Imitrex
Imitrex
Imitrex (Sumatriptan)Pharmacological action
Specific selective agonist 5HT1D-receptors (5-5-5-like), located mainly in brain blood vessels. Stimulation of 5HT1D-receptors leads to narrowing of vessels. The preparation does not operate on other subtypes 5HT-receptors (5HT2-5HT7).
In experimental researches it is shown, that Imitrex causes selective narrowing of carotids, not rendering thus essential influence on a cerebral blood flow. Carotids supply with blood intracranial tissues, including cerebral covers. It is considered, that expansion of these vessels and-or their edema is the basic mechanism of development of a migraine at the person. It is besides, experimentally established, that Imitrex inhibits activity of a trigeminal nerve.
The clinical effect becomes perceptible through 30 mines after peroral reception of a preparation in a dose of 100 mg, through 15 mines after intranasal introduction of a preparation.
Indications
- Cupping of acute attacks of a migraine with aura or without it.
Dosage regimen
Imitrex is not intended for application for the purpose of preventive maintenance.
Imitrex recommend to apply as soon as possible after occurrence of an attack of a migraine, but it is equally effective at any stage of an attack.
Inside for cupping of acute attacks of a migraine by the adult Imitrex prescribe in a recommended dose of 50 mg, in some cases - 100 mg. If migraine symptoms do not disappear and do not decrease after introduction of first Imitrex dose the preparation should not be prescribed repeatedly for cupping of a proceeding attack.
However Imitrex is possible to apply to cupping of the subsequent attacks of a migraine.
If symptoms have decreased or have passed, and then have renewed, it is possible to accept the second dose during the following 24 h provided that the interval between doses makes not less than 2 h. During any 24-sentry of the period the maximum dose Imitrex should not exceed 300 mg.
Tablets should be swallowed entirely, washing down with water.
If symptoms do not disappear and do not decrease after introduction of first Imitrex dose introduction of the second dose for cupping of a proceeding attack to prescribe does not follow. However Imitrex is possible to apply to cupping of the subsequent attacks of a migraine.
Side effect
From cardiovascular system: the arterial hypotension, a bradycardia, a heart consciousness, a tachycardia (including ventricular), transitional rising of a BP soon after preparation introduction are possible; on occasion - disturbances of a warm rhythm, transient changes of an electrocardiogram of ischemic type, a myocardial infarction, a spastic stricture of coronary arteries.
From the alimentary system: at some patients the nausea and vomiting were observed, but communication of these phenomena with Imitrex application is not proved; seldom - an ischemic colitis; on occasion - slight increase of activity of enzymes of a liver, a dysphagia, sensation of discomfort in a stomach.
From party TSNS: inflow, giddiness, delicacy (usually weakly or are moderately expressed and are transient); seldom - drowsiness, feeling of weariness; on occasion - convulsive attacks (the majority of such patients had in the anamnesis epilepsy or structural lesions of a brain which can lead to epilepsy development). Sometimes after Imitrex reception the diplopia, a flicker before eyes, a nystagmus, a scotoma, visual acuity depression becomes perceptible; very seldom - a transient partial loss of sight (thus it is necessary to mean, that sight disturbances can be bound with a migraine attack).
Allergic reactions: on occasion - dermal reactions (an eruption, an itch, an erythema), an anaphylaxis.
The other: the pain, sensation of a pricking, sensation of fever, feeling of gravity, pressure or compression are possible. These symptoms usually are transient, can be intensive and arise in any part of a body, including a thorax and a throat.
Contraindications
- Hemiplegic, basilar migraine forms;
- An ischemic heart disease (including a myocardial infarction, a postinfarction cardiosclerosis) or presence of the symptoms, allowing to assume or suspect ischemic heart disease presence;
- Occlusal diseases of peripheric vessels;
- A stroke or transient disturbance of a cerebral circulation (including in the anamnesis);
- An uncontrollable arterial hypertensia;
- The expressed disturbances of function of a liver/or of kidneys;
- Simultaneous reception of the preparations containing Ergotaminum or its derivatives;
- Simultaneous reception of inhibitors MAO and the period till 14 days after their cancellation;
- Pregnancy;
- The age of patients till 18 years also is more senior 65 years;
- A hypersensibility to a preparation.
With care prescribe at an epilepsy (including at any conditions with depression of a threshold of convulsive readiness), to patients with a controllable arterial hypertensia since the preparation can cause transitional rising of a BP.
Pregnancy and lactemia
The preparation is contraindicative to application at pregnancy since clinical experience of Imitrex application at pregnancy is limited.
With care it is necessary to apply a preparation in a lactemia. It is not recommended to nurse the child during 24 h after Sumatriptan reception.
Special indicatings
Imitrex is necessary to prescribe only in the event that the diagnosis of a migraine does not cause doubts.
Preparation do not apply for the purpose of preventive maintenance of attacks.
In the absence of effect from application of the first dose it is necessary to specify the diagnosis.
Imitrex is necessary to apply as soon as possible after the beginning of an attack of a migraine, however the preparation is effective at any stage of an attack (especially at a combination of an attack to a nausea and vomiting).
At Imitrex appointment for the purpose of cupping of a headache at patients with earlier not diagnosed migraine or at a migraine proceeding with atypical symptoms, it is necessary to exclude other potentially dangerous neurologic diseases (as well as at application of other agents intended for cupping of attacks of a migraine). It is necessary to mean, that patients with a migraine have a risk of development of cerebrovascular complications (including a stroke or transient disturbances of a cerebral circulation).
The preparation should not be prescribed to the patients concerning group of risk of development of a pathology from cardiovascular system, without pilot survey for the purpose of a disease exception. Women concern such patients in the postclimacteric period, men aged are more senior 40 years, the person with ischemic heart disease risk factors.
After preparation reception there can be such transient by-effects, as a pain and feeling of constraint in a breast. The pain can be intensive and irradiate in a neck. If there are bases to believe, that these symptoms are ischemic heart disease implication, it is necessary to spend corresponding diagnostic inspection.
With care prescribe a preparation to patients with a controllable arterial hypertensia (since transitional rising of a BP and peripheric vascular resistance is on occasion observed).
Medicinal interaction
At simultaneous reception with Ergotaminum the long vasospasm became perceptible. Imitrex is possible to prescribe not earlier than through 24 h after reception of the preparations containing Ergotaminum; and on the contrary, the preparations containing Ergotaminum, it is possible to prescribe not earlier than through 6 h after Sumatriptan reception.
Interaction between Imitrex and inhibitors MAO is possible, their simultaneous application is contraindicative.
There are separate reports on development of delicacy, a hyperreflexia and disturbance of coordination for patients after simultaneous Imitrex reception and selective inhibitors of return capture of a serotonin (application of a combination demands care and the control of a condition of the patient).
Conditions and periods of storage
Imitrex in the form of the tablets covered with a cover, it is necessary to store at temperature not above 30 C. The Period of validity of the tablets covered with a cover, 100 mg - 4 years.
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