine immediately and seek urgent medical advice:

• Sudden life-threatening reaction with signs of allergy such as rash, itching or hives on the skin, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing (anaphylactic reaction)
• Epileptic seizures or fits (these are more likely in patients prone to epilepsy)
• Heart attack (myocardial infarction) presenting as chest pain, shortness of breath, indigestion, nausea, vomiting, lack of energy or discomfort in the upper body
• Chest pain (angina pectoris) or reduced blood flow to your heart muscles with signs of chest pain (ischaemic heart disease)
• Inflammation of the colon (which may show as a pain in the left side of your stomach with bloody diarrhoea)

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard  or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

Warning & Precautions

Do not take Sumatriptan:

• if you are allergic to sumatriptan or any of the other ingredients of this medicine
• if you have heart problems such as reduced blood flow to your heart muscles with signs of chest pain, including heart attack (ischaemic heart disease) or cardiac chest pain due to contraction of the vessel walls (Prinzmetal’s angina) or suffer from hardened arteries, circulation problems in your legs that cause cramp-like pain when walking (peripheral vascular disease)
• if you have ever had a heart attack (myocardial infarction)
• if you have had a stroke (cerebrovascular accident) in the past or if you have had the symptoms of a stroke, which only lasted a short time and from which you made a complete recovery (transient ischaemic attack)
• if you have severe liver problems
• if your blood pressure is not controlled or you are being treated for moderately high or very high blood pressure (hypertension)
• if you are taking, or have taken in the last 24 hours, medicines used to treat migraine containing ergotamine or methysergide: or any triptan or 5-HT1 agonist such as naratriptan or zolmitriptan
• if you are taking or have recently taken any medicines to treat depression or Parkinson’s disease called Monoamine Oxidase Inhibitors (MAOIs) in the last 2 weeks,
• if you are taking lithium (normally used to treat mental health conditions such as severe depression, mania or severe types of headache known as cluster headaches).

Sumatriptan should not be used for unusual forms of migraine caused by brain or eye problems (e.g. hemiplegic, basilar or opthalmoplegic migraine).

Talk to your doctor or pharmacist before taking Sumatriptan:

• if you have risk factors for heart disease such as, a family history of heart disorders, diabetes, high blood cholesterol, are overweight, smoking regularly or using any form of nicotine replacement therapy (NRT), being a male and over 40 years old or a postmenopausal woman
• if you are being treated for mildly high blood pressure (hypertension) that is being controlled
• if you have had fits (convulsions) or epilepsy in the past
• if you have kidney problems
• if you have liver problems
• if you are allergic to antibiotics called sulfonamides (such as co-trimoxazole)
• if you use sumatriptan at the same time as medicines used to treat depression as this can cause increased heart rhythm, shivering, sweating, fever, high blood pressure, agitation, confusion, hallucinations, shaking which are signs of serotonin syndrome

If you use Sumatriptan regularly

Using sumatriptan too often may cause or worsen headaches. This may also occur if you find that you need to use other medicines, such as painkillers, regularly for migraine. Talk to your doctor or pharmacist if this applies to you.

Sumatriptan can cause tightness in the chest and throat

You may notice pain or a feeling of tightness in your chest and throat after taking sumatriptan. If these symptoms don’t pass quickly, tell your doctor immediately.

Age Restrictions

For adults over the age of 18 years – 65 years

Other Medicines and Conditions

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. In particular, inform your doctor if you are taking:

• antidepressants called SSRIs (for example citalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline), SNRIs (like venlafaxine or duloxetine (which may also be used for urinary problems)). If you are taking SSRIs and SNRIs and take sumatriptan, this may increase the risk of developing a potentially serious side effect called serotonin syndrome, Your doctor may want to keep an eye on you.
• lithium
• medicines used to treat depression or Parkinson’s disease called Monoamine Oxidase Inhibitors (MAOIs). Do not take sumatriptan if you have taken an MAOI in the last 2 weeks
• herbal medicines containing St John’s Wort

If you are taking or have taken other migraine medicines

If you have taken another medicine for migraine such as ergotamine or ergotamine derivatives (such as methysergide), or a triptan/5-HT1 agonist (such as naratriptan or zolmitriptan) you should wait for at least 24 hours before you take sumatriptan.

If you have taken sumatriptan you should wait for at least 6 hours before taking ergotamine or ergotamine derivatives (such as methysergide) and wait for at least 24 hours before taking triptan/5-HT1 agonist.

Driving and using machines

You may feel sleepy, dizzy or sick either due to the migraine itself or the use of these tablets. If ever occur, this may influence the ability to drive and to operate machinery. Caution is recommended if you engage in such activities.

Pregnancy and Breastfeeding

Not recommended for use in pregnancy and breastfeeding.

Patient Information Leaflet

https://www.medicines.org.uk/emc/files/pil.12391.pdf

Ingredients

• Active Ingredients: Sumatriptan succinate
• Other Ingredients: Table core: lactose monohydrate, cellulose, microcrystalline, croscarmellose sodium and magnesium stearate. Tablet coating:  titanium dioxide (E171), polydextrose, hypromellose, triacetin, macrogol, iron oxide red (E172) and iron oxide yellow (E172). Sumatriptan contains lactose and sodium.

Product Information

• Brand Name: Sumatriptan (Generic)
• Route of Administration: Oral
• Legal Classification: POM
• Strength: 50mg & 100mg
• Dosage Form: Film-coated Tablet

Storage

• Keep this medicine out of the sight and reach of children.
• This medicinal product does not require any special storage conditions.
• Do not take this medicine after the expiry date which is stated on the carton or blister after “EXP”. The expiry date refers to the last day of that month.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

Advice and Helpful Links

https://www.nhs.uk/conditions/migraine/

https://patient.info/brain-nerves/headache-leaflet/medication-overuse-headache