What Is Serotonin Syndrome? What You Need to Know If You Take SSRIs
Serotonin syndrome is a reaction to commonly prescribed medications and supplements. Learn what serotonin syndrome is, what causes it, and how to treat it.
sumatriptan
Used for Cluster Headache, Migraine
Used for Cluster Headache, Migraine
Sumatriptan nasal spray, also known by its brand names Tosymra and Imitrex, is a triptan medication for adults. It can treat migraine attacks with or without aura. Typically, you spray this medication into the nose at the start of a migraine attack. Sometimes, you might need to give yourself another dose. But using sumatriptan nasal spray more often than recommended can worsen headaches. Some common side effects of sumatriptan nasal spray include burning in the nose, throat irritation, and changes in taste.
What is Sumatriptan nasal spray?
What is Sumatriptan nasal spray used for?
How Sumatriptan nasal spray works
Sumatriptan nasal spray is a triptan. It works by attaching to and turning on serotonin receptors in the blood vessels and nerves in your brain. This causes the blood vessels to tighten as well as lower the release of proteins that cause inflammation and pain. This is thought to help relieve migraines.
Drug facts
| Common Brands | Imitrex, Tosymra |
|---|---|
| Drug Class | Triptan |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Sumatriptan nasal spray essentials
Side effects of Sumatriptan nasal spray
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Bad or unusual taste (14-25%)
- Nausea or vomiting (11-14%)
- Nose irritation (3-4%)
Less Common Side Effects
- Throat irritation
- Dizziness (vertigo)
- Burning feeling
Sumatriptan nasal spray serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Seizures
- Stroke: sudden weakness on one side of your body, headache, changes in your speech or vision, confusion
- Brain bleeds: sudden headache, nausea, vomiting, changes in vision or balance, weakness on one side of the body, trouble with movement
- Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness or twitching, uncoordinated movement, hallucinations
- Allergic reaction: rash or hives, swelling of face or throat, trouble breathing
- Blood vessel spasms: bloody diarrhea, severe stomach pain, loss of vision, tightness or numbness of legs or feet
- Heart attack: dizziness, chest pain or tightness, cold sweat, heartburn, tiredness, nausea, trouble breathing
- Dangerously high blood pressure: anxiety, blurry vision, chest pain, feeling confused, headaches, nausea, vomiting
More on Sumatriptan nasal spray side effects
The following Sumatriptan nasal spray side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Abdominal or stomach pain
blurred vision
changes in patterns and rhythms of speech
chest pain or tightness
chills
confusion
dizziness
fast, slow, irregular, pounding, or racing heartbeat or pulse
headache
muscle cramps and stiffness
neck, throat, or jaw pain
nightmares
shivering
sweating
swelling of the fingers, hands, feet, or lower legs
tightness in the chest
trouble breathing
Rare
Blindness
chest pain or discomfort
chest tightness or heaviness
flushing or redness of the skin, especially on the face and neck
increased blinking or spasms of the eyelid
itching, pain, redness, or swelling
lightheadedness, dizziness, or fainting
nerve pain
severe numbness, especially on one side of the face or body
severe or continuing stomach pain
trouble speaking or swallowing
twitching
unusual bleeding or bruising
vomiting of blood or material that looks like coffee grounds
weakness of the arms and legs
Incidence not known
Agitation
back, leg, or stomach pains
bleeding gums
changes in vision
muscle twitching
pinpoint red spots on the skin
poor coordination
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
restlessness
unexplained bleeding or bruising
unusually warm skin
weakness in the arm or leg on one side of the body, sudden and severe
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in color vision
change in hearing
difficulty with concentrating
drowsiness
increased sensitivity of the eyes to sunlight
joint pain
muscle aching or cramping
muscle stiffness or tightness
swollen joints
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$115.41
GoodRx discount
$12.62
Pros and cons of Sumatriptan nasal spray
Pros
- Good for people who can't swallow pills or want to avoid injections
- Small and easy to carry around
- Available in different strengths
- Can start to work within about 15 minutes
- Lower-cost generic available (Imitrex brand name only)
Cons
- Can irritate the nose and throat
- Can't be used to prevent migraines
- Hasn't been studied in children
- Not used to treat cluster headaches like the sumatriptan (Imitrex) injection
- Can cause worse headaches if used 10 or more days per month
Pharmacist tips for Sumatriptan nasal spray
- Make sure you know how to use sumatriptan nasal spray to avoid wasting the medication and accidentally hurting yourself. Read the Instructions For Use for the medication you're prescribed (Imitrex (sumatriptan) and generic nasal spray or Tosymra (sumatriptan) nasal spray) and ask your provider or pharmacist if you have any questions.
- Sumatriptan nasal spray can cause nose or throat irritation. This should go away within 2 hours of taking the dose.
- Don't take the sumatriptan nasal spray unit out to test the spray. This medication only has 1 spray in each unit. The dose will be wasted if you test the spray.
