The People's Perspective on Medicine



Imitrex is the first of a new kind of medicine prescribed to treat migraines.

It works through serotonin receptors to cause constriction of blood vessels to the brain. This in turn stops a migraine in progress.

It is effective for up to 80 percent of people with these debilitating headaches.

Imitrex is available both as an injection for self-administration and as tablets.

Side Effects and Interactions

Imitrex has, in rare cases, caused spasm of a coronary artery or a change in heart rhythm. This dangerous reaction makes it wise for people with heart disease to avoid Imitrex.

The most common side effects include, for the injection, pain at the injection site; sensations of warmth, cold, tingling, pressure, or tightness; flushing; pressure or pain in the chest; drowsiness; dizziness; and fatigue.

Common reactions to Imitrex tablets include sensations of warmth, cold, tingling, or pressure; flushing; chest tightness; dizziness; weakness; stiff neck; and a bad taste in the mouth.

Report symptoms or suspected side effects to the physician promptly.

Severe allergic reactions to Imitrex are rare but dangerous. Symptoms such as breathing difficulty or wheezing with hives or itching may signal life-threatening anaphylactic shock and require immediate emergency treatment.

Imitrex should not be given at the same time as ergot-containing migraine medicine such as Cafergot, Ergostat or Wigraine.

As noted above, Imitrex is potentially very dangerous in combination with MAO inhibitors such as Eldepryl, Nardil or Parnate.

Check with your doctor and pharmacist to make sure Imitrex is safe in combination with any other drugs you take.

Special Precautions

Imitrex must not be taken at the same time as MAO inhibitor medications (Eldepryl, Nardil, Parnate). At least two weeks should go by between the last dose of an MAO inhibitor and the first dose of Imitrex.

Imitrex should not be taken within 24 hours of an ergotamine or ergot-type migraine medicine.

Imitrex is inappropriate for people who have had angina or a heart attack, or who have blockage in the coronary arteries.

People with uncontrolled high blood pressure should not take Imitrex. Because it could cause coronary blood vessel spasm, a life-threatening condition, it should never be injected intravenously. It may also raise blood pressure and should not be given to anyone with uncontrolled hypertension.

There is some controversy about how well it can be determined who has heart disease and therefore should not get Imitrex.

The diagnosis of migraine should be confirmed with care before this medication is administered, as it can be dangerous if given to people with other neurological problems.

This medication is inappropriate for basilar or hemiplegic migraine.

Taking the Medicine

Imitrex injection is given subcutaneously during a migraine. The first signs of relief may be noticeable within 10 minutes, but the full effect may take an hour to develop.

Maximum dose is two injections in 24 hours. At least one hour should go by before a second injection is given.

Imitrex tablets are given with water or other fluids. The tablet is effective at any stage of the migraine, although the manufacturer recommends it be taken as early as possible.

If the headache returns after two hours or more, another tablet may be taken.

The maximum 24-hour dose for healthy people is 300 mg; those with chronic conditions may need to observe a lower maximum dose.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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This thread is now a few years old…I was just prescribed Dr Reddy’s Imitrex but after reading the comments here wonder if it will work at all. Does anyone have recent experience with Dr Reddy’s Imitrex? Perhaps the qulaity control has improved. By the way, I had very little benefit from the Ranbaxy Imitrex. Thanks

I have been taking Imitrex since it first came out– Originally it was in injection form, and i still take that depending on how my head feels. After 40 years of migraines i can just “tell.” The Imitrex injection worked beautifully. Then i began taking the generic made by Sun Pharmaceuticals and that worked well. Most recently Walgreens has provided Dr Reddy’s and the headache is lessened, but it takes two injections — sometimes more— to work. In addition, the auto-injector is unpredictable—- sometimes it works and sometimes it does not fire. I have returned 3 auto-injectors in the last two months. I visited the neurologist today and mentioned that to her. She confirmed that patients have noticed that there has been a change in the Dr Reddy’s formulation. She has provided me with a sample of Zembrace, also made by Dr. Reddy’s— but it is a branded drug that has proved to be successful… i am going to try it. I am also ordering a head device known as Cefaly, which has been successful in the prevention of migraines. It is expensive, but would be worth the money if it works!

I wanted to take a moment and ask if anyone else is having problems with their sumatriptan auto injector. I have had two different brands; Sun and Dr. Reddy’s. Sun worked fine, but I’ve consistently had problems since my pharmacy switched to Dr. Reddy’s.

