Patient leaflet - Sumatriptan 6 mg / 0.5 ml injection, Imigran Subject injection
1 What Sumatriptan is and what it is used for
What is in this leaflet
- 1 What Sumatriptan is and what it is used for
2 What you need to know before you use Sumatriptan
Each Sumatriptan pre-filled cartridge syringe contains a single dose of sumatriptan, which belongs to a group of medicines called triptans (also known as 5-HT1 receptor agonists).
- 3 How to use Sumatriptan
- 4 Possible side effects
- 5 How to store Sumatriptan
- 6 Contents of the pack and other information
7 Step-by-step guide to using Sumatriptan
Sumatriptan is used to treat migraine headache and a rare condition called cluster headache.
Migraine and cluster headache symptoms may be caused by the temporary widening of blood vessels in the head. Sumatriptan is believed to reduce the widening of these blood vessels. This in turn helps to take away the headache and relieve other symptoms such as feeling or being sick (nausea or vomiting) and sensitivity to light and sound.
3 How to use Sumatriptan
Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
Sumatriptan is usually injected into the thigh. There’s a step-by-step guide to using the syringe at the end of this leaflet (see section 7 overleaf).
If you use more Sumatriptan than you should
Using too much Sumatriptan could make you ill. If you have
used more than two injections in 24 hours:
→ Contact your doctor for advice.
If you have further questions about the use of this medicine, ask your doctor or pharmacist.
When to use Sumatriptan
- It’s best to use Sumatriptan as soon as you feel a migraine or a cluster headache coming on, although you can use it at any time during an attack
- Don’t use Sumatriptan to try to prevent an attack - only use it after your migraine symptoms start.
How much to use
Adults aged 18 to 65
- The usual dose for adults aged 18 to 65 with migraine or a cluster headache is one 6 mg injection.
Children under 18
Sumatriptan is not recommended for children under
18 years old.
Older people (aged over 65)
- Sumatriptan is not recommended for people aged over 65.
If your symptoms start to come back
- You can use a second Sumatriptan injection if at least 1 hour has passed since the first injection.
If the first injection has no effect
- Don’t use a new injection or any other Sumatriptan preparation for the same attack.
If Sumatriptan doesn’t give you any relief:
→ Ask your doctor or pharmacist for advice.
4 Possible side effects
Like all medicines, this medicine can cause side effects, but not everybody gets them. Some symptoms may be caused by the migraine itself.
Allergic reaction: get doctor’s help straight away
The following side effects have occurred but their exact frequency is not known.
- The signs of allergy include rash, hives (itchy rash); wheezing; swollen eyelids, face or lips; complete collapse.
If you get any of these symptoms soon after using Sumatriptan:
→ Don’t use any more. Contact a doctor straight away.
Very common side effects
(affect more than 1 in 10 people)
- Temporary pain at the site of injection
Stinging or burning, redness, swelling, bruising and
bleeding at the site of injection.
Common side effects
(affect up to 1 in 10 people)
Pain, heaviness, pressure or tightness in the chest, throat or other parts of the body, or unusual sensations, including numbness, tingling and warmth or cold. These effects may be intense but generally pass quickly.
- 2 What you need to know before you use Sumatriptan
- 3
Don’t use Sumatriptan:
Take special care with Sumatriptan
- If you’re allergic to sumatriptan, or any of the other ingredients of this medicine (listed in section 6)
- If you have a heart problem such as narrowing of the arteries (ischaemic heart disease) or chest pains (angina), or have already had a heart attack
- If you have circulation problems in your legs that cause cramp-like pains when you walk (peripheral vascular disease)
- If you have had a stroke or a mini-stroke (also called a transient ischaemic attack or TIA)
- If you have high blood pressure. You may be able to use Sumatriptan if your high blood pressure is mild and is being treated
- If you have serious liver disease
With other migraine medicines, including those which contain ergotamine, or similar medicines such as methysergide maleate; or any triptan or 5-HT1 agonist (such as naratriptan or zolmitriptan)
Talk to your doctor or pharmacist before using Sumatriptan.
