Imigran nasal spray (sumatriptan)

How does it work?

Imigran nasal spray contains the active ingredient sumatriptan, which is a type of medicine called a serotonin (or 5HT) agonist. This type of medicine is also commonly known as a 'triptan'. It is a painkiller specifically used to relieve migraine attacks.

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.

Imigran nasal spray is administered into one nostril to relieve a migraine attack. The medicine is absorbed into the bloodstream through the blood vessels lining the nose and starts to work within about 15 minutes. It may be particularly useful for people who feel sick or vomit during their migraine attack, as it is not taken by mouth.

What is it used for?

Relieving migraine attacks.

Warning!

This medicine should not be used to prevent migraines.

This medicine should only be used by people with a clear diagnosis of migraine from their doctor.

Follow the instructions provided with your Imigran nasal sprays. Each spray contains one dose and is for single use only.

If the first dose of this medicine doesn't relieve your migraine headache then you should NOT take another dose for the same attack, as trials have shown that this is not effective. (You can still take Imigran for your next attack.) If your first dose does initially relieve your migraine, but the headache then comes back, you can take a second dose. However, if you need a second dose because your migraine has returned, you should NOT take it within two hours of your first dose. Do not exceed the recommended dose. Do not use more than two nasal sprays in any 24 hours.

This medicine can cause feelings of warmth, heaviness, pressure, tightness or pain in certain parts of the body, including the chest or throat. Although sometimes very strong, these feelings usually only last a few minutes. If they continue or are particularly severe (especially chest pain), you should tell your doctor immediately, as there have been extremely rare reports of such problems being caused by a heart attack. Do NOT take another dose; your doctor will decide if you should stop using this medicine.

This medicine may cause drowsiness. If affected do not drive or operate machinery.

Imigran nasal spray can be used in adolescents aged 12-17 years, on the recommendation of a specialist or doctor with particular experience in migraine. The nasal spray is not recommended for children aged under 12 years or adults aged over 65 years, as there is insufficient experience with the nasal spray in these age groups.

Use with caution in

Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole.

Controlled high blood pressure .

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.

Not to be used in

People who have had a heart attack.

Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina.

A severe form of angina pectoris, not caused by exertion (Prinzmetal's angina).

Narrowing of blood vessels in the extremities, eg legs (peripheral vascular disease).

History of stroke.

History of small temporary temporary strokes (transient ischaemic attacks).

Uncontrolled or moderate to severe high blood pressure .

Severely decreased liver function.

People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days.

A form of migraine associated with paralysis of the eye muscles (ophthalmoplegic migraine).

A form of migraine associated with temporary paralysis of one side of the body (hemiplegic migraine).

A type of migraine where there is a disturbance in brain function which initially presents with total blindness followed by dizziness, speach disturbances, ringing in the ears and double vision (basilar migraine).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established. It should only be used by pregnant women if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.

This medicine passes into breast milk. It should be used with caution by breastfeeding mothers. Exposure of the baby to the medicine can be minimised by not breastfeeding for 12 hours after you have taken a dose. Discard any breast milk you express in this time. Seek further medical advice from your doctor.

Label warnings

Follow the printed instructions you have been given with this medication.

This medication may cause drowsiness. If affected do not drive or operate machinery.

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