Imitrex

What is the most important information I should know about Imitrex?

• Do not take this medication without first talking to your doctor if you have heart disease including angina (chest pain), history of a heart attack, or high blood pressure. Serious, even fatal, side effects involving the heart have been reported with Imitrex and other similar medicines.
• Do not use Imitrex without first talking to your doctor if the headache you are experiencing is not like other migraines that you have had.
• Never take more of this medication than is prescribed by your doctor. If your symptoms are not being treated, contact your doctor.
• Imitrex may cause dizziness or drowsiness. Use caution when driving, operating machinery, or performing other hazardous activities until you can evaluate the effects of the medication.

What is Imitrex?

• Imitrex is a headache medicine. It is believed to work by causing vasoconstriction (narrowing) of blood vessels (arteries and veins) around the brain. Imitrex also reduces the release of substances in the body that contribute to headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.
• Imitrex is used to treat vascular headaches such as migraine and cluster headaches. Imitrex will not prevent migraines or cluster headaches or reduce the number of attacks. It will only treat a migraine or cluster headache that is already occurring.
• Imitrex may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before using Imitrex?

• Do not take this medication without first talking to your doctor if you have heart disease including angina (chest pain), history of a heart attack, or high blood pressure. Serious, even fatal, side effects involving the heart have been reported with Imitrex and other similar medicines.
• Do not take Imitrex without first talking to your doctor if you
  · are taking or have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days;
  · have taken an ergot-based medication within the last 24 hours--ergot-based medicines include methysergide (Sansert), ergotamine (Ergostat, Medihaler Ergotamine), dihydroergotamine mesylate (D.H.E., Migranal Nasal Spray), and ergotamine combination products (Cafergot, Ercaf, Wigraine, Cafatine, Cafatine-PB, Cafetrate);
  · have taken almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or zolmitriptan (Zomig) within the last 24 hours;
  · have basilar or hemiplegic migraine headaches;
  · have a history of stroke or transient ischemic attack (TIA or "mini-stroke");
  · are experiencing a headache that is not like other migraines you have had; or
  · have an allergy to Imitrex or other similar medicines such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).
• Taking Imitrex may be dangerous if you have any of the conditions, or have taken any of the medications listed above.
• Before taking Imitrex, tell your doctor if you have
  · risk factors for heart disease such as high blood pressure, a family history of heart disease, high cholesterol (a type of fat in the blood), are overweight, have diabetes, smoke cigarettes, are postmenopausal, or are a male over 40 years of age;
  · have circulation problems such as Raynaud's syndrome;
  · liver disease;
  · kidney disease; or
  · seizures or epilepsy.
• You may not be able to take Imitrex, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Imitrex is in the FDA pregnancy category C. This means that it is not known whether Imitrex will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Imitrex passes into breast milk and may affect a nursing infant. Do not use Imitrex without first talking to your doctor if you are breast-feeding a baby.

How should I use Imitrex?

• Use Imitrex exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take one tablet, administer an injection, or use the nasal spray as soon as you notice symptoms of a migraine, or at any time during an attack.
• Take each tablet whole with a full glass of water. Do not split the tablets. If your symptoms go away, but then return, you can take an additional oral dose with an interval of at least 2 hours between doses, up to a maximum of 200 mg in 24 hours, unless otherwise directed by your doctor. Do not take more than is recommended by your doctor.
• Administer Imitrex injectable directly beneath the skin (subcutaneously) as soon as you notice symptoms of a migraine or cluster headache. Ask your doctor or nurse to show you how to use the auto-injector, and read the directions that accompany the package. Do not inject this medication if you are unsure how. Never inject any Imitrex that is discolored or that has particles in it. If your headache is relieved, but then returns, you can use a second dose 1 hour after the first dose. Do not use more than 2 doses in 24 hours.
• For Imitrex nasal, gently blow your nose to clear any mucous. Insert the tip about 1 cm (one-half inch) into the nostril, pointing it straight up into the nasal canal. Block your other nostril and keep your head upright. Pump and sniff gently at the same time. Try not to sneeze or blow your nose just after using the spray. If your headache is relieved, but then returns, you can use a second dose 2 hours after the first dose. Do not use more than 2 doses in 24 hours.
• If your symptoms do not improve, contact your doctor before taking any more doses of Imitrex.
• Never take more of this medication than is prescribed by your doctor. If your symptoms are not being treated, contact your doctor.
• Store Imitrex at room temperature away from moisture, heat, light, and the reach of children. Throw away any unused medicine on the expiration date.

What happens if I miss a dose?

• Since Imitrex is used to treat migraines or cluster headaches as they occur and not to prevent them, missing a dose is not a problem. Use only the doses you need, according to your doctor's instructions.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Imitrex overdose might include tremor, redness, or a warm feeling in your arms and legs, irregular breathing, large pupils; an uncoordinated feeling; and chest pain.

What should I avoid while using Imitrex?

• Imitrex may cause dizziness or drowsiness. Use caution when driving, operating machinery, or performing other hazardous activities until you can evaluate the effects of the medication.

What are the possible side effects of Imitrex?

• If you experience any of the following serious side effects, stop using Imitrex and seek emergency medical attention:
  · an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  · severe or prolonged chest pain or an irregular heartbeat;
  · chest, jaw, or neck pain or tightness;
  · sudden or severe stomach pain;
  · problems seeing; or
  · unusual weakness or numbness.
• Other, less serious side effects may be more likely to occur. Continue to use Imitrex and talk to your doctor if you experience
  · nausea;
  · drowsiness or dizziness;
  · tingling, flushing, warmth, redness, or heaviness of a body part;
  · unpleasant taste in the mouth (nasal spray);
  · nasal irritation (nasal spray); or
  · injection site discomfort (injection).
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Imitrex?

• Do not use Imitrex if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) within the last 14 days. The combination could cause seizures, nausea, vomiting, sweating, flushing, and dizziness.
• Do not use Imitrex without first talking to your doctor if you have taken any of the following medicines within the previous 24 hours:
  · an ergot-based medication such as methysergide (Sansert), ergotamine (Ergostat), dihydroergotamine (D.H.E., Migranal Nasal Spray), and ergotamine combination products (Cafergot, Ercaf, Wigraine, Cafatine, Cafatine-PB, Cafetrate); or
  · another migraine medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or zolmitriptan (Zomig, Zomig-ZMT).
• Using Imitrex within 24 hours of any of the medicines listed above may be dangerous.
• Before using Imitrex, tell your doctor if you are taking a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva), or sertraline (Zoloft). You may not be able to use Imitrex, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed.
• Drugs other than those listed here may also interact with Imitrex. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has more information about Imitrex written for health professionals that you may read.