If you have any extra risk factors
- If you are a heavy smoker or are using nicotine replacement therapy, and especially
- If you are a man aged over 40, or
- If you are a woman who has been through the menopause
In very rare cases, people have developed serious heart conditions after using Sumatriptan, even though they had no signs of heart disease before. If any of the points above applies to you it could mean you have a greater risk of developing heart disease - so:
→ Tell your doctor so that your heart function can be
checked before Sumatriptan is prescribed for you.
If you have a history of fits (seizures)
Or if you have other conditions which might make it more likely that you’ll have a fit - for example, a head injury or alcoholism:
With any of the following anti-depressants:
- MAOIs (monoamine oxidase inhibitors) or if you have taken an MAOI in the last 2 weeks
- SSRIs (selective serotonin reuptake inhibitors) including citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline
SNRIs (serotonin noradrenaline reuptake inhibitors) including venlafaxine or duloxetine.
→ Tell your doctor so that you can be supervised more
closely.
If you have had high blood pressure Sumatriptan may not be suitable for you
- → Tell your doctor or pharmacist before using Sumatriptan.
If you have liver or kidney disease
If either of these apply to you:
- For children under 18 years of age.
If any of these apply to you:
→ Tell your doctor, and don’t use Sumatriptan.
→ Tell your doctor or pharmacist before using Sumatriptan.
If you are allergic to antibiotics called sulphonamides
If so, you may also be allergic to Sumatriptan. If you know you are allergic to an antibiotic but you are not sure whether it is a sulphonamide:
→ Tell your doctor or pharmacist before using Sumatriptan.
If these effects continue or become severe (especially the chest pain):
→ Get medical help urgently. In a very small number of people these symptoms can be caused by a heart attack.
Other common side effects include:
- Feeling sick (nausea) or being sick (vomiting), although this may be due to the migraine itself
- Tiredness or drowsiness
- Dizziness, feeling weak, or getting hot flushes
- Temporary increase in blood pressure
- Shortness of breath
Aching muscles.
- Diarrhoea
- Pain in the joints
- Feeling anxious
- Excessive sweating.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.
Very rare side effects
(affect up to 1 in 10,000 people)
- Liver function changes. If you have a blood test to check your liver function, tell your doctor or nurse that you are using Sumatriptan.
Some patients may have the following side effects but it
is not known how often they occur
- Seizures/fits, tremors, muscle spasm, neck stiffness
Visual disturbances such as flickering, reduced vision,
double vision, loss of vision, and in some cases even permanent defects (although these may be due to the migraine attack itself)
- Heart problems, where your heartbeat may go faster, slower or change rhythm, chest pains (angina) or heart attack
- Pale, blue-tinged skin and/or pain in your fingers, toes, ears, nose or jaw in response to cold or stress (Raynaud’s phenomenon)
- Feeling faint (blood pressure may go down)
- Pain in the lower left side of the stomach and bloody diarrhoea (ischaemic colitis)
5 How to store Sumatriptan
Keep out of the sight and reach of children.
You may wish to carry Sumatriptan with you in case of a migraine attack
Always keep your injections in the case provided to protect
them from the light. Do not store above 30°C.
Don’t use Sumatriptan injection after the expiry date shown on the carton. The expiry date refers to the last day of that month.
Ask your doctor, practice nurse or pharmacist how to
dispose of your empty Cartridge Packs safely. You may be able to do this at your doctor’s surgery.
If you are taking anti-depressants called SSRIs
(Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin Noradrenaline Reuptake Inhibitors)
→ Tell your doctor or pharmacist before using Sumatriptan. Also see Other medicines and Sumatriptan, below.
Sumatriptan syringe may contain latex
The syringe needle shield may contain latex.
→ Tell your doctor if you are allergic to latex.
If you use Sumatriptan frequently
Using Sumatriptan too often may make your headaches worse.
→ Tell your doctor if this applies to you. He or she may recommend you stop using Sumatriptan.
