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Sumatriptan - Interactions and Warnings

The frequent use (>15 times/month) of medication for the treatment of acute migraine attacks may cause medication overuse headache. This kind of headache can be caused by the intake of a combination of analgesics, opioids, ergot alkaloids and triptans.
- Curr Med Res Opin 2001;17 Suppl 1:s17-21 -- Medication overuse headache. -- Diener HC, Katsarava Z.

If butorphanol nasal spray is administered <30 min="" after="" sumatriptan="" nasal="" spray,="" the="" analgesic="" effect="" of="" butorphanol="" may="" be="" diminished="" due="" to="" reduced="" nasal="" absorption="" resulting="" from="" probable="" transient="" vasoconstriction="" of="" nasal="" blood="" vessels="" by="">
- Cephalalgia 2002 May;22(4):282-7 -- A pharmacokinetic interaction study between butorphanol and sumatriptan nasal sprays in healthy subjects: importance of the timing of butorphanol administration. -- Vachharajani NN, Shyu WC, Nichola PS, Boulton DW.

Major depression and migraine are commonly comorbid. Therefore, there is considerable opportunity for serotonin reuptake inhibitors, which are commonly prescribed for the treatment of depression, to be used at the same time as sumatriptan, an anti-migraine treatment. As both of these drugs increase serotonin transmission, the potential for drug interaction is considerable. Adverse event reports were obtained from the post-marketing surveillance of fluoxetine in Canada. Of 22 adverse event reports obtained six showed varying degrees of evidence of a drug interaction between fluoxetine and sumatriptan, suggesting that this combination is not entirely free of side-effects and should be used with caution when indicated.
- Acta Psychiatr Scand 1997 Jun;95(6):551-2 -- Co-administration of fluoxetine and sumatriptan: the Canadian experience. -- Joffe RT, Sokolov ST.

All triptans narrow coronary arteries by 10% to 20% at clinical doses and should not be administered to patients with coronary or cerebrovascular disease. Some triptans have the potential for significant drug-drug interactions (sumatriptan, rizatriptan, and zomitriptan and monoamine oxidase inhibitors; rizatriptan and propanolol; zolmitriptan and cimetidine; and eletriptan and CYP3A4 metabolized medications and p-glycoprotein pump inhibitors).
- Med Clin North Am 2001 Jul;85(4):959-70 -- Safety and rational use of the triptans. -- Tepper SJ.

Care should be taken when sumatriptan is administered to patients with liver disease.
- Clin Pharmacokinet 1994 Nov;27(5):337-44 -- Sumatriptan clinical pharmacokinetics. -- Scott AK.

Interactions may occur with other prescription medications. Consult with your physician if you are pregnant or breastfeeding and before taking herbs or supplements.

last update: November 2008

This information is not intended to be a substitute for professional medical advice. You should not use this material to diagnose or treat a health condition or disease without consulting with your healthcare provider.
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