IMIGRAN 100/MG TAB 2/TAB

Indications

Approved Uses

Acute treatment of migraine attacks with or without aura in adults

Off-Label Uses

No common, well-established off-label uses for the oral tablet; pediatric migraine use is generally age- and formulation-specific and often involves intranasal sumatriptan rather than routine off-label oral use.

Dosage & Administration

Dosing by Condition

migraine_acute_oral_tablet: initial_dose: 50 mg orally once (some patients may use 25-100 mg based on response/tolerability).
repeat_dose: If symptoms recur, may repeat the same dose after at least 2 hours; if no response to the first dose, do not repeat for the same attack.
max_dose: 200 mg in 24 hours., cluster_headache: note: Oral tablets are not recommended for cluster headache; use subcutaneous sumatriptan 6 mg (or intranasal in some cases) per guidelines/labeling.

Initial Dose

50mg or 100mg orally as a single dose at the first sign of migraine headache.

Maintenance Dose

Repeat dose of 50-100mg after 2 hours if migraine returns or partial response

Maximum Dose

200 mg in 24 hours for oral tablets (e.g., 50-100 mg, may repeat once after ≥2 hours; max 200 mg/day).

Childrens Dosage

Use and dose must be determined by your doctor.

Dose Adjustment Notes

Hepatic impairment: in mild to moderate impairment, the maximum single oral dose is 50 mg (and consider lower starting dose); severe hepatic impairment: oral sumatriptan is contraindicated/should not be used. Renal impairment: no adjustment generally required.

How to Take

Swallow 1 tablet whole with water as soon as possible after migraine pain begins (or when you recognize the attack); do not crush or chew; may be taken with or without food.

Side Effects

Common Side Effects

Tingling/paresthesia, flushing, sensations of warmth/heaviness/pressure (including chest/neck/throat/jaw tightness), dizziness, drowsiness/fatigue, nausea; (SC form) injection-site reactions.

Side Effect Frequency

Common (1-10%): atypical sensations (e.g., tingling/paresthesia, warm/cold sensation), flushing, dizziness, fatigue/asthenia, drowsiness/somnolence, nausea; pain/pressure/tightness sensations (including chest/throat/neck/jaw) are also commonly reported

Safety & Warnings

Contraindications

Contraindicated in: ischemic heart disease/previous MI/angina; coronary vasospasm (Prinzmetal); history of stroke/TIA; peripheral vascular disease/ischemic bowel disease; uncontrolled hypertension; severe hepatic impairment; hemiplegic or basilar migraine; hypersensitivity to sumatriptan; use within 24 hours of ergotamine/ergot derivatives or another triptan/5‑HT1 agonist; use with MAO‑A inhibitors or within 2 weeks of stopping them.

Warnings & Precautions

Use only for acute migraine with a clear diagnosis (not prophylaxis); assess cardiovascular risk and consider CV evaluation in patients with risk factors; do not use in hemiplegic/basilar migraine; avoid medication-overuse headache (limit frequent use, commonly >10 days/month); monitor for serotonin syndrome with serotonergic drugs; evaluate significant chest/neck/jaw symptoms and avoid further doses if ischemia suspected; use caution in mild-moderate hepatic impairment and in older patients.

Age Restriction

Not recommended in patients <18 years; use in elderly (≥65 years) is not recommended/should be used with caution due to limited data and higher cardiovascular risk (many labels state not recommended >65).

Driving Warning

May Cause Drowsiness

Drug Interactions

Drug Interactions

Major interactions: MAO‑A inhibitors (contraindicated and for 2 weeks after stopping); ergotamine/ergot derivatives (contraindicated within 24 h); other triptans/5‑HT1 agonists (avoid within 24 h); SSRIs/SNRIs and other serotonergic agents (including lithium and St John’s wort) - monitor for serotonin syndrome.