If you feel pain or tightness in your chest after you use Sumatriptan
These effects may be intense but they usually pass quickly. If they don’t pass quickly, or they become severe:
→ Get medical help immediately. Section 4 (below) has more information about these possible side effects.
Other medicines and Sumatriptan
Tell your doctor or pharmacist if you’re taking, have recently taken or might take any other medicines. This includes any herbal products or medicines you’ve bought without a prescription.
Some medicines must not be taken with Sumatriptan and others may cause adverse effects if they’re taken with Sumatriptan. You must tell your doctor if you are taking:
- ergotamine also used to treat migraine, or similar medicines such as methysergide (see section 2 Don’t use Sumatriptan). Don’t use Sumatriptan at the same time as these medicines. Stop taking these medicines at least 24 hours before using Sumatriptan. Don’t take any medicines which contain ergotamine or compounds similar to ergotamine again for at least 6 hours after using Sumatriptan.
6 Contents of the pack and other information
- 7
What Sumatriptan contains
- Each pre-filled 0.5 ml cartridge syringe contains 6 mg sumatriptan (as the succinate) in saline.
- The other ingredient is 0.5ml sterile sodium chloride solution.
What Sumatriptan looks like and contents of the pack
Each Sumatriptan injection treatment pack comes complete with an injection device (Pen) and a Cartridge Pack which contains two pre-filled syringes.
Manufactured by: Glaxo Wellcome Operations, Harmire Road- County Durham, DL12 8DT, Barnard Castle, UK.
Procured from within the EU & repackaged by product License holder: Kosei Pharma UK Limited,
956 Buckingham Avenue, Slough Trading Estate,
SL1 4NL, UK.
Sumatriptan 6mg/0.5ml Injection,
PL: 39352/0075
POM
Leaflet date: 20/09/2019
other triptans/5-HT1 receptor agonists (such as
naratriptan, rizatriptan, zolmitriptan), also used to treat migraine, (see section 2 Don’t use Sumatriptan). Don’t use Sumatriptan at the same time as these medicines. Stop taking these medicines at least 24 hours before using Sumatriptan. Don’t take another triptan/5-HT1 receptor agonist for at least 24 hours after using Sumatriptan.
- MAOIs used to treat depression. Don’t use Sumatriptan if you have taken these in the last 2 weeks.
SSRIs and SNRIs used to treat depression.
Using Sumatriptan with these medicines can cause serotonin syndrome (a collection of symptoms which can include restlessness, confusion, sweating, hallucinations, increased reflexes, muscle spasms, shivering, increased heartbeat and shaking). Tell your doctor immediately if you are affected in this way.
- St John’s Wort (Hypericum perforatum). Taking herbal remedies containing St John’s Wort while using Sumatriptan may make side effects more likely.
Pregnancy and breast-feeding
- If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. There is only limited information about the safety of Sumatriptan for pregnant women, though up till now there is no evidence of any increased risk of birth defects. Your doctor will discuss with you whether or not you should use Sumatriptan while you are pregnant
- Don’t breast-feed your baby for 12 hours after using Sumatriptan. If you express any breast milk during this time, discard the milk and don’t give it to your baby.
Driving and using machines
Either the symptoms of migraine or your medicine may make you drowsy. If you are affected, don’t drive or operate machinery.
To listen to or request a copy of this leaflet in Braille, large print or audio please call: 01753515054 (UK only)
- 7 Step-by-step guide to using your Sumatriptan injection system
This leaflet shows you how to load the Subject pen and how to use it to give a dose of Sumatriptan medicine.
Please read this leaflet before using the injection system.
The GlaxoSmithKline Subject injection system is designed for use with a medicine called Sumatriptan.
Each Subject injection system comes complete with an Imigran cartridge pack.
The cartridge pack contains two pre-filled cartridge syringes.
Subject refill packs containing one Imigran cartridge are also available.
Important: In the unlikely event that you have a problem with the Sumatriptan
Subject injection mechanism, please:
- Return it to your pharmacist who will replace it; or
- Contact GlaxoSmithKline customer contact centre on freephone 0800 221441 and they will tell you how to return it.
