Imigran Nasal Spray

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:

One Imigran 20mg spray into one nostril. Only use Imigran after your migraine headache begins Don’t use Imigran to try to prevent an attack.

It’s best to use Imigran as soon as you feel a migraine coming on, although it can be used at any time during an attack.

If your symptoms start to come back, you can use a second Imigran nasal spray after 2 hours, but don’t use more than two sprays in 24 hours.

If the first spray has no effect, do not use a second spray, or any other Imigran preparation for the same attack.

If Imigran doesn’t give you any relief, speak to your prescriber.

Dose adjustment to 10mg may be made by the prescriber. Always speak to them for more information.

If you use more Imigran than you should

Don’t use more than two Imigran nasal sprays in 24 hours.

Using too much Imigran could make you ill. If you have used more than two sprays in 24 hours, seek medical attention.

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

Very common

• Unpleasant taste

Common

• Heaviness, pressure, tightness or pain in the chest, throat or other parts of the body, or feelings of 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), seek medical help urgently. In a very small number of people these symptoms can be caused by a heart attack.
• Irritation or burning sensation in the nose or throat; nose bleeds
• Nausea or 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

Rare 

• Breast pain

Very Rare

• Liver function changes. If you have a blood test to check your liver function, tell your doctor or nurse that you are using Imigran.

Frequency Not Known

• Seizures/fits, tremors, short-lived/temporary muscle spasm (which may affect jaw movement), neck stiffness
• Visual disturbances such as flickering, reduced vision, double vision, loss of vision and in some cases even permanent defects (although these may be due to the migraine attack itself)
• Heart problems, where your heart beat may go faster, slower or change rhythm, chest pains (angina) or heart attack
• Pale blue-tinged skin and/or pain in your fingers, toes, ears, nose or jaw in response to cold or stress (Raynaud’s phenomenon)
• Feeling faint (blood pressure may go down)
• Pain in the lower left side of the stomach and bloody diarrhoea (ischaemic colitis)
• Diarrhoea
• 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
• Pain in the joints
• Feeling anxious
• Difficulty swallowing
• Excessive sweating

Serious Side Effects

Some symptoms may be caused by the migraine itself.

The following side effects (allergic reaction) have occurred but their frequency is not known:

• The signs of allergy include rash, hives (itchy rash); wheezing; swollen eyelids, face or lips; complete collapse.

If you get any of these symptoms soon after using Imigran, don’t use any more. Contact a doctor straight away.

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

Don’t use Imigran:

• If you’re allergic to sumatriptan, or any of the other ingredients of this medicine
• If you have a heart problem such as narrowing of the arteries (Ischaemic heart disease) or chest pains (angina), or have already had a heart attack
• If you have circulation problems in your legs that cause cramp-like pains when you walk (peripheral vascular disease).
• If you have had a stroke or a mini-stroke (also called a transient ischaemic attack or TIA).
• If you have high blood pressure. You may be able to use Imigran if your high blood pressure is mild and is being treated.
• If you have serious liver disease.
• With other migraine medicines, including those which contain ergotamine, or similar medicines such as methysergide or any triptan/5-HT1 receptor agonist (medicines which are also used for treating migraine).
• With anti-depressants called MAOIs (monoamine oxidase inhibitors), or if you have taken these medicines in the last 2 weeks.

If any of these apply to you, tell your doctor, and don’t use Imigran nasal spray.

If you have any extra risk factors, such as, if you are a heavy smoker, or are using nicotine replacement therapy, and especially, if you are a man aged over 40, or if you are a woman who has been through the menopause.

In very rare cases, people have developed serious heart conditions after using Imigran, even though they had no signs of heart disease before. If any of the points above applies to you it could mean you have a greater risk of developing heart disease – so inform your doctor so that your heart function can be checked before Imigran is prescribed for you.

If you have a history of fits (seizures)

Or if you have other conditions which might make it more likely that you’ll have a fit – for example, a head injury or alcoholism. Tell your doctor so that you can be supervised more closely.

If you have liver or kidney disease, tell your doctor so that you can be supervised more closely.

If you are allergic to antibiotics called sulphonamides

If so, you may also be allergic to Imigran. If you know you are allergic to an antibiotic but you are not sure whether it is a sulphonamide, tell your doctor or pharmacist before using Imigran.

If you are taking anti-depressants called SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin Noradrenaline Reuptake Inhibitors), tell your doctor or pharmacist before using Imigran.

If you use Imigran frequently

Using Imigran too often may make your headaches worse. Tell your doctor if this applies to you.

If you feel pain or tightness in your chest after you use ImigranThese effects may be intense but they usually pass quickly. If they don’t pass quickly, or they become severe, seek medical help immediately.

Age Restrictions

For adults over the age of 18 years – 65 years

Other Medicines and Conditions

Tell your doctor or pharmacist if you’re taking, have recently taken or might take any other medicines. This includes any herbal products or medicines you’ve bought without a prescription.

Some medicines must not be taken with Imigran and others may cause adverse effects if they’re taken with Imigran. You must tell your doctor if you are taking:

• ergotamine also used to treat migraine, or similar medicines such as methysergide. Don’t use Imigran at the same time as these medicines. Stop taking these medicines at least 24 hours before using Imigran. Don’t take any medicines which contain ergotamine or compounds similar to ergotamine again for at least 6 hours after using Imigran
• other triptans/5-HT1 receptor agonists (such as naratriptan, rizatriptan, zolmitriptan), also used to treat migraine. Don’t use Imigran at the same time as these medicines. Stop taking these medicines at least 24 hours before using Imigran. Don’t take another triptan/5-HT1 receptor agonist again for at least 24 hours after using Imigran
• SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin Noradrenaline Reuptake Inhibitors) used to treat depression. Using Imigran with these medicines can cause serotonin syndrome (a collection of symptoms which can include restlessness, confusion, sweating, hallucinations, increased reflexes, muscle spasms, shivering, increased heartbeat and shaking). Tell your doctor immediately if you are affected in this way
• MAOIs (monoamine oxidase inhibitors) used to treat depression. Don’t use Imigran if you have taken these in the last 2 weeks
• St John’s Wort (Hypericum perforatum). Taking herbal remedies that contain St John’s Wort while you are using Imigran may make side effects more likely

Driving and using machines

You may feel sleepy, dizzy or sick either due to the migraine itself or the use of the medication. 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.2214.pdf

Ingredients

• Active Ingredients: Sumatriptan
• Other Ingredients: potassium dihydrogen phosphate, dibasic sodium phosphate anhydrous, sulphuric acid, sodium hydroxide and purified water

Product Information

• Brand Name: Imigran
• Route of Administration: Nasal
• Legal Classification: POM
• Strength: 1omg & 20mg
• Dosage Form: Nasal Spray

Storage

• Keep this medicine out of the sight and reach of children.
• Keep this medicine in the sealed blister in the box to protect it from light.
• Don’t store above 30°C and don’t freeze.
• Don’t use this medicine after the expiry date shown on the carton. The expiry date refers to the last day of that month.
• Don’t 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 protect the environment.

Advice and Helpful Links

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

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