- Let your provider know if sumatriptan nasal spray doesn’t give you any migraine relief after the first dose. They can help you find out what type of headache you have, and see if there might be better options for you.
- If you have migraines multiple times a month requiring treatment with sumatriptan nasal spray, let your provider know. They can consider other medication options to help with your symptoms. If appropriate, they can also recommend medications for migraine prevention.
- Don't use sumatriptan nasal spray alone or in combination with other migraine medications for 10 days or more in a month because it can make headaches worse. You might experience daily headaches or more frequent migraine attacks if this happens. Talk to your provider about additional options for migraine relief.
- Sumatriptan nasal spray interacts with a lot of commonly used medications. Make sure to let your provider and pharmacist know about all the medications you're taking (including vitamins and supplements) before starting sumatriptan nasal spray so that they can help you check for interactions. If there are any serious interactions, your provider might even switch you to a different migraine medication.
- Sumatriptan nasal spray can make you feel sleepy or dizzy. Don't drive or do anything that requires a lot of attention until you know how this medication affects you. Also, don't drink alcohol because this can worsen sleepiness and dizziness.
- You might feel tightness, pressure, or pain in the chest, throat, jaw, or neck after taking sumatriptan nasal spray. This usually doesn't last long and will go away. However, these symptoms are very similar to symptoms of a heart attack or heart problems. Tell your provider if you notice these symptoms and they'll let you know if you need more medical attention.
Risks and warnings for Sumatriptan nasal spray
Sumatriptan nasal spray can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart problems and high blood pressure
- Risk factors: History of heart problems | Age older than 65 | Diabetes | Identified as obese | High blood pressure | Smoking tobacco | Family history of heart disease
Although rare, some people have reported serious heart problems, such as heart attack and heart rhythm problems, within a few hours after taking sumatriptan nasal spray. In addition, sumatriptan nasal spray can raise your blood pressure, rarely to dangerously high levels. If you have a history of heart problems, talk to your provider first to make sure sumatriptan nasal spray is as safe for you as possible. Make sure to check your blood pressure periodically while you're taking sumatriptan nasal spray, and let your provider know if it's higher than usual. Get emergency help right away if you experience a heart attack, severe headache, chest pain, or irregular heartbeat.
Stroke or other brain injury
Some people who've taken triptans like sumatriptan nasal spray have experienced life-threatening strokes or bleeding in the brain. Symptoms of such brain injury include sudden weakness on one side of the body, bad headaches, drooping face, trouble breathing, or changes in your speech or vision. These symptoms can be similar to migraine symptoms, so strokes can be mistaken for a migraine. To lower the risk of making this mistake, it's important that you're properly diagnosed with migraines before you start sumatriptan nasal spray. In addition, people who've had strokes before shouldn't take sumatriptan nasal spray. If you notice symptoms of a stroke, stop taking sumatriptan nasal spray and get medical help as soon as possible, especially if you haven't had a migraine before.
Blood vessel spasms
Sumatriptan nasal spray can cause blood vessel spasms in certain parts of your body. This can lead to serious stomach problems (e.g., stomach pain, bloody diarrhea), vision problems, and changes in sensation in your hands and feet. It can also lead to color changes in your hands and feet (can turn red, white, or bluish depending on how much blood is flowing through). If you notice these symptoms after taking sumatriptan nasal spray, don't take any more medication until you see a provider so they can check out what's going on.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels in your brain
Some people taking sumatriptan nasal spray have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome goes up if you use sumatriptan nasal spray with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, pain medications, and migraine medications.
Let your provider know about all the medications you take before starting sumatriptan nasal spray, as well as any medications you plan to take. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.
Allergic reactions
Allergic reactions to sumatriptan nasal spray are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). If you notice dizziness, difficulty breathing, a choking sensation, nausea, swelling around your eyes, or swelling of the lips or tongue after using sumatriptan nasal spray, get medical attention as soon as possible.
Seizures
- Risk factors: History of seizures or epilepsy
Some people have had seizures after taking sumatriptan nasal spray. This has happened in people who have a history of seizures, but can also happen in people who've never had them as well. Get medical help right away if you have a seizure while taking sumatriptan nasal spray.
Nose or throat irritation
Sumatriptan nasal spray might cause irritation in the nose and throat, which can include burning, numbness, tingling sensation, runny nose, pain or soreness. These symptoms are usually temporary and goes away in less than 2 hours, but let your provider know if this continues to bother you.
More on Sumatriptan nasal spray warnings
Sumatriptan nasal spray dosage
The average cost for 1 dose pack of 9 tablets of 100mg of Sumatriptan nasal spray is $14.09 with a free GoodRx coupon. This is 82.01% off the average retail price of $78.32. 
Nasal spray
Nasal spray| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 6 unit doses of 20mg | 1 nasal spray | $74.04 | $74.04 |
| 6 unit doses of 5mg | 1 nasal spray | $97.30 | $97.30 |
Typical dosage for Sumatriptan nasal spray
-
Sumatriptan nasal spray: The typical dose is either 5 mg, 10 mg, or 20 mg. The 5-mg and 20-mg doses are given as a single spray in one nostril. The 10-mg dose is given by spraying 5 mg once in each nostril. If your migraine doesn't go away or comes back, you can take a second dose at least 2 hours after your first dose. The maximum dose is 40 mg in a 24-hour period.