Keep out of the sight and reach of children
How to give an injection using the Subject pen
- Read the leaflet fully and carefully before using the Subject pen
- Each Imigran injection system comes complete with a cartridge pack which contains two cartridge syringes pre-filled with Sumatriptan
- Use the photo on the left to help you identify the different parts of the injection system.
Do not load the pen until you are ready to give the injection.
- 1. Swing open the lid of the carrycase.
- 2.
Tear off the red seal from one of the
cartridges. Open the blue hinged lid
underneath the seal.
- 3. Take out the Subject pen from the
carrycase. Check that the white rod
is not sticking out beyond the end of
the pen (see picture 11). If it is
sticking out, place the pen back
inside the carrycase, push firmly
and the rod should click into place.
The pen is now ready for use.
- 7 Step-by-step guide to using your Sumatriptan injection system (continued)
- 9.
Return the used cartridge syringe to
the empty space in the cartridge pack
straight away.
- 11.
Withdraw the Subject pen from the
cartridge pack. Close the blue
hinged lid over the used syringe.
- 10.
Pushing the pen down into the
cartridge pack as far as it will go,
unscrew the pen by twisting it
anti-clockwise (about half a turn)
until it comes away.
- 12.
Put the Subject pen back into the
carrycase and push it down until it
stays down. It will click into place.
The Subject pen is then ready for
use next time.
- 13.
Close the lid of the carrycase until
you need to use the next cartridge
syringe. When you have used both
cartridges, remove and replace the
cartridge pack. (See right.)
- 4.
Push the Subject pen firmly into the
opened cartridge pack and gently
screw it clockwise (about half a turn)
until it will twist no further.
- 5.
Keeping your finger away from the
blue release button, pull the Subject
pen out of the cartridge pack. You
may have to pull quite hard to do this.
A safety catch stops accidental
injection until you are ready.
- 6.
The loaded pen is now ready for immediate use.
Do not try to put the loaded pen back into the carrycase until after you have used the injection, or the needle may be damaged and the pen will not inject correctly.
- 4.
How to remove the used cartridge pack
- 1.
When both syringes have been used,
you can remove the cartridge pack.
- 2.
Hold the carrycase and press the two
blue locating buttons with one hand.
- 3.
Gently pull out the cartridge pack
with the other hand.
- 4.
Be careful to dispose of your empty
cartridge packs safely. The cartridge
pack will hold the used Subject
cartridge syringes and needles until
you can safely dispose of them. You
should be able to do this at your
doctor’s surgery, so ask your doctor or
practice nurse.
- 7.
Press the pen with the long blue nose
end firmly against a clean area of skin
- usually the outside of the thigh (as in picture) - so the grey part slides down to cover part of the blue nose.
- 7.
This releases the safety catch.
- 8.
Hold the pen firmly and press the
blue release button at the top of the Subject pen. Count slowly to 10 keeping the Subject pen very still and the release button depressed.
Do not take the pen away from the skin too soon or some of the
injection may be wasted.
Then lift the pen away taking care not to touch the needle point.
How to put a new cartridge pack into the carrycase
Each Subject pen comes complete with an Imigran cartridge pack which contains two pre-filled cartridge syringes.
- 1.
Swing open the lid of the carrycase,
the Subject pen is already in its place.
- 2.
Push the cartridge pack into the
carrycase, pressing the blue buttons on either side so it slides in smoothly.
- 3.
It does not matter which side of the
cartridge pack is closest to the
Subject pen.
- 4.
The cartridge pack is in the right
position when the blue locating
buttons show through the holes on either side of the carrycase.
- 5.
Close the carrycase by swinging
back the lid and snapping it shut.
- 6.
You can keep your cartridge pack
safely in the carrycase until you need to give yourself an injection.
- 7.
Keep your carrycase and any refill cartridge packs at a temperature
below 30°C/86°F. If they are kept warmer than this for more than
24 hours it could spoil them.