Sumatriptan (Imitrex, Glaxo Smith Kline) is a selective 5-hydroxytryptamine-1 receptor agonist. It can be used to treat an acute migraine headache by causing vasoconstriction in dural vessels and cranial arteries. However, it also may be associated with serious side effects in patients with coronary artery disease or other comorbid conditions. A simple questionnaire can help alert a patient to not use the drug before talking to a physician.


NOTE: Since Imitrex Nasal Spray is only available as a prescription drug, hopefully the prescribing health care provider will already know the answers to these questions. Such questionnaires might be useful for drugs directly marketed to patients by drug companies.


Questions about cardiovascular disease:

(1) Have you had a heart attack?

(2) Do you have any chest pain, heart disease, shortness of breath or an irregular heart beat?

(3) Do you have high blood pressure, a high serum cholesterol, obesity, or diabetes?

(4) Do you smoke cigarettes or use tobacco products?

(5) Do you have a strong family history for heart disease?

(6) Do you have Raynaud's syndrome or peripheral vascular disease?


Questions about neurologic disease:

(1) Do you have a history of epilepsy or seizures?

(2) Have you had a stroke or transient ischemic attack (TIA)?

(3) Is this headache different from your usual migraine headache?


Questions about other comorbid conditions:

(1) Do you have any disease of the liver?

(2) Do you have any disease of the kidney?


Questions about concurrent medications:

(1) Are you taking any other migraine medications, such as ergotamine, dihydroergotamine, methysergide or other 5-HT1 agonists?

(2) Are you taking any herbal treatments?

(3) Are you taking any medications for depression, include monoamine oxidase inhibitors or selective serotonin reuptake inhibitors (SSRI)?

(4) Do you have any allergies to any drugs?


Questions for women:

(1) Are you pregnant or are you likely to become pregnant?

(2) If you are using contraception, is it inadequate?

(3) Are you breastfeeding?

(4) Are you postmenopausal?


Questions for men:

(1) Are you over 40 years of age?


The patient should talk to a physician before using Imitirex Nasal Spray if:

(1) s/he gives one or more positive responses

(2) s/he are uncertain about an answer


To read more or access our algorithms and calculators, please log in or register.