Alsuma

1 What is Alsuma?

Brand: Alsuma, Imitrex, Imitrex Stat Dose Refill, Sumavel Dosepro

Generic: Sumatriptan

Alsuma is used to treat acute migraine attacks and cluster headaches in adults. Sumatriptan works in the brain to relieve pain from migraine headaches. It belongs to a group of medications called Triptans.

Many patients find that their headaches go away completely after they use Sumatriptan. Other people find their headaches are much less painful and that they are able to go back to their normal activities, even if their headaches are not completely gone.

Alsuma often relieves other symptoms caused by migraines such as nausea, vomiting and light and sound sensitivities.

This medication is not an ordinary pain reliever. It will not relieve any kind of pain other than migraine headaches. This medication is normally used for people whose headaches are not relieved by acetaminophen, ibuprofen or other pain relievers.

Alsuma has caused serious side effects in some people, especially people who have heart or blood vessel disease. Be sure that you discuss the risks and benefits with your doctor.

This medication is only available with your doctor’s prescription. This medication is available in the following forms:

  • Kit
  • Solution

2 What To Know Before Using

Before using Alsuma, you must know all about the risks and complications associated with it. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

Allergies

Inform your doctor if you have ever had an allergic reaction to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.

Pediatric

No appropriate studies have been performed on the relationship of age to the effects of this medication in children. Safety and efficacy have not been established.

Geriatric

Use of this medication is not recommended in elderly patients with kidney problems, heart or blood vessel disease or hypertension (high blood pressure) and should not be used in patients with liver problems.

Pregnancy

This medication is listed as Pregnancy Category C. This means that animal studies have shown an adverse effect and no studies have been performed on pregnant women OR there are no adequate studies on pregnant animals and pregnant women.

Breastfeeding 

Studies in women suggest that this medication poses minimal risk to the infant when used while breastfeeding.

Drug Interactions

Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions.

When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive.

Using this medication with any of the following is not recommended.

Your doctor may decide not to treat you with this medication, or change some of the other medications you take:

  • Almotriptan
  • Bromocriptine
  • Dihydroergotamine
  • Eletriptan
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Frovatriptan
  • Furazolidone
  • Iproniazid
  • Isocarboxazid
  • Linezolid
  • Methylene Blue
  • Methylergonovine
  • Methysergide
  • Moclobemide
  • Naratriptan
  • Phenelzine
  • Procarbazine
  • Rasagiline
  • Rizatriptan
  • Safinamide
  • Selegiline
  • Tranylcypromine
  • Zolmitriptan

Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases.

Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:

  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Citalopram
  • Clomipramine
  • Dasabuvir
  • Desipramine
  • Desvenlafaxine
  • Dexfenfluramine
  • Dibenzepin
  • Dolasetron
  • Doxepin
  • Duloxetine
  • Escitalopram
  • Fentanyl
  • Fluoxetine
  • Fluvoxamine
  • Granisetron
  • Imipramine
  • Levomilnacipran
  • Lofepramine
  • Lorcaserin
  • Melitracen
  • Meperidine
  • Milnacipran
  • Mirtazapine
  • Nefazodone
  • Nortriptyline
  • Opipramol
  • Palonosetron
  • Paroxetine
  • Protriptyline
  • Reboxetine
  • Sertraline
  • Sibutramine
  • St John's Wort
  • Tapentadol
  • Tianeptine
  • Tramadol
  • Trazodone
  • Trimipramine
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Ziprasidone

Other Interactions

Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.

Other Medical Problems

Pre-existing medical problems may affect the use of this medication.

Be sure to tell your doctor if you have any other medical problems, especially:

3 Proper Usage

To use Alsuma properly, you must follow all instructions given by your doctor. Do not use this medication for a migraine or a cluster headache that is different from your normal headaches.

To relieve your migraine as soon as possible, use this medication as soon as your headache pain begins. If you get warning signals of a migraine (auras), you should wait until the pain starts before using this medication.

Ask your doctor ahead of time about other medication you can use if Sumatriptan does not work. After using the other medication, inform your doctor immediately. Headaches that are not relieved by this medication may be caused by conditions that need other treatment.

