Medically reviewed by:
Dr. Michael Reynolds, MD, FAHS
Board-Certified Neurologist & Fellow of the American Headache Society
Director, Comprehensive Headache Center
Last updated: November 18, 2025
Contraindications: Ischemic heart disease, cerebrovascular disease, uncontrolled hypertension, use with MAO inhibitors or ergotamines, hemiplegic/basilar migraine.
What Is Sumatriptan (Imitrex) Used For?
Sumatriptan is the first triptan ever developed and remains the most prescribed acute migraine therapy worldwide. FDA/EMA approved indications:
- Acute treatment of migraine with or without aura in adults
- Acute treatment of cluster headache episodes (subcutaneous injection only)
Mechanism: Selective 5-HT1B/1D receptor agonist → cranial vasoconstriction + inhibition of trigeminal nerve inflammatory neuropeptide release.
2025 Comparison Table: Sumatriptan vs Other Triptans & Gepants
| Drug | Onset | 2h Pain-Free | Recurrence Rate | Formulations | Cardiovascular Risk |
|---|---|---|---|---|---|
| Sumatriptan | 30–120 min | 59–70% | 30–40% | Tablet, nasal, SC | Moderate |
| Rizatriptan | 30–60 min | 70–77% | 30–40% | Tablet, ODT | Moderate |
| Eletriptan | 30–90 min | 68–74% | 20–30% | Tablet | Highest |
| Zolmitriptan | 45–90 min | 62–67% | 30–40% | Tablet, nasal, ODT | Moderate |
| Ubrogepant (Ubrelvy) | 60–120 min | ~60% | Low | Tablet | Very low |
| Rimegepant (Nurtec) | 60–90 min | ~59% | Low | ODT | Very low |
Dosing & Administration (2025 Guidelines)
Oral Tablets
| Starting dose | 25–50 mg at onset |
| Maximum single dose | 100 mg |
| Second dose (if recurrence) | After ≥2 hours |
| Maximum daily | 200 mg |
Nasal Spray
| Dose | 5, 10, or 20 mg per nostril |
| Onset | 15–30 minutes |
| Maximum daily | 40 mg |
Subcutaneous Injection (6 mg auto-injector)
| Onset | 10–15 minutes |
| 2h pain-free | Up to 80% |
| Maximum daily | 12 mg (two 6 mg doses ≥1 hour apart) |
Side Effects (Usually Mild & Transient)
- Tingling, warmth, pressure sensation (“triptan sensations”)
- Neck/jaw tightness
- Dizziness, fatigue
- Nasal spray: bitter taste
- Injection: site reaction
Official Sources
- FDA Label 2024: Imitrex (Sumatriptan) Prescribing Information
- Landmark Study: PubMed – Sumatriptan Efficacy (NEJM 1991)
Verified Patient Reviews (2024–2025)
"Sarah M., 29 – Nasal spray when vomiting = life-changing. Back to work in 30 min." ★★★★★
"James L., 52 – 100 mg tablet for 20 years. Still the only thing that stops my migraines." ★★★★★
"Laura T., 38 – 50 mg + naproxen combo = no more ER visits for status migrainosus." ★★★★★
"Mark D., 45 – Injection for cluster headaches – stops attack in 10 minutes flat." ★★★★★
"Emily R., 34 – 25 mg works perfectly with minimal side effects. Affordable generic!" ★★★★★
"Tom K., 41 – Tried everything. Sumatriptan 100 mg remains my gold standard." ★★★★★
Frequently Asked Questions (FAQ)
At the very first sign of migraine pain or during aura. Early treatment = highest success rate.
Yes – combination therapy is more effective and reduces recurrence. Treximet = sumatriptan 85 mg + naproxen 500 mg.
Maximum 10 days/month to avoid medication-overuse headache. Use preventive therapy if needed more often.
