Sumatriptan (Sumatriptan succinate)
Also sold as: Suminat, Migranil, Imigran, Sumavel
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet (25mg, 50mg, 100mg) +2
Indications
- Acute migraine with or without aura
- Cluster headache (SC and nasal spray formulations)
Adult Dosing
Acute migraine (oral)
50–100 mg at onset of headache
May repeat after 2 hours if partial response; maximum 300 mg/day
Take as early as possible once headache phase begins (not during aura). Lower 50 mg dose preferred initially to assess tolerability.
Acute migraine (nasal spray)
20 mg (one spray into one nostril)
May repeat after 2 hours; maximum 40 mg/day
Useful when oral dosing is not feasible due to vomiting. Onset 15–30 minutes.
Acute migraine / Cluster headache (subcutaneous injection)
6 mg SC
May repeat after 1 hour; maximum 12 mg/day
Fastest onset (10–15 minutes). Preferred for cluster headache. Inject into thigh or abdomen.
Pediatric Dosing
Not recommended under 12 years. SC injection not routinely used in paediatrics. Consult paediatric neurology.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Mild-moderate impairment | No dose adjustment required |
| Severe impairment | Use with caution |
Hepatic Adjustment
Moderate hepatic impairment: maximum 50 mg oral dose. Avoid in severe hepatic impairment.
Pregnancy & Lactation
Pregnancy: Category C
Use only if benefit outweighs risk. Registry data has not demonstrated increased teratogenic risk, but data are limited. Avoid if possible, particularly in the first trimester.
Lactation: Caution
Excreted in breast milk. Pump and discard breast milk for 12 hours after each dose to minimise infant exposure.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| MAOIs (phenelzine, tranylcypromine, selegiline) | Risk of severe serotonin syndrome and hypertensive crisis | Major |
| Ergotamine / dihydroergotamine | Additive vasospasm and risk of ischaemia | Major |
| Linezolid | MAO inhibition increases serotonergic effects — serotonin syndrome risk | Major |
| SSRIs / SNRIs (fluoxetine, sertraline, venlafaxine) | Increased risk of serotonin syndrome — monitor for agitation, hyperthermia, tachycardia | Moderate |
| Other triptans | Additive vasoconstrictive effects — do not use within 24 hours of another triptan | Moderate |
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Side Effects
Common
- Chest tightness or pressure (non-cardiac, triptan sensation)
- Tingling, warmth, flushing
- Dizziness, drowsiness
- Injection site reaction (SC formulation)
- Nasal irritation, bad taste (nasal spray)
- Nausea
Serious / Discontinue If
- Coronary vasospasm, myocardial infarction (rare — avoid in CAD)
- Stroke / cerebral ischaemia (rare)
- Serotonin syndrome (with interacting drugs)
- Peripheral vascular ischaemia
- Severe hypertension
Contraindications
- Hemiplegic or basilar migraine
- Coronary artery disease, angina, history of MI
- Uncontrolled hypertension
- History of stroke or TIA
- Peripheral vascular disease
- MAOIs within 14 days
- Ergotamine or another triptan within 24 hours
- Severe hepatic impairment
- Use for migraine prophylaxis (not indicated)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Suminat 25mg | Sun Pharma | ₹85/2 tab |
| Migranil 50mg | Cipla | ₹125/2 tab |
| Imigran 50mg | GSK | ₹185/2 tab |
Monitoring Required
- Blood pressure before initiation (rule out uncontrolled hypertension)
- ECG in patients with cardiovascular risk factors before first dose
- Frequency of triptan use — limit to ≤10 days/month to avoid medication overuse headache
Patient Counseling Points
- Take at the first sign of headache, not during aura phase
- Do not take for migraine prevention — it only treats acute attacks
- If no relief after 2 hours, you may take a second dose; do not exceed the daily maximum
- Tell your doctor if you have chest pain, heart disease, or high blood pressure before using
- Avoid alcohol during migraine attacks — it worsens headache
- Using triptans more than 10 days per month can cause medication overuse headache (rebound headache)
- If breastfeeding, discard milk for 12 hours after each dose
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Clinically reviewed by: Dr. Priya Nair, DM Neurology, DM Neurology, Senior Consultant Neurologist
Last reviewed: 2026-04-01
References
- Tfelt-Hansen P, et al. Triptans in migraine. Drugs. 2000;60(6):1259-1287.
- Indian Headache Society Guidelines 2021.
- Sumatriptan prescribing information — GSK India.