If you feel better after a dose of this medication, but your headache comes back or gets worse after a while, wait at least 1 hour before taking another dose. Use this medication as directed by your doctor. Do not use more of this medication or more often than directed. Using too much of this medication can increase the chance of serious side effects. Do not use more than 2 doses in 24 hours.

This medication is given as a shot under your skin (subcutaneous), normally on the abdomen, stomach, thighs or upper arms). Sumatriptan may sometimes be given at home to patients who do not need to be in a hospital or clinic. If you are using this medication at home, a doctor or nurse will teach you how to prepare and inject the medication.

If using this medication at home, you will be shown the body areas that this shot can be given. Use a different body area each time you use this medication. Keep track of where you give each shot to make sure you rotate body areas. This will help to prevent skin problems.

This medication is available in 3 forms:

  • Single dose vial
  • Pre-filled syringe
  • Pre-filled autoinjector

Do not use this medication if it is dark-coloured or cloudy.

After you are done injecting the medication, follow the precautions in the patient directions and safely discard the empty cartridge and needle. Always return the empty cartridge and needle to their container before discarding them. Refills are available, so do not throw away the injector unit.

This medication comes with a patient information brochure. It is very important that you read this information. Ask your doctor if you have any questions.

Dosing

Different patients will be given a different dose of this medication based on the strength of the medication. The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

  • Adults - 4-6 mg injected under the skin (subcutaneous). If a headache comes back after being relieved, one more dose may be injected after 1 hour. Do not use more than 2 doses of 6 mg or 3 doses of 4 mg in a 24 hour period.
  • Children - Use and dose must be determined by your doctor.

Storage

Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.

Keep out of the reach of children. Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

Throw away used syringes or autoinjectors in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

4 Precautions to Take

Before using Alsuma, there are some precautions you must take. It is very important that your doctor checks in with you often while you are receiving this medication to make sure that it is working properly.

Inform your doctor if you have used this medication and have not had relief. Inform your doctor if your migraine or cluster headaches are worse or if they occur more often than before you started using this medication.

You should not receive this medication if you have used a MAO inhibitor (MAOI) such as phenelzine or tranylcypromine within the past 2 weeks. Do not use this medication if you have used other triptan migraine medications. Some examples of triptan medications are almotriptan, eletriptan, naratriptan or zolmitriptan. Some examples of ergot-type medications are dihydroergotamine, ergotamine or methysergide.

This medication may increase your risk of having abnormal heart rhythm, heart attack, angina or stroke. This is more likely if you or a family member already has heart disease, if you have diabetes or hypertension (high blood pressure) or if you smoke.

Call your doctor immediately if you have any symptoms of a heart problem such as chest pain or discomfort, uneven heartbeat (arrhythmia), nausea or vomiting, pain or discomfort in the shoulders, arms jaw, back or neck, shortness of breath, severe abdominal pain or bloody diarrhea after using this medication.

Call your doctor immediately if you have any symptoms of a stroke, such as confusion, difficulty speaking, double vision, headaches, inability to move the arms, legs or facial muscles, inability to speak or slow speech.

Inform your doctor immediately if blurred vision, difficulty reading or another change of vision occurs during or after your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist.

Using this medication alone or with another migraine medication for 10 or more days per month may lead to a worsening headache. You may need to keep a headache diary to record the headache frequency and drug use.

Be sure your doctor knows the other medications you are using. Sumatriptan may cause a serious condition called serotonin syndrome when used with some medications. This includes medications used to treat depression such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, olanzapine, paroxetine, sertralin and venlafaxine.

Inform your doctor immediately if you have agitation, confusion, diarrhea, abnormal excitement while talking, fever, overactive reflexes, poor coordination, restlessness, shivering, sweating, trembling or shaking that you cannot control or twitching. These could be symptoms of serotonin syndrome.

This medication may cause a serious type of allergic reaction called anaphylaxis, which is life-threatening and requires immediate emergency medical help.

Inform your doctor immediately if you have fast or irregular breathing, gasping for breath, wheezing, fainting (syncope), changes in the colour of the face, fast and irregular heartbeat, hive-like swelling on the skin or puffiness or swelling around the eyelids or eyes.

Drinking alcoholic beverages can make headaches worse or cause new headaches. People who suffer from severe headaches should avoid alcoholic beverages, especially during a headache.

