Alternatively, your doctor may prescribe one of the triptans marketed as nasal sprays: sumatriptan nasal spray (Tosymra) or zolmitriptan nasal spray (Zomig). It helps to relieve headache, pain, and other migraine symptoms (including nausea, vomiting, sensitivity to light/sound). Read and follow the instructions carefully. Triptans are not effective for all patients with migraine and will not stop every headache, even in those patients who do benefit from the drugs. Overdoses may be fatal and patients should be monitored for 3-5 half lives or while symptoms persist. Rectal sumatriptan has a clearance of 0.17L/min (95% CI of 0.14-0.21L/min). If your symptoms are only partly relieved, or if yourheadachecomes back, you may take another dose at least two hours after the first dose. (2021). Migraines are common, with a prevalence of 1% to 3% in children three to seven years of age, 4% to 11% in children seven to 11 years of age, and 8% to 23% in those 15 years of age. Treatment with more than 200 mg per day of topiramate may decrease the effectiveness of combined oral contraceptives. Our fast, convenient service is extremely straight forward and you don't need to visit a doctor to use it. You can learn more about how we ensure our content is accurate and current by reading our. When a drug is directly absorbed into your bloodstream, it avoids being broken down by your digestive system or by your liver during first-pass metabolism. Imigran 10 mg Nasal Spray: unit dose spray device containing 0.1mL solution. Adults10 mg given as 1 spray in one nostril. This dose may be repeated after 2 hours, except for naratriptan and frovatriptan, which can be repeated after 4 hours. Triptans are one of the first-line treatments for migraine thats moderate-to-severe in intensity. While the melts may be more convenient (no liquid is required to wash them down) and may be preferred by patients who have migraine-associated nausea, there is no evidence to suggest that they work faster than the tablets. How and when should I take my nasal spray medication? feeling warm or cold. Sumatriptan was devoid of genotoxic and carcinogenic activity in in-vitro systems and animal studies. 4 CONTRAINDICATIONS Although amitriptyline combined with CBT has been shown to be more effective than amitriptyline without CBT, amitriptyline has a boxed warning from the U.S. Food and Drug Administration concerning risk of suicidal thoughts and behavior in children and adolescents. Insert half of the spray nozzle into the open nostril and angle outward. Portions of this document last updated: May 01, 2023. The pharmacokinetics of sumatriptan in patients with severe hepatic impairment have not been studied (see Section 4.3 Contraindications and Section 4.4 Warnings and Precautions). Extended-release divalproex (Depakote), amitriptyline, and propranolol lack evidence that they are more effective than placebo at reducing headache frequency or disability in children. CMI Trade Names and Active Ingredients containing Imigran. (see Section 4.4, Warnings and Precautions). Imigran FDA label. Pain, sensations of heat or cold, pressure or tightness (these events are usually transient and may be intense and can affect any part of the body including the chest and throat); feelings of weakness, fatigue (both events are mostly mild to moderate in intensity and transient). The intranasal triptans, sumatriptan nasal spray, and zolmitriptan nasal spray tend to have a faster onset of action than the orally administered triptans. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. The recommended adult dose of sumatriptan nasal spray, USP for the acute treatment of migraine is 5 mg, 10 mg, or 20 mg. Tosymra nasal spray is approved to treat migraine episodes that occur with or without aura in adults. Zolmitriptan works in the brain to relieve the pain from migraine headaches. How long will it to take for the medication to work? Imigran is recommended as monotherapy for the acute treatment of a migraine attack and should not be given concomitantly with ergotamine or derivatives of ergotamine (including methysergide) (see section 4.3). Folic acid supplementation may decrease congenital malformations in children of women with epilepsy who are taking anticonvulsants and should be considered for young women taking these medications for migraine prevention. Potential side effects of triptans include nausea; jaw, neck, or chest tightness, pressure or squeezing; rapid heart rate; fatigue; numbness-tingling, especially involving the face; or a burning/flushing sensation over the skin. What migraine treatment options are available? Because of its route of administration, Imigran Nasal Spray may be particularly suitable for patients who suffer nausea and vomiting during a migraine attack. These are: Advances in nasal spray technology are also occurring. Imigran Nasal Spray should only be used where there is a clear diagnosis of migraine.  . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. GLAXOSMITHKLINE GMBH & CO. KG . glass vial with rubber stopper and applicator. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Sumatriptan works in the brain to relieve the pain from migraine headaches. Imigran is used to treat migraine or cluster headaches once the pain has started, but there are other medicines available that may help to reduce the number and frequency of attacks. Anyone with migraineand without contraindicationsis a good candidate for triptans. Rarely, serious adverse cardiac events including acute myocardial infarction, arrhythmia, cardiac arrest, and death have been reported within a few hours following the administration of 5-HT1 agonists, in some cases even in patients with no prior history or findings of coronary artery disease (CAD). The dose of sumatriptan varies widely by route of administration and in most cases, no more than 2 doses should be given daily. All of your medication will be delivered in plain, unlabeled packaging. Migranal (dihydroergotamine mesylate) nasal spray. Total plasma clearance of sumatriptan is approximately 1200mL/min. Now lets explore the general mechanisms behind the drugs that are used in migraine nasal sprays. The 10-mg dose . Prices include prescription and delivery. Sumatriptan should not be administered to patients with severe hepatic impairment. If it does get on these areas, rinse it off right away. Once the new sprayer formulation for DHE is FDA-labeled for this indication, this advantage will no longer be of major . A 25mg rectal dose of sumatriptan reaches a Cmax of 22.9ng/mL (95% CI of 18.4-28.6ng/mL) with a Tmax of 1.00h (95% CI of 0.75-3.00h), an AUC of 14.6h*ng/mL (95% CI of 11.3-18.8h*ng/mL), and a bioavailability of 19.2% (95% CI of 15.3-24.1%). Do not take more than 200 milligrams in a 24-hour period. This content is owned by the AAFP. Counseling and education are important for patients and their families, especially because of the lack of useful pharmacologic therapy. Acute migraine in people ages 12 and older. the unsubscribe link in the e-mail. Imigran is not recommended for use if you have reduced kidney function. The tablets usually work within 30 to 60 minutes. Following an oral dose, sumatriptan plasma exposure (AUC and Cmax) almost doubled (increased approximately 80%) in patients with mild to moderate hepatic impairment compared to the control subjects with normal hepatic function. Blow forcefully through the mouthpiece to deliver the medicine into the nasal cavity. Order Imigran online - our service is fast, discreet and confidential. Triptans are a family of drugs used for the acute treatment of migraine. In a rat fertility study a reduction in success of insemination was seen at exposures sufficiently in excess of the maximum human exposure. (n.d.). The empirical formula is C 14 H 21 N 3 O 2 S, representing a molecular weight of 295.4. Hypersensitivity reactions ranging from cutaneous hypersensitivity (such as urticaria) to anaphylaxis. being able to get an erection sometimes, but not every time you want to have sex. Frovatriptan and naratriptan have a longer half-life than the other triptans, meaning that it may take longer to take effect. Initially, these oral and intranasal triptans were studied in the treatment of migraine of moderate to severe intensity and were superior to placebo in those pivotal trials. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Imigran Nasal Spray should be kept in the sealed blister, preferably in the box, to protect from light. The pharmacokinetic profile of intranasal sumatriptan does not appear to be significantly affected by migraine attacks. tandfonline.com/doi/full/10.1080/00325481.2020.1767402, ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research, accessdata.fda.gov/drugsatfda_docs/label/2004/20626s004lbl.pdf, impelnp.com/2020/11/09/impel-neuropharma-announces-fda-submission-of-new-drug-application-for-inp104-for-the-acute-treatment-of-migraine/, accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf, ncbi.nlm.nih.gov/pmc/articles/PMC7003832/, accessdata.fda.gov/drugsatfda_docs/label/2010/022382s000lbl.pdf, headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.12045, accessdata.fda.gov/drugsatfda_docs/label/2019/210884s000lbledt.pdf, accessdata.fda.gov/drugsatfda_docs/label/2013/021450s007lbl.pdf, Migraine with Brainstem Aura (Basilar Migraine), How to Treat Migraine Attacks with OTC Medications, Is Chronic Migraine Affecting Your Mental Well-Being? Rizatriptan. The following information includes only the average doses of this medicine. Do not use more than 44 mg (4 nosepieces) in a 24-hour period (one day). Imigran is a short-acting medication with a half-life of around two hours. There are limited data on an interaction with preparations containing ergotamine or another triptan/5-HT1 receptor agonist. Glaxosmithkline, Glaxosmithkline Uk, Glaxo Saudi Arabia, Glaxo Saudi Arabia Ltd. Pakistan, United Kingdom, Saudi Arabia, Netherlands, Portugal, Spain. Imigran Nasal Spray is indicated for the acute relief of migraine attacks with or without aura. a liquid solution . Imigran Nasal Spray is indicated for the acute treatment of migraine attacks with or without aura. Also, some patients are sensitive to melting ingredients like aspartame. CVA, TIA) if the patient presents with atypical symptoms or if they have not received an appropriate diagnosis for sumatriptan use. You may have heard of using nasal sprays as a potential treatment option for migraine. This may influence the ability to drive and to operate machinery. Press the clear tab to remove the first nosepiece. You may opt-out of email communications at any time by clicking on If you get migraines, you want pain relief that works. Topamax is a drug used for migraine prevention. Ask your doctor if you have any questions. Reporting suspected adverse reactions after authorisation of the medicinal product is important. Yes, Published source:Neurology. You may take the tablet with or without food. Triptans can be a very effective acute treatment for relieving migraine attacks. ChildrenUse and dose must be determined by your doctor. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Discuss your migraine symptoms with your doctor to create an optimal treatment plan. See permissionsforcopyrightquestions and/or permission requests. The period of time that should elapse between the use of sumatriptan and ergotamine-containing preparations or another triptan/5-HT1 receptor agonist is not known. In fact, a 2013 research review showed that its possible for nasal sprays to begin to ease the symptoms of an acute migraine attack in as quickly as 15 minutes. Zolmitriptan nasal spray is used to treat acute migraine headaches in adults and children 12 years of age and older. For treating migraine, Imitrex nasal spray may be prescribed in doses of 5 mg, 10 mg, or 20 mg. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Imigran constricts cranial blood vessels and prevents the release of vasoactive peptides. There are two types of migraine medications. If you feel much better after a dose of sumatriptan, but your headache comes back or gets worse after a while, you may use one additional dose of sumatriptan at least 1 hour (Tosymra) or 2 hours (Imitrex or Onzetra) after the first dose. Most of our doctors and staff are based in our headquarters in London, some other members of the team work remotely. Non-renal clearance accounts for about 80% of the total clearance. Patients with known hypersensitivity to sulphonamides may exhibit an allergic reaction following administration of sumatriptan. This helps take away the headache and eases other symptoms such as feeling or being sick and sensitivity to light and sound. (2019). Migraine-related disability is determined using an evaluation tool such as the Pediatric Migraine Disability Assessment, a six-question scale that measures migraine impact over three months (Table 11,2). Imigran is an agonist of 5-HT1B and 5-HT1D. Industry: Employment Services , Services to Buildings and Dwellings , Other Support Services , Semiconductor and Other Electronic Component Manufacturing , Other Specialty Trade Contractors See All Industries, General Freight Trucking , Lessors of Real Estate , Business Support Services , Employment agencies, Help supply services, Building and office cleaning services, Packaging and labeling . The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. Do not crush, break, or chew it. In these cases the attack can be treated with paracetamol, acetylsalicylic acid or non-steroidal anti-inflammatory drugs. the nonsteroidal anti-inflammatory drug (NSAID), blood pressure medications like beta-blockers (, calcitonin gene-related peptide (CGRP) monoclonal antibodies like galcanezumab (Emgality) and fremanezumab-vfrm (. Enter your email address and stay in the know. There is moderate evidence that ibuprofen oral solution and sumatriptan (Imitrex) nasal spray relieve pain better than placebo at two hours. It belongs to the group of medicines called triptans. Ketorolac, the type of NSAID thats available as a nasal spray, can be prescribed to help with migraines that cause severe pain. Following administration of sumatriptan nasal spray mild, transient irritation or burning sensation in the nose or throat or epistaxis have been reported. Pregnancy Category C.Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. In the past, doctors were concerned about the risk of serotonin syndrome when triptans were taken together with medications that impact serotonin, like many antidepressants. (2020). other information we have about you. Another spray (5 mg, 10 mg, or 20 mg) may be used as long as it has been at least 2 hours since the last spray. UK based customer call centres - in case you ever need to contact us. nasal (nose) spray. 1. sumatriptan nasal spray (generic for Imitrex nasal spray) 2. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Do not use more than 40 mg in a 24-hour period (one day). Generally speaking, medications that are given intranasally can be absorbed more rapidly and effectively than oral medications. As a precaution, the manufacturers recommend that the first dose be administered under medical surveillance in such patients, and that electrocardiographic monitoring be considered during the interval immediately following administration to help detect any asymptomatic cardiac ischemia that may occur. Swallow the tablet whole with water or other liquids. 