Sumatriptan (Imitrex, Imigran) is by far the most popular triptan because it was the first one on the market. Because it came out a long time ago, many manufacturers make generic copies of this drug. This has reduced its price. Sumatriptan is available in combination with naproxen (Treximet). This combination is more effective than either drug alone.
The drug is available in 25, 50 and 100 mg strength. The starting dose for most patients is 100 mg. If after two hours one tablet has not relieved your migraine, take a second dose. In Europe, 50 mg tablets of sumatriptan have been sold without a prescription for over a decade.
The nasal spray of sumatriptan is not as effective as the tablets but the newer forms of nasal sumatriptan (Onzetra, Tosymra) are work better. However, the newer forms are much more expensive.
Sumatriptan injection is the most effective abortive migraine treatment. Over 80% of patients respond to it. Unfortunately, the injections are highly underutilized. The doctors are not very familiar with them, forget to offer them, and are afraid to prescribe them. The perception is that the side effects are common or they think that patients will not be receptive to the idea of injections.
The injection begins to work within 10-15 minutes and can quickly restore people to normal functioning. They are particularly useful for people for whom tablets are not likely to work well or work fast enough. People who wake up with a severe migraine, have a rapid onset of intense pain or have pronounced nausea or vomiting with their attacks.
Tightness in the jaw, neck, or chest is more common with the injection than with the tablet. This can be frightening but is not dangerous and is not related to the heart. This sensation usually subsides in about 15 minutes.
The injection is available in a vial and an easy-to-use autoinjector. Each shot contains 3 mg, 4 mg, or 6 mg of sumatriptan. The most effective dose for most people is 6 mg. If cost is an issue, sumatriptan is significantly cheaper in a vial than in an autoinjector. With the vial, you will also need a prescription for syringes..