Interaction Severity

"contraindicated_major: ["MAO-A inhibitors (and within 2 weeks of stopping an MAOI)
Ergotamine/ergot derivatives or ergot-type medicines (avoid within 24 hours of each other)
Other 5-HT1 agonists/triptans (avoid within 24 hours of each other)"], "major_or_moderate_clinically_significant: ["SSRIs/SNRIs/other serotonergic drugs (risk of serotonin syndrome-monitor; not absolutely contraindicated in most guidance)
Linezolid or methylene blue (serotonin syndrome risk-avoid/monitor depending on clinical context)"], "other: ["Lithium (serotonin syndrome risk-monitor)"]

Food Interaction

No restriction.

Special Populations

Pregnancy

Category C

Children

Use and dose must be determined by your doctor.

Elderly

Standard adult dosing; however, use with caution due to increased risk of cardiovascular disease in elderly patients. Cardiovascular assessment recommended before use

Kidney Impairment

No dosage adjustment required in renal impairment (use clinical caution in severe renal disease due to limited data).

Liver Impairment

Mild-moderate hepatic impairment: do not exceed 50 mg as a single oral dose (use lower starting dose); severe hepatic impairment: contraindicated.

Storage & Patient Advice

Missed Dose

Not a scheduled medicine: take a dose at the onset of a migraine attack; if the first dose is ineffective, do not take a second dose for the same attack; if the headache improves then returns, a second dose may be taken after at least 2 hours (do not exceed 200 mg/24 h).

Stopping the Medicine

Safe to stop anytime; no tapering required.

Overdose

Overdose may cause marked hypertension or hypotension, tachycardia/bradycardia, chest pain/ischemia, arrhythmias, seizures, and serotonin-toxicity features; management is supportive with cardiac/vital-sign monitoring (often at least 10 hours) and urgent medical evaluation/poison center involvement.

Patient Counseling

Use for acute migraine only (not prevention). Take 1 tablet (100 mg for this product) as soon as migraine pain starts; swallow whole with water. If the headache improves then returns, you may take 1 more tablet after at least 2 hours; do not exceed 200 mg in 24 hours. If the first dose does not help at all, do not repeat for the same attack-seek medical advice. Avoid using with ergot medicines or another triptan within 24 hours, and tell your clinician about antidepressants/other serotonergic drugs. Seek urgent care for severe/persistent chest, jaw, neck or throat tightness, shortness of breath, or signs of stroke; avoid driving if dizzy/drowsy.

Monitoring Requirements

Assess cardiovascular risk before use; in patients with multiple CV risk factors, perform a cardiovascular evaluation prior to initiation and consider first-dose administration under medical supervision; monitor for chest symptoms, blood pressure elevation, and serotonin syndrome when combined with serotonergic agents.

Pharmacology

Mechanism of Action

Selective 5‑HT1B/5‑HT1D receptor agonist that constricts dilated cranial vessels and inhibits trigeminal neurotransmission/neuropeptide release, aborting migraine attacks.

Onset of Action

Oral onset: about 30-60 minutes, with meaningful assessment of response at ~2 hours.

Duration of Effect

Clinical benefit is typically assessed within 2 hours; recurrence can occur within 24 hours, which is why a second dose may be taken after 2 hours (within the 24-hour max).

Half-Life

Approximately 2 hours.

Bioavailability

Approximately 14% (oral bioavailability; often cited as ~14-15%)

Metabolism

Hepatic metabolism primarily via monoamine oxidase A (MAO-A) to an inactive indole acetic acid metabolite

Excretion

Primarily renal excretion, mainly as metabolites (major inactive indole acetic acid metabolite); only a small fraction is excreted unchanged in urine

Protein Binding

14-21%.

Product Information

Available Dosage Forms

Tablet (oral), nasal spray (intranasal), subcutaneous injection.

Composition per Dose

Each tablet: 100mg sumatriptan as sumatriptan succinate.

Generic Availability

Yes

OTC Alternatives

No OTC migraine-specific alternative to a triptan; OTC options for mild attacks include paracetamol (acetaminophen) and NSAIDs (e.g., ibuprofen, naproxen) and, where available OTC, aspirin (often with caffeine).

Pain Type

Migraine

Nsaid

No

Opioid

No

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