Purchase Sumatriptan Succinate (Imitrex) tablets online

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Indications and usage:

Sumatriptan Succinate (Imigran, Imitrex, Suminat) is a serotonin (5-HT1B/1D) receptor agonist (triptan) indicated for acute treatment of migraine with or without aura, cluster headaches, post-dural puncture headache in adults.


Dosage and administration:

Single dose of sumatriptan 25 mg, 50 mg, or 100 mg tablet.

A second dose should only be considered if some response to the first dose was observed. Separate doses by at least 2 hours.

Maximum dose in a 24-hour period: 200 mg.

Maximum single dose should not exceed 50 mg in patients with mild to moderate hepatic impairment.


Dosage forms and strengths:

Imitrex, Suminat (Sumatriptan Succinate) tablets 25 mg, 50 mg, 100 mg.

Imigran (Sumatriptan Succinate) tablets 50 mg, 100 mg.


Contraindications:

History of coronary artery disease or coronary artery vasospasm.

Wolff-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders.

History of stroke, transient ischemic attack, or hemiplegic or basilar migraine.

Peripheral vascular disease.

Ischemic bowel disease.

Uncontrolled hypertension.

Recent (within 24 hours) use of another 5-HT1 agonist (e.g., another triptan) or of an ergotamine-containing medication.

Concurrent or recent (past 2 weeks) use of monoamine oxidase-A inhibitor.

Hypersensitivity to Imitrex (angioedema and anaphylaxis seen).

Severe hepatic impairment.


Overdosage:

Patients in clinical trials (N = 670) received single oral doses of 140 to 300 mg without significant adverse reactions. Volunteers (N = 174) received single oral doses of 140 to 400 mg without serious adverse reactions.

Overdose in animals has been fatal and has been heralded by convulsions, tremor, paralysis, inactivity, ptosis, erythema of the extremities, abnormal respiration, cyanosis, ataxia, mydriasis, salivation, and lacrimation.

The elimination half-life of sumatriptan is approximately 2.5 hours, and therefore monitoring of patients after overdose with Imitrex tablets should continue for at least 12 hours or while symptoms or signs persist.

It is unknown what effect hemodialysis or peritoneal dialysis has on the serum concentrations of sumatriptan.


Warnings and precautions:

Myocardial ischemia/infarction and Prinzmetal's angina: perform cardiac evaluation in patients with multiple cardiovascular risk factors.

Arrhythmias: discontinue Imitrex pills if occurs.

Chest/throat/neck/jaw pain, tightness, pressure, or heaviness: generally not associated with myocardial ischemia; evaluate for coronary artery disease in patients at high risk.

Cerebral hemorrhage, subarachnoid hemorrhage, and stroke: discontinue Imitrex or Imigran if occurs.

Gastrointestinal ischemic reactions and peripheral vasospastic reactions: discontinue Sumatriptan if occurs.

Medication overuse headache: detoxification may be necessary.

Serotonin syndrome: discontinue this medication if occurs.

Seizures: use with caution in patients with epilepsy or a lowered seizure threshold.


Adverse reactions, side effects:

Most common adverse reactions ( >= 2% and > placebo) were paresthesia, warm/cold sensation, chest pain/tightness/pressure and/or heaviness, neck/throat/jaw pain/tightness/pressure, other sensations of pain/pressure/tightness/heaviness, vertigo, and malaise/fatigue.

To report suspected adverse reactions of Imitrex and Imigran (Sumatriptan Succinate) tablets contact GlaxoSmithKline or your local FDA.


Drug interactions:

Ergot-containing drugs have been reported to cause prolonged vasospastic reactions. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) and Imitrex tablets within 24 hours of each other is contraindicated.

Monoamine Oxidase-A inhibitors: MAO-A inhibitors increase systemic exposure by 7-fold. Therefore, the use of sumatriptan tablets in patients receiving MAO-A inhibitors is contraindicated.

Other 5-HT1 agonists: because their vasospastic effects may be additive, coadministration of Imitrex (Sumatriptan Succinate) tablets and other 5-HT1 agonists (e.g., triptans) within 24 hours of each other is contraindicated.

Selective serotonin reuptake inhibitors/serotonin norepinephrine reuptake inhibitors and serotonin syndrome: cases of serotonin syndrome have been reported during coadministration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors.


Use in specific populations:

Pregnancy

Based on animal data, may cause fetal harm.

Nursing mothers

Sumatriptan is excreted in human milk following subcutaneous administration. Infant exposure to sumatriptan can be minimized by avoiding breastfeeding for 12 hours after treatment with Imitrex tablets.

Pediatric use

Safety and effectiveness in pediatric patients have not been established. Imigran and Imitrex (Sumatriptan Succinate) tablets are not recommended for use in patients younger than 18 years of age.

Geriatric use

Clinical trials of sumatriptan pills did not include sufficient numbers of patients aged 65 and older to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy.

Hepatic impairment

The maximum single dose in patients with mild to moderate hepatic impairment should not exceed 50 mg. Imitrex tablets are contraindicated in patients with severe hepatic impairment.


Patient counseling information:

Risk of myocardial ischemia and/or infarction, prinzmetal's angina, other vasospasm-related events, arrhythmias, and cerebrovascular events

Inform patients that Imitrex and Imigran (Sumatriptan Succinate) tablets may cause serious cardiovascular side effects such as myocardial infarction or stroke. Although serious cardiovascular events can occur without warning symptoms, patients should be alert for the signs and symptoms of chest pain, shortness of breath, irregular heartbeat, significant rise in blood pressure, weakness, and slurring of speech, and should ask for medical advice if any indicative sign or symptoms are observed. Apprise patients of the importance of this follow-up.

Anaphylactic/anaphylactoid reactions

Inform patients that anaphylactic/anaphylactoid reactions have occurred in patients receiving Imitrex tablets. Such reactions can be life-threatening or fatal. In general, anaphylactic reactions to drugs are more likely to occur in individuals with a history of sensitivity to multiple allergens.

Concomitant use with other triptans or ergot medications

Inform patients that use of Sumatriptan tablets within 24 hours of another triptan or an ergot-type medication (including dihydroergotamine or methysergide) is contraindicated.

Serotonin syndrome

Caution patients about the risk of serotonin syndrome with the use of this medicine or other triptans, particularly during combined use with SSRIs, SNRIs, TCAs, and MAO inhibitors.

Medication overuse headache

Inform patients that use of acute migraine drugs for 10 or more days per month may lead to an exacerbation of headache and encourage patients to record headache frequency and drug use (e.g., by keeping a headache diary).

Pregnancy

Advise patients to notify their healthcare provider if they become pregnant during treatment or plan to become pregnant.

Lactation

Advise patients to notify their healthcare provider if they are breastfeeding or plan to breastfeed.

Ability to perform complex tasks

Treatment with Imitrex tablets may cause somnolence and dizziness; instruct patients to evaluate their ability to perform complex tasks after administration of this medication.