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  • 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


  • 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




  • 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


See Also