Imigran Tablets/Nasal Spray

How does Imigran work?

• Although the cause of migraine attacks is not fully understood, it is thought that widening of blood vessels in the brain causes the throbbing pain of migraine headaches. Sumatriptan relieves this pain by causing the blood vessels in the brain to narrow.
• Sumatriptan works by stimulating receptors called serotonin (or 5HT) receptors that are found in the brain. A natural substance called serotonin normally acts on these receptors, causing blood vessels in the brain to narrow. Sumatriptan mimics this action of serotonin by directly stimulating the serotonin receptors in the brain. This narrows the blood vessels and so relieves the pain of migraine headaches.
• The dose of sumatriptan should be taken as early as possible after the migraine headache has started, though it is also effective if taken at a later stage during the migraine attack.
• During a migraine attack, the normal movements of the stomach can slow down or stop. This can delay tablets from dissolving in the stomach and the medicine being absorbed into the bloodstream. 

What is Imigran used for?

• Relieving migraine attacks.

Use Imigran with caution in:

• Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole.
• Controlled high blood pressure (hypertension).
• People with risk factors for ischaemic heart disease, such as smoking, high cholesterol levels, diabetes, obesity, or a family history of heart disease.
• Men over 40 years.
• Postmenopausal women.
• Decreased kidney function.
• Decreased liver function.
• History of seizures eg epilepsy, or people with conditions that increase the risk of seizures, eg head injury, alcoholism.

How to take Imigran

• Take sumatriptan exactly as your doctor has told you. Make sure you know how to administer the preparation you have been given.
• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack as well any additional information you have been given by your doctor.
• If you have been supplied the tablets: take one dose as soon as possible at the first sign of an attack, with a drink of water. If your migraine improves but then returns, you may take one further dose, providing it is at least two hours after the initial dose. Do not take more than two doses in 24 hours.
• If you have been supplied the injection: use one dose as soon as possible at the first sign of an attack. If your migraine improves but then returns, you may use one further dose, providing it is at least one hour after the initial dose. Do not administer more than two doses in 24 hours.
• If you have been supplied the nasal spray: spray one puff into one nostril at the first sign of an attack. If your migraine improves but then returns, one further puff can be sprayed into one nostril, providing it is at least two hours after your first dose. Do not administer more than two doses in 24 hours.
• If your migraine is not eased after the first dose of sumatriptan, do not take a second dose for the same attack. You may however take a painkiller such as paracetamol, aspirin, or a non-steroidal anti-inflammatory preparation such as ibuprofen.

Side effects of Imigran

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

• Sensation of tightness, pressure, tingling, heaviness, heat or pain in any part of the body, including the chest and throat (see warning above).
• Flushing.
• Increase in blood pressure.
• Shortness of breath.
• Dizziness.
• Drowsiness.
• Weakness.
• Fatigue.
• Nausea and vomiting (though these may also be due to the migraine).

Very rare (affect less than 1 in 10,000 people)

• Visual disturbances such as flickering, reduced vision, double vision or loss of vision (though these may also be due to the migraine).
• Tremor.
• Seizures.
• Stiff neck.
• Increased or decreased heart rate (tachycardia or bradycardia).
• Awareness of your heart beat (palpitations).
• Irregular heart beats.
• Chest pain
• Heart attack.
• Alteration in results of liver function tests.
• Narrowing of the blood vessels in the hands leading to periods of white, painful hands (Raynaud's phenomenom).
• Low blood pressure (hypotension).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.
The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.
Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Imigran:

• ergotamine
• methysergide
• nicotine

The following types of medicine may interact with Imigran:

• ergot derivatives
• monoamine oxidase inhibitors
• noradrenaline reuptake inhibitors
• selective serotonin re-uptake inhibitors
• triptans

If you are taking Imigran and one of the above medicines or types of medicines, make sure your prescriber knows about it.

How to store Imigran

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

If you have any more questions please ask your pharmacist.

Remember to keep all medicines out of reach of children

Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.patient.co.uk/medicine/Sumatriptan.htm

http://www.netdoctor.co.uk/aches-and-pains/medicines/imigran-tablets.html

http://www.imigranrecovery.co.uk

http://www.medicines.org.uk/emc/medicine/751

http://en.wikipedia.org/wiki/Sumatriptan

http://www.nhs.uk/medicine-guides/pages/MedicineSideEffects.aspx?condition=Migraine%20Headache&medicine=Imigran

http://www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?condition=Migraine%20Headache&medicine=Imigran