Sumatriptan
Acute migraine, Cluster headache
Indications
- Acute migraine
- Cluster headache
Adult dosing
- po: dose: 50; unit: mg; route: PO; interval: May repeat 50-100mg in 2h; max 200mg/day; fixed: true; sc: dose: 6; unit: mg; route: SQ; interval: May repeat once in 1h; max 12mg/day; fixed: true; nasal: dose: 20; unit: mg; route: Intranasal; interval: May repeat in 2h; max 40mg/day; fixed: true
Contraindications
- Uncontrolled HTN
- CAD/prior MI/stroke
- Hemiplegic or basilar migraine
- MAOI use within 14 days
- Use within 24h of ergotamine
Clinical pearls
- Subcutaneous route is fastest and most effective for acute migraine and cluster headache
- Avoid in patients with vascular risk factors — coronary vasospasm risk
- Medication overuse headache if used >10 days/month — counsel on limits
- Cluster headache: 6mg SQ is first-line abortive therapy
Source and review
- AHS Consensus Statement on Acute Migraine Treatment 2021. Last reviewed: 2024-11-01