Sumatriptan + DihydroergotamineContraindicated
Ergot-type medication causing prolonged vasospastic reactions with additive effects. Use within 24 hours of sumatriptan is contraindicated.
Source: NLP:sumatriptan
Sumatriptan Interactions
Brand names: Sumatriptan
Serotonin-1b and Serotonin-1d Receptor Agonist · Serotonin 1b Receptor Agonists · Serotonin 1d Receptor Agonists
Route: Nasal
Contraindications
4 CONTRAINDICATIONS Sumatriptan Nasal Spray is contraindicated in patients with: • Ischemic coronary artery disease (CAD) (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal’s angina [see Warnings and Precautions ( 5.1 )] • Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders [see Warnings and Precautions ( 5.2 )] • History of stroke, transient ischemic attack (TIA), or history of hemiplegic or basilar migraine because these patients are at a higher risk of stroke [see Warnings and Precautions ( 5.4 )] • Peripheral vascular disease [see Warnings and Precautions ( 5.5 )] • Ischemic bowel disease [see Warnings and Precautions ( 5.5 )] • Uncontrolled hypertension [see Warnings and Precautions ( 5.8 )] • Recent use (i.e., within 24 hours) of ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide), or another 5-hydroxytryptamine 1 (5-HT 1 ) agonist [see Drug Interactions ( 7.1 , 7.3 )] • Concurrent administration of a monoamine oxidase (MAO)-A inhibitor or recent (within 2 weeks) use of an MAO-A inhibitor [see Drug Interactions ( 7.2 ), Clinical Pharmacology ( 12.3 )] • Hypersensitivity to sumatriptan (angioedema and anaphylaxis seen) [see Warnings and Precautions ( 5.10 )] • Severe hepatic impairment [see Clinical Pharmacology ( 12.3 )] • History of coronary artery disease or coronary artery vasospasm ( 4 ) • Wolff-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders ( 4 ) • History of stroke, transient ischemic attack, or hemiplegic or basilar migraine ( 4 ) • Peripheral vascular disease ( 4 ) • Ischemic bowel disease ( 4 ) • Uncontrolled hypertension ( 4 ) • Recent (within 24 hours) use of another 5-HT 1 agonist (e.g., another triptan) or of an ergotamine-containing medication. ( 4 ) • Concurrent or recent (past 2 weeks) use of monoamine oxidase-A inhibito
Pregnancy & Breastfeeding
8.1 Pregnancy Risk Summary Data from a prospective pregnancy exposure registry and epidemiological studies of pregnant women have not detected an increased frequency of birth defects or a consistent pattern of birth defects among women exposed to sumatriptan compared with the general population (see Data) . In developmental toxicity studies in rats and rabbits, oral administration of sumatriptan to pregnant animals was associated with embryolethality, fetal abnormalities, and pup mortality. When administered by the intravenous route to pregnant rabbits, sumatriptan was embryolethal (see Data ). In the U.S. general population, the estimated background risk of major birth defects and of miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. The reported rate of major birth defects among deliveries to women with migraine ranged from 2.2% to 2.9% and the reported rate of miscarriage was 17%, which were similar to rates reported in women without migraine. Clinical Considerations Disease-Associated Maternal and/or Embryo/Fetal Risk: Several studies have suggested that women with migraine may be at increased risk of preeclampsia during pregnancy. Data Human Data: The Sumatriptan/Naratriptan/TREXIMET (sumatriptan and naproxen sodium) Pregnancy Registry, a population-based international prospective study, collected data for sumatriptan from January 1996 to September 2012. The Registry documented outcomes of 626 infants and fetuses exposed to sumatriptan during pregnancy (528 with earliest exposure during the first trimester, 78 during the second trimester, 16 during the third trimester, and 4 unknown). The occurrence of major birth defects (excluding fetal deaths and induced abortions without reported defects and all spontaneous pregnancy losses) during first-trimester exposure to sumatriptan was 4.2% (20/478 [95% CI: 2.6% to 6.5%]) and during any trimester of exposure was 4.2% (24/576 [95% CI: 2.7% to 6.2%]). The sample size in this study
12 interactions on record
Sumatriptan + Dihydroergotamine MesylateContraindicated
Should not be taken within 24 hours of each other; both cause coronary artery vasospasm with additive effects.
Source: NLP:dihydroergotamine mesylate
Sumatriptan + ErgotamineContraindicated
Ergotamine-containing drugs cause prolonged vasospastic reactions that may be additive with sumatriptan. Use within 24 hours of each other is contraindicated.
Source: NLP:sumatriptan
Sumatriptan + Mao InhibitorsContraindicated
MAO-A inhibitors increase systemic exposure of sumatriptan 7-fold. Use of sumatriptan in patients receiving MAO-A inhibitors is contraindicated.
Source: NLP:sumatriptan
Sumatriptan + MethysergideContraindicated
Ergot-type medication causing prolonged vasospastic reactions with additive effects. Use within 24 hours of sumatriptan is contraindicated.
Source: NLP:sumatriptan
Sumatriptan + TriptansContraindicated
Other 5-HT1 agonists (triptans) have additive vasospastic effects with sumatriptan. Coadministration within 24 hours of each other is contraindicated.
Source: NLP:sumatriptan
Postmarketing reports describe weakness, hyperreflexia, and incoordination with concurrent SSRI and sumatriptan use, consistent with serotonin syndrome.
Source: NLP:escitalopram
Postmarketing reports describe weakness, hyperreflexia, and incoordination following concomitant use. Appropriate patient observation is advised if concomitant treatment is clinically warranted.
Source: NLP:escitalopram oxalate
Triptan that increases risk of serotonin syndrome with mirtazapine. Monitor for symptoms during initiation and dose increases.
Source: NLP:mirtazapine
Sumatriptan + TcasMajor
Serotonin syndrome cases reported during coadministration of sumatriptan and tricyclic antidepressants. Monitor for serotonin syndrome symptoms.
Source: NLP:sumatriptan
Butorphanol pharmacokinetics significantly altered when administered 1 minute after sumatriptan nasal spray (29% AUC decrease, 38% Cmax decrease). Analgesic effect may be diminished with concurrent use. Safety not established.
Source: NLP:butorphanol tartrate
Rare postmarketing reports of weakness, hyperreflexia, and incoordination. Monitor appropriately if concomitant treatment is clinically warranted.
Source: NLP:fluvoxamine maleate