3 DOSAGE FORMS AND STRENGTHS Unit dose nasal spray device containing 20 mg sumatriptan USP. Clinical response begins 15 minutes following a 20 mg dose given by intranasal administration. This content does not have an English version. Musculoskeletal and connective tissue disorders. PA 1077/008/004 . Intrsnasal sumatriptan has a clearance of 0.21L/min (95% CI of 0.18-0.25L/min). No, Recommendations based on patient-oriented outcomes? They can help you find out if a nasal spray may be beneficial for your acute migraine symptoms, and can inform you of any side effects or interactions to be aware of. Instead, check with your doctor. These drugs bind to certain subtypes of receptors in your brain that are specific for serotonin. Sumatriptan is eliminated primarily by oxidative metabolism mediated by monoamine oxidase A. In animals, sumatriptan selectively constricts the carotid arterial circulation, but does not alter cerebral blood flow. Max: 300 mg/24 hr. Learn what you need to know about how Excedrin Migraine works and how to use it safely. Remove the device from your nostril. (2013). Imigran Ftab 100 mg F ilm-coated Tablets . If you're unsure, our in-house GPs can also recommend the best treatment for you. Zolmitriptan and rizatriptan are available in melt formulations as well as in tablet form. They can also often work to ease your symptoms faster than oral abortive medications. Weight loss isn't a direct side effect of Imigran. The amount of medicine that you take depends on the strength of the medicine. Use Imigran as soon as the migraine headache or cluster headache develops. Subcutaneous sumatriptan has a clearance of 0.22L/min (95% CI of 0.19-0.25L/min). Do not store in the refrigerator or freezer. 5 Documents available. Rectal sumatriptan has a half life of 1.8h (95% CI of 1.6-2.2h). It should not be used to prevent migraine attacks from occurring. Losing weight has been shown to reduce headaches in overweight children. Consider trigger avoidance for children and adolescents who have frequent headaches or migraine-related disabilities. It can narrow your blood vessels leading to heart problems such as chest pains, abnormal heart rhythm or a heart attack. If so, which type of nasal spray medication do you recommend? It is probably best to use them particularly early in an attack. 2023 Healthline Media LLC. pressure or pain in your chest, neck, jaw, or throat. If youre interested in a nasal spray for migraine, there are several questions that you may want to ask your doctor first. Our doctors will review your order, issue your prescription and pass it straight to the Superdrug pharmacists to be dispensed. Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP. Experimental studies of acute and chronic toxicity showed no evidence of toxic effects within the human therapeutic dose range. Press it only once. You'll complete a short online health assessment and select your preferred treatment. Concurrent administration of monoamine oxidase inhibitors (MAOIs) and sumatriptan is contraindicated. A 25mg oral dose of sumatriptan reaches a Cmax of 16.5ng/mL (95% CI of 13.5-20.1ng/mL) with a Tmax of 1.50h (95% CI of 0.50-2.00h), an AUC of 8.7h*ng/mL (95% CI of 6.1-12.5h*ng/mL), and a bioavailability of 14.3% (95% CI of 11.4-17.9%). It belongs to the group of medicines called triptans. September 2, 2021 Oral and Intranasal Triptans for Migraine Spread the News! Table 2 summarizes the evidence for acute migraine treatments. In rabbits, embryo-lethality without marked teratogenic defects was seen. While side effects are not uncommon, triptans are a very safe class of medications when used appropriately by the patients for whom they are indicated. Prolonged use of any type of painkiller for headaches can make them worse. There is no experience of the use of Imigran Nasal Spray in patients over 65. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. The 5-mg and 20-mg doses require a single spray in one nostril. 224% is excreted in the urine as unchanged sumatriptan and 387% in urine as indole acetic acid approximately 40% is excreted in the feces. Seizures, although some have occurred in patients with either a history of seizures or concurrent conditions predisposing to seizures. It can make you feel tired or sleepy. Learn more about treatment options. Keep from freezing. Do not look down as this may cause the medicine to drip from your nose. This medicine comes with a patient information leaflet and patient instructions. Drowsiness may occur as a result of migraine or treatment with sumatriptan. A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide. If this happens, do not drive and do not use tools or machines. include protected health information. Do not get any of it into your eyes or on your skin. Do not use this medicine for a headache that is different from your usual migraines. A pharmacokinetic study in adolescent subjects (1217 years) indicated that the mean maximum plasma concentration was 13.9ng/mL and mean elimination half-life was approximately 2 hours following a 20 mg intranasal dose. There are a number of oral triptans, including sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig), rizatriptan (Maxalt), almotriptan (Axert), frovatriptan (Frova), or eletriptan (Relpax). For help finding a healthcare provider, check out our Find a Doctor tool. Can Vaccines Cause Headaches or Migraine? Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. 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