Home Drug Guide Sumatriptan Succinate

Drug Guide

Generic Name

Sumatriptan Succinate

Brand Names Imitrex, Imitrex Statdose, Sumavel Dosepro, Alsuma, Zecuity, Onzetra Xsail, Zembrace Symtouch

Classification

Therapeutic: Antimigraine agent

Pharmacological: Serotonin (5-HT1) receptor agonist

FDA Approved Indications

  • Acute treatment of migraine with or without aura
  • Cluster headaches

Mechanism of Action

Selective agonist for serotonin (5-HT1) receptors, resulting in vasoconstriction of intracranial blood vessels and inhibition of pro-inflammatory neuropeptide release, thereby alleviating migraine symptoms.

Dosage and Administration

Adult: Typically 25-100 mg orally at the onset of migraine; may repeat after 2 hours if needed, not exceeding 200 mg/day.

Pediatric: Safety and effectiveness not established in children.

Geriatric: Use with caution due to increased cardiovascular risk; start at lower dose and titrate as needed.

Renal Impairment: Adjust dose; use with caution in severe impairment.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Rapid, peak plasma concentrations in about 2-4 hours (oral).

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Primarily hepatic via monoamine oxidase A (MAO-A).

Excretion: Renally excreted as metabolites.

Half Life: Approximately 2 hours.

Contraindications

  • Ischemic heart disease, history of stroke or transient ischemic attack, uncontrolled hypertension, peripheral vascular disease.
  • Use with monoamine oxidase inhibitors (MAOIs).

Precautions

  • Use cautiously in patients with risk factors for cardiovascular disease, uncontrolled hypertension, or cerebrovascular disease. Not recommended in hemiplegic or basilar migraine.

Adverse Reactions - Common

  • Sensations of tingling, warmth, or flushing (Common)
  • Dizziness or vertigo (Common)
  • Coronary artery vasospasm leading to chest pain (Serious)
  • Serious allergic reactions including anaphylaxis (Rare)

Adverse Reactions - Serious

  • Serious cardiac events (e.g., myocardial infarction, arrhythmias) (Rare)
  • Serotonin syndrome (when combined with other serotonergic drugs) (Rare)

Drug-Drug Interactions

  • Ergot-containing drugs, other 5-HT1 agonists (e.g., triptans), SSRIs, SNRIs, MAOIs, vasoconstrictors.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Evaluate for contraindications such as ischemic heart disease; monitor response and adverse effects.

Diagnoses:

  • Risk for decreased cardiac perfusion
  • Ineffective health management

Implementation: Administer as prescribed, monitor blood pressure and cardiovascular status, evaluate migraine relief.

Evaluation: Assess effectiveness of symptom relief and monitor for adverse reactions.

Patient/Family Teaching

  • Take at the first sign of migraine.
  • Report chest pain, dizziness, or unusual symptoms immediately.
  • Do not use jointly with other serotonergic drugs or ergotamines.

Special Considerations

Black Box Warnings:

  • Serious cardiovascular adverse events, including myocardial infarction and arrhythmias, may occur, especially in patients with risk factors.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Severe vasospasm, hypertension, chest pain, agitation, hallucinations.

Treatment: Supportive care, monitoring cardiac status, use of vasodilators if indicated, and symptomatic management.

Storage and Handling

Storage: Store at room temperature (20-25°C), away from light and moisture.

Stability: Stable for at least 2 years under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.