So far I’ve wasted one out of every two pack. They seem to have mechanical problems. I have had a hard time engaging them to inject; they will be pressed flush against my skin and the indicator that provides the okay to go ahead showing, but won’t “fire” when I depress the injection button. Even those that have worked have taken multiple tries and repositioning. When it does finally work, there is no obvious difference from previous attempts.

Most recently, it went though and appeared as though it *had* injected, with the described clicks, but no injection and no medication came out. The shield was locked back, but would not dispense. That is until I removed it from my arm, where it remained locked back and yet engaged this time and sprayed the sumatriptan all over the wall. Needless to say, this was a frustrating outcome in the middle of a migraine.

I first assumed the problem was user error on my part, but as I had successfully used another brand with zero issues and had increasingly tried to be mindful with these new injectors, I don’t believe it was. They felt cheap and creaky- I suspect a big part of the problems I was having.

I guess this is as much a question and a cautionary tail. I would love to hear from others experience with this and other brands of autoinjectors.

I’ve been having the same issues with the Dr. Reddy’s autoinjectors. They don’t fire! I’ve used other brands without an issue. But my Walgreens switched to this garbage brand and it’s all they can get. The damn injectors don’t respond when the button is pushed. I have to manipulate the blue plastic tip by moving it up and down while holding the button down. Sometimes it makes the injector fire, but other times it does nothing. Looks like I’m gonna have to find a pharmacy that sells other brands. This one is crap.

I’ve suffered for a long time with migraines and cluster headaches since I was 16…I am 33 now. I have usually taken the pill form of different medications Imitrex being the best. I recently went to injections as to not get the potential rebound headaches etc.

I now have the Dr Reddy’s auto injectors and the first 3 I have tried did not work. These things are awful, I can not believe they’re even on the market. By far the worst brand I have used and I can not wait to fight the insurance company and Dr. Reddy’s to try and get my money back. In the meantime I am suffering through cluster headaches and in misery without any relief. Following to see suggestions for a work around good luck guys!

I have been using Sumatriptan injections for 3 years without any problem and also recently have been having the same problems. I had three from one batch that were not dispensing. So far, the manufacturer has not replaced them. Now I have two from the same batch that are doing the same thing. This is really a problem because as you know, your insurance company will only pay for so many injections a month. My doctor has now switched me over to a different type of injection, the pen style injection, which in my opinion is far less painful than the other type. However, I only get two to a pack as opposed to six.

We’re knew to this medication my daughter is 17yrs old got diagnosed with traveling migraines and I just want to know if she can take tylonal or over the counter cold and flu meds with imatrex

I have been taking Sumatriptan for six years now. At first, it was a miracle find for my headaches. Took them away every time. It seems that lately I have been having headaches all of the time (more than I ever have), and my usual dose of sumatriptan doesn’t work anymore. I also am experiencing dizziness and chest pains that come and go. I have read that this can be a symptom of long term use of this drug. I am trying to not be so dependent on this for my migraines, as I am scared I am damaging my body……has anyone else heard of this happening? And if it is causing damage, can it be healed by me stopping this medication?

I have also been experiencing chest pain, so I have opted to quit the drug altogether. You can die from heart failure, but not the pain of a migraine!(Although it feels as if you can!)

Even though taking Tylenol is pretty much like putting a band aid on a broken arm, it still psychologically helps me in that I feel like I am getting a minuscule amount of relief until the cursed thing ends (usually three days). I have also begun to tightly tie a belt from a robe or something around my forehead to help with the pain. Something about applying the pressure helps.

Since I’ve quit the drug, ( four months now) I still have occasional stabs to my heart that worry me. Have I caused permanent damage? Time will tell, but I have faith in how the body heals itself, and I am praying that it isn’t too late.
Best of luck to you.

Imitrex or the generic works on the blood vessels in the head. It constricts them so they do not press against adjacent nerves. It does not have the same effect as Tylenol, Aspirin, or Ibuprofen. Therefore there should be no issues with interaction. As a matter of fact it has been shown that taking Imitrex with Ibuprofen actually is very effective. However, remember Ibuprofen, Aspirin are NSAID’s (Non steroid Anti-Inflammatory) accordingly they can be hard on the stomach so take them with some food. On the other hand, while Tylenol is easy on the stomach it is not an anti-inflammatory and is very hard on the liver.

Aspirin is such an excellent and strong medication doctors are still of the opinion that it should be by prescription only. It is actually a good choice for pain as long as you use it sparingly and do not take it on an empty stomach.

