Sumatriptan (Transdermal)

Generic name: Sumatriptan

Drug class: Antimigraine agents

Dosage form: Transdermal patch

Root of administration: Transdermal

Dose: 6.5 mg over 4 hours

Mechanism of action: Sumatriptan is a selective agonist for serotonin receptors (5-HT1B and 5-HT1D) on intracranial blood vessels and sensory nerves of the trigeminal system. It causes cranial vessel constriction and inhibition of the release of pro-inflammatory neuropeptides, such as substance P and calcitonin gene-related peptide. The iontophoretic system (single-use patch) is applied to the upper arm or thigh. It uses low-level electrical energy to transport the drug across the skin. When activated, the electrical current is started, and the positively charged drug moves away from the anode. A controlled amount of sumatriptan is delivered into the bloodstream over 4 hours.

Drug usage cases:

• Acute treatment of migraine headaches with or without aura in adults
• Acute treatment of cluster headaches in adults

Drug contraindications:

• Hypersensitivity to sumatriptan or any component of the formulation, including allergic contact dermatitis to the transdermal patch
• Ischemic heart disease (including Prinzmetal angina, angina pectoris, myocardial infarction, or silent myocardial ischemia)
• Cerebrovascular events (including stroke, transient ischemic attack, or hemiplegic or basilar migraine)
• Peripheral vascular disease
• Uncontrolled hypertension
• Use of another triptan or ergot-related medication within the last 24 hours
• Concomitant or recent use of a monoamine oxidase inhibitor (MAOI)
• Severe hepatic impairment

Side effects:

• Application site reactions: redness, pain, itching, or skin rash
• Chest tightness or heaviness
• Abdominal or stomach pain
• Agitation
• Arm, back, or jaw pain
• Bloody diarrhea
• Blurred vision
• Chest pain or discomfort
• Chest tightness or heaviness
• Confusion
• Cough
• Diarrhea
• Difficulty with speaking
• Difficulty with swallowing
• Dizziness
• Double vision
• Fainting
• Fast, pounding, or irregular heartbeat or pulse
• Fever
• Headache
• Hives, itching, or skin rash
• Inability to move the arms, legs, or facial muscles
• Inability to speak
• Nausea
• Overactive reflexes
• Pain or discomfort in the arms, jaw, back, or neck
• Paleness or cold feeling in the fingertips and toes
• Partial loss of vision
• Poor coordination
• Pounding in the ears
• Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• Restlessness
• Seizures
• Shivering
• Slow or fast heartbeat
• Slow speech
• Sweating
• Talking or acting with excitement you cannot control
• Tingling or pain in the fingers or toes when exposed to cold
• Trembling or shaking
• Twitching
• Unusual tiredness or weakness
• Vomiting

Warnings:

• Risk of serious burns and potential permanent scarring with the use of the Zecuity patch
• Discontinue use and contact a healthcare provider if severe redness, pain, skin discoloration, blistering, or cracked skin occurs at the application site
• Remove the patch before undergoing MRI procedures to prevent skin burns
• Monitor for signs of serotonin syndrome, including agitation, confusion, diarrhea, fast or irregular heartbeat, muscle twitching, stiff muscles, trouble walking, sweating, high fever, seizures, chills, and vomiting
• Use caution in patients with a history of cardiovascular disease, including coronary artery disease, peripheral vascular disease, and cerebrovascular events
• Monitor blood pressure regularly during treatment
• Not recommended for use in patients under 18 years old

Use during pregnancy or breastfeeding:

It is not known whether sumatriptan transdermal passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine. The safety of sumatriptan during pregnancy has not been established. Tell your doctor if you are pregnant or plan to become pregnant. Use during pregnancy should be considered only if the potential benefit justifies the potential risk to the fetus.