Intranasal Sumatriptan

Abstract

Sumatriptan, a serotonin 5-HT(1B/1D) agonist, constricts cranial blood vessels and inhibits neuroinflammatory processes. A single dose of sumatriptan 10 mg (approved European dosage) was significantly more effective than placebo in achieving headache relief at 1 hour post-dose in a well designed study. Headache relief occurred in significantly more adolescents administered a single dose of intranasal sumatriptan 20 mg (at 1 and 2 hours) and 5 mg (at 2 hours) than placebo (pooled data from two studies). Sustained headache relief (1-24 and 2-24 hours) occurred in significantly more recipients of a single dose of intranasal sumatriptan 20mg and 5mg than placebo (pooled data from two studies). Intranasal sumatriptan was generally well tolerated in adolescent migraineurs (in single-episode studies or long term in multiple-episode studies). Taste disturbance occurred more often with intranasal sumatriptan than with placebo [Chart: see text].

Migraine treatment: a chain of adverse effects

“…Domperidone is the only antiemetic drug licensed for use in children up to 12 years of age (Evers et al 2009 ). Moderate to severe migraine crisis in teenagers over 12 years old can be managed with sumatriptan (Winner et al 2000 ; Curran et al 2005 ; Cady and Schreiber 2006 ; Evers et al 2009 , Pereira-Monteiro 2009 ; Goldman and Meckler 2015 ), rizatriptan (Ahonen et al 2006 ) or zolmitriptan (Evers et al 2006 ; Lewis et al 2007 ) and the efficacy of these drugs has been supported by moderate to high quality evidence. The off-label use of triptans is still a matter of debate, however more recently sumatriptan nasal spray and zolmitriptan nasal spray have been approved for adolescents in Europe; almotriptan has been approved for adolescents in the USA, as has rizatriptan for patients aged 6–17 years (Wöber-Bingöl 2013 ).…”