I’ve had migraine headaches since I was 12 (now 52). Imitrex worked for me and so does Treximet which I’ve been using used since it was introduced. The full cost of Treximet when launched was about $170 US dollars. Over the few years that its been out, the price has increased to $255. That was until yesterday when I went to pick up my prescription and learned that the price of 9 pills is now $640.00 I did some research and learned that Glaxo sold the US rights to Pernix in May and wasted no time in jacking up the price. I consulted with my Doc this morning and he wrote me a new prescription for Sumatriptan which I filled for $54. I’m lucky to have great prescription insurance and could have stayed with Treximet but I don’t like the idea that Pernix raises the price without adding any value.

That was not a side effect – it was an allergic reaction, which is something that can be caused by any medication. Do you not ask about side effects when you are prescribed a medication? You are just as responsible for your own health and should not be left up to just the doctors.

Taking imitrex and naproxen separately is NOT the same as taking treximet. Treximet also has a slow-release additive so the medication lasts longer and is therefore more effective. I am disabled due to chronic migraines and I have been through all the various medications. I would advise anyone that is taking imitrex-type medication to also request a prescription for nausea medication, such as phenergan, as nausea is the most common side effect of this drug and not to mention as a result of the migraine itself.

I, too, have had migraines for 40 years. Name brand Imitrex was my life saver. My headaches were relieved within the hour. However when I changed over to generic Imitrex by Dr. Reddy, the results have not been so good. I may end up taking 3 pills over the course of the day to get rid of the headache and/or I may have to take a combination of the generic plus 1 or 2 Excedrin.
I was wondering if I was the only one having problems getting relief with the Dr. Reddy brand. Also the pills have increased in size and they are difficult to get out of the packaging – frustrating when your head hurts!

Thank goodness for Imitrex. I am in that small group of migraine sufferers that are male. I get very strong migraines and do not do well on narcotics.
This medication completely relieves the debilitating pain and allows me to function normally.

I have also been suffering from migraines for almost 40 years. I am fine with taking generic sumatriptan but, I used to get Aurobindo brand generic sumatriptan and they work GREAT. Now every pharmacy in my city seems to only sell DR. Reddy brand and they are useless. Dr. Reddy generic imitrex is like taking a placebo, I don’t think there is any sumtriptan in the pills. I can’t seem to find the Aurobindo brand anywhere. I am thinking about contacting the FDA to have the Dr. Reddy sumtriptan checked into. I think Dr. Reddy came in and offered all the pharmacies a lower price to sell their brand and are now selling the lowest quality sumtriptan available. Now I have to suffer.

I just switched from Sumatriptan to Amerge as my Gasto doc thought there might be some relation to my stomach issues and the Amerge was worthless. I spent three months with constant headaches before I went back to 100 mg of Sumatriptan which has always worked perfectly for me. When I did the switch from Imitrex to Sumatriptan I had no problems. I have had migraines for over 30 years, spent many days in the ER where they used to just knock you out for the day; so I was one of the original Imitrex users. I was very grateful when they came out with Imitrex first in injections and then in the pill form.

Have been migraining for years. After an episode that sent me to the ER four years ago, I began taking sumatriptan succinate, which worked beautifully. However, the headaches became more and more frequent, and I ended up having the “rebound” drug effect, i.e. I needed to take it more and more often, and its efficacy became shorter and shorter.
After a 10-day “detox” in May to get it out of my system, my headache doc put me on a preventative – a daily blood pressure medication (though my bp has always been low) – and my migraine occurrences have become infrequent – none at all in August. Hallelujah! When one does come in, I take Relpax, which works well.

I take generic Imitrex and it seems to do the trick for me however I experience tightness in my shoulders when taking it, so I am going to consult with my doctor about changing it.

anyone taking imitrex injections and had to switch to generic? I am fine with imitrex but am deathly allergic to the generic injections. has this happened to anyone else?

Imitrex put me in the ER last night for four hours! I wasn’t notified of the many side effects that can occur; my throat started to close up, severe nausea, vertigo, confusion; you name it, it happened. Definitely consult with your doctor on the many side effects of this medication before taking.

I have been having migraines for 45 years and have been using Imitrex since it’s been on the market. When Treximet was introduced it was very expensive so I stayed with Imitrex and then the generic (Dr. Reddy’s). My doctor informed me that the Treximet formula was just 85 mg of sumatriptan and 2 Alleve!
So I now take one 100 mg sumatriptan with 2 Alleve and my headache is gone in 30 to 45 minutes. This is a much less expensive solution and works just as well as Treximet.

