Active Ingredient: Sumatriptan succinate

Excipients: May include lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, triacetin, iron oxide, and other inactive ingredients depending on the formulation.

Imitrex is available in various formulations, including:

• Tablets: Available in strengths such as 25 mg, 50 mg, and 100 mg.
• Nasal Spray: Available in single-dose nasal spray devices containing sumatriptan solution.
• Injection: Available in prefilled syringes or autoinjectors containing sumatriptan solution for subcutaneous administration.

Imitrex belongs to the pharmacological group of selective serotonin receptor agonists (5-HT1 receptor agonists) (ATC code: N02CC01).

Pharmacological Properties:

• Pharmacodynamics: Sumatriptan exerts its therapeutic effects by selectively activating serotonin (5-HT1) receptors, leading to vasoconstriction of cranial blood vessels and inhibition of pro-inflammatory neuropeptide release, thereby alleviating migraine symptoms.
• Pharmacokinetics: Following oral administration, sumatriptan is rapidly absorbed, with peak plasma concentrations reached within 1-2 hours. It undergoes extensive first-pass metabolism in the liver to inactive metabolites. The elimination half-life is approximately 2 hours for the tablets and 2.5 hours for the nasal spray, allowing for rapid onset of action.

Imitrex is indicated for the acute treatment of migraine headaches with or without aura in adults. It is not intended for the prophylactic therapy of migraine or for the treatment of cluster headaches.

Imitrex is contraindicated in individuals with:

• Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction)
• Uncontrolled hypertension
• Peripheral vascular disease
• History of stroke or transient ischemic attack (TIA)
• Hemiplegic or basilar migraine
• Severe hepatic impairment
• Hypersensitivity to sumatriptan or any component of the formulation

Imitrex may interact with various medications, including monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), ergot alkaloids, and other triptans, potentially increasing the risk of serotonin syndrome or other adverse effects. Caution is advised when using Imitrex concomitantly with these agents.

Imitrex tablets should be taken orally with water, with or without food. The dosage and administration of Imitrex depend on the severity of the migraine and the response to treatment. The nasal spray should be administered into one nostril, and the injection should be administered subcutaneously into the thigh or upper arm. Patients should be instructed on the proper use of the nasal spray or injection device.

The safety of Imitrex during pregnancy and breastfeeding has not been established. It should be used during pregnancy only if clearly needed and under the supervision of a healthcare provider. It is not recommended for use during breastfeeding due to the potential risk to the infant.

Imitrex may cause dizziness, drowsiness, or visual disturbances in some patients. Patients should exercise caution when driving or operating machinery, especially during migraine attacks or after taking Imitrex.

The recommended dosage of Imitrex varies depending on the formulation and the severity of the migraine. For oral tablets, the usual starting dose is 25 mg or 50 mg, with the option to repeat the dose after 2 hours if needed. The maximum recommended dose is 200 mg in a 24-hour period. For the nasal spray, the usual dose is 5 mg or 10 mg per nostril, with the option to repeat the dose after 2 hours if needed. For the injection, the usual dose is 4 mg administered subcutaneously, with the option to repeat the dose after 1 hour if needed. The maximum recommended dose is 12 mg in a 24-hour period.

In case of overdose, supportive measures should be initiated as needed. Symptoms of overdose may include dizziness, drowsiness, chest pain, tremor, and seizures. Patients should seek medical attention if overdose is suspected.

Common side effects of Imitrex may include:

• Pain or tightness in the chest or throat
• Flushing or warmth sensation
• Dizziness or vertigo
• Nausea or vomiting
• Nasal discomfort or irritation (with nasal spray)
• Injection site reactions (with injection)

Serious adverse effects such as myocardial ischemia, stroke, serotonin syndrome, and allergic reactions are rare but may occur.

Imitrex tablets should be stored at room temperature (20-25°C) in a dry place, protected from light and moisture. The nasal spray should be stored upright at room temperature (15-30°C), and the injection should be stored in the refrigerator (2-8°C). Check the expiration date on the packaging and discard any expired or unused medication.