sumatriptan

How much Sumatriptan can I take in a 24 hour period?

Orange County Migraine & Headache Center

For oral Sumatriptan the maximum total daily dose is 200 mg in adults typically taken as a 100 mg tablet and then repeated 2 or more hours later. For injectable Sumatriptan the maximum total mg in adults is 12 mg and can be broken up as 3 mg, 4 mg or 6 mg spaced 1 hour apart. For generic Sumatriptan nasal spray, the maximum adult dose in 24 hours is 40 mg and taken as 1 spray 1 nostril of 20 mg and may be repeated 2 or more hours later. For the Tosymra form of Sumatriptan nasal spray the total adult dose is 30 mg taken as 1 spray of 10 mg in 1 nostril and may be repeated every hour to a maximum of 3 sprays or 30 mg. For the Onzetra breath-powered nasal delivery of Sumatriptan, the maximum total adult dose is 44 mg/4 nosepieces with the initial dose of 22 mg (2 nosepieces) followed by 2 more nosepieces (1 in each nostril) 2 or more hours later.

An oral and a non-oral form of Sumatriptan can be safely taken in a 24-hour period. Often individuals may choose to use a non-oral for a morning migraine then later in the day take an oral form of Sumatriptan. Alternatively, an individual may start with an oral tablet of Sumatriptan then choose to rescue with a non-oral route of delivery if the headache escalates.

 

To make an appointment, please call 949-861-8717.

May I take Fioricet after taking Ubrelvy for acute migraine?

Orange County Migraine & Headache CenterFioricet and other Butalbital containing medications are CYP3A4 inducers and will cause Ubrelvy to be potentially less effective.  CYP3A4 is an enzyme and activation of this enzyme with an inducer like Fioricet will decrease exposure to Ubrelvy. So it would not be recommended to take both in the same 24-hour period.

 

To make an appointment, please call 949-861-8717.

May I take my Imitrex (Sumatriptan) in addition to Ubrelvy in the same 24-hour period?

Orange County Migraine & Headache CenterYes. In the clinical trials with Ubrelvy individuals were allowed to take a 2nd dose of Ubrelvy or take their triptan like Sumatriptan in 2 hours after dosing if not headache free. There does not appear to be any safely issue taking both Ubrelvy and a triptan in the same 24-hour period.

 

To make an appointment, please call 949-861-8717.

Summer Newsletter 2019

(Download PDF)

Summer Newsletter 2019

Orange County Migraine & Headache Center

Summer-a time to take vacation, enjoy longer days of sunshine, and a time to learn about some newly approved migraine & cluster headache treatments. This is truly an exciting time in the headache world. In recent weeks, three new treatments have received FDA approval in the United States. Emgality, one of the 3 CGRP monoclonal antibodies approved for prevention of migraine, got approved for the prevention of episodic cluster. Dr. Hutchinson will be going to Indianapolis (home of Lilly pharmaceutical) in July to learn the specifics of how to prescribe for cluster headache and will be a trained speaker to educate other health care providers.  Cluster headache patients will be able to inject Emgality just during their cluster periods unlike migraine patients who inject every month for prevention.  So, if you or someone you know has episodic cluster headaches, plan a visit at the end of July or sometime in August to get this treatment and have it on hand before your next cluster headache flare-up.

Two new treatments have received approval for migraine headache. One is called Tosymra and is a novel nasal delivery of Sumatriptan. It contains a patented membrane permeater enhancer that allows quick absorption into the nasal tissue. In fact, it has been shown to act as quickly as Sumatriptan 4 mg injectable. No needle and better tolerated than the injectable-a great option for migraine attacks associated with nausea and/or vomiting or for those attacks that have rapidly progressed and for which an oral tablet may not work quick enough to bring relief.  The other recently approved product is a device called Nerivio Migraine. It is a remote electrical modulation device placed on the arm and controlled by your smartphone. It is for the acute treatment of migraine.  Some advantages include good tolerability and non-invasiveness.  To learn more, go to www.Theranica.com.  Dr. Hutchinson will be attending an Advisory Board on July 13th in Philadelphia to learn more about this new device.

Lastly, I want to being to your attention that we offer both B-12 and B-complex injections in our office. They can address B-vitamin deficiencies as well as help energy. They can be especially helpful if you are stressed, recovering from an illness or surgery, suffer from fibromyalgia or chronic fatigue syndrome, or have absorption issues due to gastric by-pass. If you are interested in either injection, they can be scheduled as an injection visit with Aurora, our certified medical assistant (CMA).

If you are looking for updated information in the resource/handout section of our website, the following 4 handouts have been recently updated: Preventive Treatment of Migraine; Acute Treatment of Migraine; Medication Overuse Headache; and Cluster Headache. We are going to work on updating all handouts on our website. Feel free to offer suggestions you may have to improve our website and educational services to you, our patient.

Have a wonderful summer. We look forward to seeing you in our office so that we can help you be as headache-free as possible this summer.

 

Warm regards,

Dr. Susan Hutchinson & Dr. Molly Rossknecht

June 21, 2019