This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Sumatriptan parenteral


Parenteral formulation of sumatriptan.

Drugs List

  • IMIGRAN SUBJECT PRE-FILLED SYRINGE 6mg subcutaneous injection
  • IMIGRAN SUBJECT SYRINGE REFILL 6mg subcutaneous injection
  • sumatriptan 3mg/0.5ml solution for injection pre-filled device
  • sumatriptan pre-filled pen 6mg/0.5ml injection
  • sumatriptan pre-filled syringe with autoinjector 6mg injection
  • sumatriptan syringe refill for autoinjector 6mg injection
  • Therapeutic Indications


    Acute treatment of cluster headache
    Acute treatment of migraine attacks with or without aura


    If the patient responds to the first dose and symptoms recur, a second dose may be administered if there is a minimum of one hour between the doses.

    Maximum dose 12mg in any 24 hour period.


    6mg by subcutaneous injection.
    Some patients may benefit from a lower dose of 3mg by subcutaneous injection.


    Children aged 10 to 18 years (unlicensed):
    6mg by subcutaneous injection.


    Subcutaneous injection only.


    Children under 10 years
    Suspected ischaemic heart disease
    Within 2 weeks of discontinuing MAOIs
    Coronary vasospasm
    History of cerebrovascular accident
    History of myocardial infarction
    History of transient ischaemic attack
    Ischaemic heart disease
    Moderate hypertension
    Peripheral vascular disease
    Prinzmetal's angina
    Severe hepatic impairment
    Uncontrolled hypertension

    Precautions and Warnings

    Children aged 10 to 18 years
    Patients over 65 years
    Predisposition to ischaemic heart disease
    Tobacco smoking
    Hepatic impairment
    History of seizures
    Reduced seizure threshold
    Renal impairment

    Not for prophylactic use
    Advise patient drowsiness may affect ability to drive or operate machinery
    Avoid within 2 weeks of discontinuing a MAOI
    Children under 18: Treatment to be initiated/supervised by a specialist
    Evaluate patients for cardiovascular disease prior to treatment
    Exclude other potentially serious neurological conditions
    Not all available brands are licensed for all age groups
    Not all available brands are licensed for all indications
    Presentation (e.g. syringe, needle cap) may contain a derivative of latex
    Avoid ergotamine-type medication for 6 hrs after sumatriptan administration
    Avoid sumatriptan for 24hrs after ergotamine-type medication administration
    For subcutaneous use only
    Only for use where a clear diagnosis of migraine has been established
    Only for use where there is a clear diagnosis of cluster headaches
    When used with SSRIs, risk of Serotonin syndrome
    Excessive use may increase frequency of headache, may require withdrawal
    If angina-like symptoms occur, discontinue treatment and investigate.
    Advise patient not to take St John's wort concurrently
    Breastfeeding: Do not breastfeed & discard milk for 12 hours after therapy
    Patients should not exceed recommended dose

    Sumatriptan should not be administered to patients with risk factors for ischaemic heart disease for example in patients that are heavy tobacco smokers or use nicotine substitution therapies, without completing a cardiovascular examination prior to sumatriptan treatment. Sumatriptan should also be used with caution in postmenopausal women, and males over 40 years old with risk factors for ischaemic heart disease.

    Sumatriptan should be used with caution in patients with mild controlled hypertension, as transient increases in blood pressure and peripheral vascular resistance has been shown in patients during use of sumatriptan.

    Patient taking concomitant treatment with sumatriptan and a selective serotonin reuptake inhibitor (SSRI) should be under careful observation due to potential risk of developing serotonin.

    Pregnancy and Lactation


    Use sumatriptan with caution during pregnancy.

    The manufacturer recommends that sumatriptan should only be used if the potential benefit to the mother is greater than the potential risk to the foetus.
    Schaefer (2015) states studies on the use of sumatriptan during pregnancy have not shown any increased risks of foetal teratogenic effects in humans. Briggs (2015) states that some animal studies have shown congenital defects, particularly rabbits, when administrated sumatriptan during pregnancy. There is limited published information regarding the use of sumatriptan crossing the placenta, however the molecular weight of approximately 414 suggests it is likely (Briggs, 2015). Fortunately, Briggs (2015) also states the risk of developing teratogenic effects in humans is considered low.


    Use sumatriptan with caution during breastfeeding.

    The manufacturer recommends to avoid breastfeeding for 12 hours after treatment, due to sumatriptan excretion into breast milk.
    Studies have shown sumatriptan to be excreted in breast milk when administrated by subcutaneous injection. Schaefer (2015) states the infants exposure to sumatriptan via breast milk after 6mg subcutaneous administration is most likely minimal as studies have shown the mean relative dose was found to be only 3.5% of the maternal dose, therefore if conventional treatment fails, a single dose of sumatriptan is considered relatively safe during breastfeeding. Briggs (2015) states any breast milk expressed for a minimum of 8 hours after treatment should be discarded. The manufacturer suggests to avoid breastfeeding for a minimum of 12 hours after treatment and any breast milk expressed in between that time should be discarded.

    Side Effects

    Altered liver function tests
    Bruising at injection site
    Burning (injection site)
    Coronary vasospasm
    Erythema at injection site
    Eye flickering
    Hypersensitivity reactions
    Impaired vision
    Increased blood pressure (transient)
    Ischaemic colitis
    Local pain (injection site)
    Loss of vision
    Minor bleeding (injection site)
    Myocardial infarction
    Neck stiffness
    Raynaud's phenomenon
    Sensation of cold
    Sensation of heat
    Sensation of heaviness
    Sensation of pressure
    Sensation of tightness
    Stinging (injection site)
    Swelling (injection site)
    Transient ischaemic ECG changes


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: December 2020

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Imigran Injection, Subject. GlaxoSmithKline UK. Revised September 2020.

    Summary of Product Characteristics: Sumatriptan 3 mg/0.5 ml Solution for Injection in pre-filled pen. Ranbaxy UK Limited. Revised September 2020.

    Summary of Product Characteristics: Sumatriptan 6 mg/0.5 ml Solution for Injection. Ranbaxy UK Limited. Revised September 2020.

    NICE Evidence Services Available at: Last accessed: 14 December 2020

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.