-
Tosymra (sumatriptan) nasal spray: The typical dose is 10 mg given as a single spray in one nostril. If your migraine doesn't go away or comes back, you can take up to two more doses given at least 1 hour apart. The maximum dose is 30 mg in a 24-hour period.
More on Sumatriptan nasal spray dosage
Interactions between Sumatriptan nasal spray and other drugs
Sumatriptan nasal spray may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Sumatriptan nasal spray. Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Almotriptan
- Bromocriptine
- Dihydroergotamine
- Eletriptan
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Frovatriptan
- Furazolidone
- Iproniazid
- Isocarboxazid
- Linezolid
- Methylene Blue
- Methylergonovine
- Methysergide
- Moclobemide
- Naratriptan
- Nialamide
- Phenelzine
- Procarbazine
- Rasagiline
- Rizatriptan
- Safinamide
- Selegiline
- Tranylcypromine
- Zolmitriptan
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Buprenorphine
- Butorphanol
- Citalopram
- Clomipramine
- Codeine
- Desipramine
- Desvenlafaxine
- Dexfenfluramine
- Dextroamphetamine
- Dibenzepin
- Dihydrocodeine
- Dolasetron
- Doxepin
- Duloxetine
- Escitalopram
- Fenfluramine
- Fentanyl
- Fluoxetine
- Fluvoxamine
- Granisetron
- Hydrocodone
- Hydromorphone
- Imipramine
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lorcaserin
- Melitracen
- Meperidine
- Metaxalone
- Methamphetamine
- Milnacipran
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nefazodone
- Nortriptyline
- Ondansetron
- Opipramol
- Oxycodone
- Oxymorphone
- Palonosetron
- Paroxetine
- Pentazocine
- Protriptyline
- Reboxetine
- Remifentanil
- Sertraline
- Sibutramine
- St John's Wort
- Sufentanil
- Tapentadol
- Tianeptine
- Tramadol
- Trazodone
- Trimipramine
- Venlafaxine
- Vilazodone
- Vortioxetine
- Ziprasidone
How much does Sumatriptan nasal spray cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Sumatriptan nasal spray contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Sumatriptan nasal spray will not be safe for you to take.
- Coronary artery disease
- Certain conditions that cause an irregular heart rhythm (arrhythmias)
- History of stroke or transient ischemic attack ("mini-stroke")
- History of hemiplegic or basilar migraines (because of higher risk of stroke)
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled high blood pressure
- Use of ergot-containing or ergot-type medications like dihydroergotamine (Migranal) or other triptans in the last 24 hours
- Currently take or have taken a monoamine oxidase inhibitor (MAOI), such as selegiline, in the last 14 days
- Severe liver problems (e.g., cirrhosis)
What are alternatives to Sumatriptan nasal spray?
There are a number of medications that your doctor can prescribe in place of Sumatriptan nasal spray. Compare a few possible alternatives below.
News about Sumatriptan nasal spray
Does Fioricet Work for Migraine Headaches?
Fioricet is a prescription med for migraines containing acetaminophen, caffeine, and butalbital, with limited effectiveness and potential side effects.
Sumatriptan Dosages for Adults: Your GoodRx Guide
Sumatriptan (Imitrex) for treating migraines comes in several forms and doses. Here is a guide on what you need to know about sumatriptan dosages for adults.
What Can You Take for a Headache While Pregnant?
Pregnancy limits your medication options, leaving mothers wondering how to treat headaches safely. Here are medications you can take for a headache while pregnant.
Different Types of Migraines: A Guide for Symptoms, Causes, and Treatments
There are eight types of migraines, each with its own symptoms, causes, and treatments. Learn what the different types of migraines are and how to find relief.
What Are the Best Migraine Treatments and Remedies?
From prescription medications to better sleep, finding the right migraine treatment can be hard. Learn the stages of a migraine and the best options for relief.
5 Outdated Migraine Medications You May Want to Upgrade
Some migraine medications have largely been replaced by safer or more effective options. Learn about the newer treatments available today with this guide.
Reyvow vs. Imitrex for Migraines: 8 Differences You Should Know About
Reyvow and Imitrex are two medications that treat migraines. Learn about differences in how they work, what forms are available, and more.
Ubrelvy vs. Imitrex (Sumatriptan): 7 Differences to Consider
Ubrelvy and sumatriptan treat migraines, but they belong to different drug classes and work in unique ways. Learn more about Ubrelvy vs sumatriptan with GoodRx.
Triptans vs. CGRP Antagonists: 5 Differences Between These Popular Migraine Medications
Triptans and CGRPs are classes of drugs for migraines. They work in unique ways and have a few key differences. Learn more about triptans and CGRPs with GoodRx.
Sumatriptan nasal spray images
