Imitrex Nasal

1 What is Imitrex Nasal?

Brand: Imitrex, Imitrex Nasal, Onzetra Xsail

Generic: Sumatriptan

Imitrex Nasal is a medication prescribed for the quick treatment of migraine with and without aura in adults.

Sumatriptan works by reducing substances in the body responsible for causing headache, pain and sensitivity to light and sound that contributes to migraine. 

Sumatriptan has certain restrictions on its effectiveness. Sumatriptan only works for migraines and is not suitable to treat other types of headaches such as tension or cluster headaches. Sumatriptan only works for migraine attacks that have already begun.

Sumatriptan does not work to prevent or reduce numbers of migraine attacks. Therefore, you only have to take Sumatriptan if you already have a migraine.

Sumatriptan nasal spray is only available with doctor’s prescription.

2 What to Know Before Using

If you are about to start Imitrex Nasal, speak with your doctor about what you need to know.

Your doctor will have to consider the following before prescribing you with Sumatriptan:

  • Having heart conditions

Sumatriptan is contraindicated for with history or having heart disease. Sumatriptan may cause side effects such as spasm of the arteries in the heart and ventricular tachycardia, which can prove life-threatening to patients with heart conditions.

You cannot use Sumatriptan if you have coronary artery disease, hypertension, angina, Wolff-Parkinson-White syndrome, history of heart attack or have suffered a stroke, have circulation problems in the intestines (ischemic bowel disease) and arrhythmias.

Use of certain medications:
Tell to the doctor all the medicines you take before taking Sumatriptan. Sumatriptan should not be taken with MAO inhibitor drugs such as phenelzine, isocarboxazid, tranylcypromine, methylene blue, hydracarbazine, selegiline, rasagiline, linezolid and many others.

Do not take Sumatriptan with ergot-containing medications such as dihydroergotamine or methysergide.

Taking Sumatriptan with selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors, which are common antidepressant medications, can cause serotonin syndrome. Serotonin syndrome can cause dangerous symptoms like convulsions, twitching of the limbs, tachycardia, and coma.

If you are taking Sumatriptan, do not take other medications without calling your doctor.

Health conditions:
Tell your doctor if you have health conditions affecting the liver, kidneys, or have epilepsy or have suffered from seizures, diabetes, high cholesterol levels or smoking. These conditions may increase the risk of adverse effects of Sumatriptan. The doctor may have to weigh benefits against potential risks of Sumatriptan if you have these conditions.

Pregnancy and breastfeeding:
Sumatriptan is an FDA category C drug, which means that there are no studies showing that the drug is safe for the fetus in pregnant women. Tell your doctor if you are pregnant, or trying to get pregnant, before taking Sumatriptan.

Sumatriptan may be expressed in breastmilk, like other drugs. Its safety in babies is not known, so you have to avoid breastfeeding if you are taking Sumatriptan.

If you became pregnant while on Sumatriptan treatment, call your doctor immediately.

Pediatric and Geriatric use:
Sumatriptan is not approved for use in patients younger than 18 years old.

Patients around 50 – 60 years old and above are more prone to conditions in the heart, kidneys, and blood vessels. For elderly patients, the doctor will have to do a careful assessment before prescribing Sumatriptan. 

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3 Proper Usage

To use Imitrex Nasal properly, you must follow all instructions given by your doctor.

Sumatriptan nasal is packaged in a nasal spray bottle. The dose is 5 mg, 10 mg or 20 mg. The doctor will tell the appropriate dose for you.

Spray Sumatriptan on the nose as soon as you feel symptoms of migraine. If your dose is 5 mg or 20 mg, do a single spray in one nostril. If your dose is 10 mg, do a single spray in each nostril.

If delivering another dose of Sumatriptan, try to spray it in a different direction inside the nostrils. Take extra care not to spray Sumatriptan into the eyes or mouth.

If migraine does not resolve within two hours or returns after momentary improvement, take another dose. Always space at least two hours between Sumatriptan doses. Do not take exceed the maximum dose of 40 mg per day.

Do not use more than the prescribed dose or overuse Sumatriptan because it can worsen migraine. If migraine does not go away after the second dose of Sumatriptan or returns shortly after that, call your doctor.

Always keep Sumatriptan sprays out of reach of children and pets. Sumatriptan may cause serious adverse effects on children. Store Sumatriptan in a place between 20 C – 25 C (68 and 77 degrees F), away from light, heat or moisture.

Do not store the medication in the freezer.

4 Precautions to Take

Before using Imitrex Nasal, there are some precautions you must take.

Note that Sumatriptan may cause dizziness or drowsiness. Avoid driving, performing hazardous tasks or operating heavy machinery after using Sumatriptan.

Rest and carefully monitor your body after using Sumatriptan. Though rare, serious and fatal heart problems have happened in some patients taking Sumatriptan.

Call your doctor at once if you have fast or irregular heart rate, tightness in the jaw, chest, throat or neck, pain or heaviness in the chest, sudden cold sweats, tingling or numbness in an arm or leg or shortness of breath. Other symptoms to watch out include severe stomach pain, dizziness, nausea, and fainting. 

Though also rare, stroke and other serious blood vessel problems in the brain have occurred after using Sumatriptan. Call your doctor and head to the nearest hospital right away if you experience one-sided weakness, confusion and changes in speech or vision after using Sumatriptan.

Sumatriptan may also cause severe allergic reactions, though this is also very rare. Call your doctor right away if you experience swelling of the face, mouth, nose or throat, hives, itching, and difficulty breathing after taking Sumaptriptan.
Sumatriptan is associated with serotonin syndrome, especially if you take high doses (20 mg) and if you take certain antidepressants such as venlafaxine, duloxetine, citaprolam, escitaprolam, paroxetine, sertraline, fluoxetine and many others.

Watch out for symptoms such as excessive sweating, tremors, fast irregular heart rate, fever, hallucinations, agitation or confusion, nausea, vomiting or diarrhea. Call the doctor at once if you have those symptoms.

When using Sumatriptan, always check your blood pressure levels often. Elderly patients need close monitoring after using Sumatriptan.

Your doctor will schedule regular clinic appointments when you are prescribed with Sumatriptan to determine its effectiveness and check for early signs of adverse effects. Stick to scheduled appointments and make sure to ask questions to your doctor.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Imitrex Nasal.

Sumatriptan may cause the following side effects:

More common

  • Anxiety
  • Drowsiness
  • Dizziness
  • Strange sensations or feelings
  • Mild flushing that is often temporary
  • Nausea
  • Stiffness of the neck
  • Feeling sick
  • Stomach upset
  • Discomfort in the throat or insides of the nose
  • Vomiting
  • Feeling too warm or hot
  • Weakness

These side effects are common and bothersome but are not serious. If you find these side effects bothersome, call your prescribing doctor.

Here are severe side effects of Sumatriptan. Call your doctor and emergency services immediately if you have the following:

  • Severe allergy (hives, rash, difficulty breathing, swelling of the face, mouth, lips, tongue or throat)
  • Bloody diarrhea
  • Burning or painful ache in the feet or toes
  • Burning, numbness or tingling sensation anywhere in the body
  • Diarrhea or constipation
  • Fainting
  • Heaviness or tightness in the muscles of the leg
  • Fever
  • Reduced or loss of hearing
  • Leg cramps
  • Having seizures
  • Difficulty swallowing
  • Severe stomach pain
  • Very cold, bluish or darkened color of feet or toes
  • Changes in vision
  • Wheezing
  • Unintended weight loss
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