This medication may cause some people to become dizzy, drowsy or less alert than normal. This is more likely to happen when you begin taking this medication, or when you increase the dosage. Make sure you know how you react to this medication before driving, using machinery or doing anything else that could be dangerous if you are not alert.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Alsuma. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

Less Common

  • Blurred vision
  • Chest pain or discomfort
  • Chills
  • Confusion
  • Difficult or labored breathing
  • Dizziness
  • Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • Fainting (syncope)
  • Fast, pounding, or irregular heartbeat or pulse (tachycardia, palpitations, arrhythmia)
  • Headache
  • Nervousness
  • Pounding in the ears (pulsatile tinnitus)
  • Shakiness in the legs, arms, hands, or feet
  • Slow heartbeat (bradycardia)
  • Sweating
  • Tight feeling in the head
  • Tightness or pressure in the chest
  • Trembling or shaking of the hands or feet
  • Unusual fatigue or weakness

Rare

  • Black, tarry stools
  • Blood in the urine
  • Blood in the vomit
  • Burning while urinating
  • Cough
  • Decreased urination
  • Depression of the skin
  • Diarrhea
  • Dry mouth
  • Feeling of warmth or heat
  • Fever
  • Flushing or redness of the skin, especially on the face and neck
  • General feeling of discomfort or illness (malaise)
  • Inability to move the eyes
  • Inability to move the legs or arms
  • Increased blinking or spasms of the eyelid
  • Increased sensitivity to pain
  • Increased sensitivity to touch
  • Indentation of the skin
  • Joint pain
  • Loss of appetite
  • Muscle aches and pains
  • Nausea and vomiting
  • Pain in the groin or genitals
  • Paleness of the skin
  • Paleness or cold feeling in the fingertips and toes
  • Paralysis of one side of the body
  • Rapid breathing
  • Runny nose
  • Severe or continuing stomach pain
  • Sharp back pain just below the ribs
  • Shivering
  • Sore throat
  • Sticking out of the tongue
  • Sunken eyes
  • Tingling in the hands and feet
  • Tingling or pain in the fingers or toes when exposed to cold
  • Trouble sleeping (insomnia)
  • Trouble speaking or swallowing
  • Uncontrolled twisting movements of the neck, trunk, arms, or legs
  • Unusual facial expressions
  • Wrinkled skin

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

More Common

  • bleeding
  • blistering
  • burning
  • coldness
  • discoloration of the skin
  • the feeling of pressure
  • hives
  • infection
  • inflammation
  • itching
  • lumps
  • numbness
  • pain
  • rash
  • redness
  • scarring
  • soreness
  • stinging
  • swelling
  • tenderness
  • tingling
  • ulceration
  • warmth at the injection site
  • burning or tingling sensation
  • drowsiness
  • the feeling of constant movement of self or surroundings
  • the feeling of warmth
  • redness of the face, neck, arms, and occasionally, upper chest
  • relaxed and calm
  • the sensation of spinning (vertigo)
  • sleepiness

Less Common

  • Abdominal or stomach discomfort
  • Anxiety
  • Bad, unusual, or unpleasant (after) taste
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • Change in color vision
  • Change in taste
  • Difficulty seeing at night
  • Difficulty with moving
  • Discomfort in the jaw, nasal cavity, or throat
  • False or unusual sense of well-being
  • Feeling strange
  • Heartburn
  • Increased sensitivity of the eyes to sunlight
  • Joint pain, stiffness, or swelling
  • Mental confusion
  • Muscle aching or cramping
  • Neck pain or stiffness
  • Red, sore eyes
  • Swollen joints
  • Tearing of the eyes
  • Weakness

Rare

  • Backache
  • Belching
  • Bloated or full feeling
  • Changes in patterns and rhythms of speech
  • Cramps
  • Dry heaves
  • Excess air or gas in the stomach or intestines
  • Extreme thirst
  • Heavy bleeding
  • Hiccups
  • Hunger
  • Increased thirst (polydipsia)
  • Muscle tiredness
  • Muscle twitching or jerking
  • Pain
  • Passing gas
  • Reduced appetite
  • Rhythmic movement of muscles
  • Severe stomach pain with nausea and vomiting
  • Tenderness of the skin

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects. Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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