I have been using sumatriptan for migraine relief for the past two years. The earlier I take it in the episode, the faster it seems to work. I’m not big on taking meds, so sometimes will try natural remedies first – a homeopathic remedy called Nat. Mur., oil of peppermint at several head pressure points, acupuncture, acupressure, heat and or ice. Sometimes one or a combination of these can work well enough to fend off the migraine developing into full-blown status.

I have had my imitrex substituted with sumatryptin and I have seen no difference whatsoever. As far as I am aware the pills contain exactly the same formula, anyway it worked ok for me. I didn’t have to increase my dosage.

I have been taken ERGOSTAT for many years first as a tablet for under the tongue and forward with changes to present ERGOTAMINE-CAFFEINE.
Ergostat is the only drug that has ever helped my migraines and now the pharmacist say it is no longer available, either generic or other?
I have suffered from migraines since a teenager and these drugs were the only thing to completely take them away, I don’t know what my doctor will prescribe. is there anything to take the place of ergostat even in the health food stores?

To respond to the user about Treximet, you should 100% try! It was actually proven to be more powerful and better than Imitrex! 1 pill takes away my entire migraine and no additional side effects. My doctor said that it is much different than the two generic pills of imitrex and naproxen. Something about Treximet being made to mimic an injection form in your body and that the pill is absorbed very quickly. All I know is that my migraine goes away and stays away!!! And with no hangover feeling. Trust me, just try it, no matter what. You will be amazed.

I used to suffer from the most dreadful migraine headaches. Sometimes they lasted 5 days. My Doctor would give me an injection to knock me out but, he didn’t want to use it too frequently. Eventually I went to a Naturopath who took me off all red meat, oranges etc. After having a migraine for 10 days, and not being allowed to take any pain killers, my migraine cleared up and I haven’t had one since. I still keep clear of red meat and oranges. This was well over 30 years ago.

I’ve been using Imitrex for many years. When it became generic, I found it to be equally effective. For anyone considering Treximet, which is a combination of Imitrex and Naproxen, it is just as easy and far less expensive to use sumatriptan with Aleve or the generic of Aleve to get an even better result.
The good thing for me about separating the two drugs is that I sometimes find Imitrex alone effective…at other times, I use the combination because the headache threatens to become a migraine.

My pharmacy also started substituting the generic brand because the insurance company dictated – they are paying. I can understand because Imitrex is so expensive. Noticed immediately the difference. Next refill the pharmacy substituted yet another generic brand which was even less effective. Spoke to my doctor and he had not heard of any complaints however did increase the dosage as I was on a very low dosage.
This seems to have helped. My insurance will not pay for the real thing under our plan and I’m retired, not rich. I too thought it must be me.

I have had migraines for 45 years and started Imitrex four years ago. I take 3 – 4 50mg pills a month and get relief in just over an hour.
Three months ago my pharmacy replaced the brand name with Dr Reddy’s generic. I am very satisfied and find absolutely no difference from the Imitrex brand .

I too had the same experience as VV posted above. I took the generic (mainly because of the cost factor be cause I do not have insurance currently) and I found that I had to take 4x the amount to get any relief. And at $150 a pack of 9 pills (for the generic) that’s CRAZY. What I don’t understand is why IF the same manufacturer makes the BRAND and the generic why would there be such a difference in my results?

I am so glad to see the two posts about generic sumatriptan. I am definitely going to call the pharmacy and ask them to substitute the generic for “the real thing” right now. I have noticed exactly the same thing– the generic prescription takes about twice as much to relieve a headache as Imatrex does. Thank you all for posting your experience and thoughts. I was beginning to think it was “all in my head.” LOL ;)

Until I read an article in Self Magazine about generic drugs and their problems I had not put two and two together. I also was switched to the generic, sumatriptan succunate for my Imitrex and discovered that it was not delivering the relief I was used to with Imitrex. I just thought it was me, not the drug that was ineffective. I just filled another prescription today, receiving the generic. I am returning it for Imitrex.

I have used Imitrex successfully for migraines for about two years now. Last month, my pharmacy substituted the generic, sumatriptan, for my Imitrex prescription. I found that I had to take 4-5 times as much to get relief and even at higher doses, did not get as much relief as I do from one tablet of Imitrex. I’m curious if others have reported similar results when comparing the two.

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