Sumatriptan: Difference between revisions
ClaireLewis (talk | contribs) (Created page with "==Administration== *Type: Ergotamine anti-migraine drug *Dosage Forms: *Routes of Administration: Intranasal, oral, subcutanous, transdermal *Common Trade Names: Imitrex ==Ad...") |
|||
| (3 intermediate revisions by 2 users not shown) | |||
| Line 7: | Line 7: | ||
==Adult Dosing== | ==Adult Dosing== | ||
*Intranasal spray: 5-20 mg, may repeat dose if headache persists after 2 hours | *Intranasal spray: 5-20 mg, may repeat dose if headache persists after 2 hours | ||
*Oral: Initial: 50 to 100 mg once. If initial dose was partially effective or headache recurs, may repeat a dose (usually same as first dose) after ≥2 hours. Maximum dose: 100 mg per dose; 200 mg per 24 hours. | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Intranasal: | |||
**5-17 years: 5mg-20mg administered in one nostril as a single dose | |||
*SubQ: | |||
**6-17 years: 3-6mg single dose | |||
*Efficacy of oral dosing has not been demonstrated in patients <17 years old. | |||
==Special Populations== | ==Special Populations== | ||
| Line 28: | Line 33: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*MI, hypertensive crisis, ventricular arrhythmias, vasospasm | *[[MI]], [[hypertensive crisis]], ventricular arrhythmias, vasospasm | ||
*Serotonin syndrome | *[[Serotonin syndrome]] | ||
*Stroke, intracranial hemorrhage, seizure | *[[Stroke]], [[intracranial hemorrhage]], [[seizure]] | ||
*Visual loss | *[[Visual loss]] | ||
===Common=== | ===Common=== | ||
*Dizziness | *[[Dizziness]] | ||
*Nausea/vomiting | *[[Nausea/vomiting]] | ||
*URI symptoms | *[[URI]] symptoms | ||
==Pharmacology== | ==Pharmacology== | ||
Latest revision as of 03:49, 24 October 2019
Administration
- Type: Ergotamine anti-migraine drug
- Dosage Forms:
- Routes of Administration: Intranasal, oral, subcutanous, transdermal
- Common Trade Names: Imitrex
Adult Dosing
- Intranasal spray: 5-20 mg, may repeat dose if headache persists after 2 hours
- Oral: Initial: 50 to 100 mg once. If initial dose was partially effective or headache recurs, may repeat a dose (usually same as first dose) after ≥2 hours. Maximum dose: 100 mg per dose; 200 mg per 24 hours.
Pediatric Dosing
- Intranasal:
- 5-17 years: 5mg-20mg administered in one nostril as a single dose
- SubQ:
- 6-17 years: 3-6mg single dose
- Efficacy of oral dosing has not been demonstrated in patients <17 years old.
Special Populations
- Pregnancy Rating: C
- Lactation risk: infant risk minimal
- Renal dosing: no adjustment
- Hepatic dosing: contraindicated in severe hepatic impairment
Contraindications
- Allergy to class/drug
- MAOI use concomitantly or within 2 weeks
- Concomitant use of ergotamine-containing/ergot-type medication within 24 hours
- Use of another 5-HT agonist within 24 hours
- History of cardiovascular (including arrythmias, CAD, uncontrolled hypertension), peripheral vascular, or ischemic bowel disease
- History of stroke/TIA or hemiplegic/basilar migraine
- Severe hepatic impairment
Adverse Reactions
Serious
- MI, hypertensive crisis, ventricular arrhythmias, vasospasm
- Serotonin syndrome
- Stroke, intracranial hemorrhage, seizure
- Visual loss
Common
- Dizziness
- Nausea/vomiting
- URI symptoms
Pharmacology
- Half-life: 2-3 hours
- Metabolism: Hepatic via monamine oxidase (mostly MAO-A)
- Excretion: mostly renal
Mechanism of Action
- Cranial vessel constriction, 5HT agonist, inhibition of pro-inflammatory neuropeptide release