Imigra
Generic Name
Sumatriptan
Manufacturer
Apex Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| imigra 5 mg capsule | ৳ 4.02 | ৳ 40.20 |
Description
Overview of the medicine
Imigra 5 mg capsule contains Sumatriptan, a selective 5-HT1B/1D receptor agonist. It is primarily used for the acute treatment of migraine attacks, with or without aura. It works by constricting blood vessels in the brain and relieving migraine symptoms.
Uses & Indications
Dosage
Adults
For acute migraine, the usual oral dose of Sumatriptan is 25 mg, 50 mg, or 100 mg. A 5 mg capsule is a very low dose and its use should be specifically guided by a physician, possibly for titration in highly sensitive patients or those who cannot tolerate higher doses. If symptoms persist or recur, a second dose may be taken after at least 2 hours, not exceeding a total of 200 mg in any 24-hour period.
Elderly
Use with caution in elderly patients (>65 years) due to increased risk of cardiovascular events. No specific dosage adjustment is generally recommended, but lower starting doses might be considered.
Renal_impairment
No specific dosage adjustment is required for patients with mild to moderate renal impairment. However, use with caution in severe renal impairment as experience is limited.
How to Take
Take the capsule whole with water, as soon as migraine symptoms appear. Do not crush or chew. It can be taken with or without food.
Mechanism of Action
Sumatriptan selectively agonizes 5-HT1B and 5-HT1D receptors on intracranial blood vessels and trigeminal nerve endings. This leads to vasoconstriction of dilated cranial blood vessels, inhibition of inflammatory neuropeptide release from trigeminal nerve terminals, and reduced pain signal transmission.
Pharmacokinetics
Onset
Oral: ~30-60 minutes.
Excretion
Mainly renal (about 60% as inactive metabolite, 20% as unchanged drug); some fecal excretion.
Half life
~2 hours (elimination half-life).
Absorption
Rapidly absorbed after oral administration, but bioavailability is low (about 14%) due to first-pass metabolism.
Metabolism
Primarily hepatic, mainly by monoamine oxidase A (MAO-A) to an inactive indole acetic acid metabolite.
Side Effects
Contraindications
- Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction, documented silent ischemia).
- Prinzmetal's angina.
- Uncontrolled hypertension.
- History of stroke or transient ischemic attack (TIA).
- Peripheral vascular disease.
- Severe hepatic impairment.
- Concomitant use with ergotamine-containing medications or other triptans.
- Concomitant use with MAOIs (or within 2 weeks of discontinuing MAOI therapy).
Drug Interactions
SSRIs/SNRIs
Increased risk of serotonin syndrome; monitor patients closely.
MAO Inhibitors (MAOIs)
Contraindicated, as MAO-A metabolizes Sumatriptan, leading to increased Sumatriptan levels.
Ergotamine-containing drugs
Contraindicated due to additive vasospastic effects; do not use within 24 hours of each other.
Other 5-HT1 agonists (triptans)
Contraindicated due to potential for additive cardiovascular effects; do not use within 24 hours of each other.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose symptoms may include convulsions, tremor, inactivity, erythema, limb weakness, and decreased respiration. Management is supportive and symptomatic treatment. Continuous monitoring of cardiac and respiratory status is recommended.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Sumatriptan is excreted in breast milk; caution is advised when administered to a nursing woman. Consider temporarily discontinuing breastfeeding for 12 hours after taking a dose.
Side Effects
Contraindications
- Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction, documented silent ischemia).
- Prinzmetal's angina.
- Uncontrolled hypertension.
- History of stroke or transient ischemic attack (TIA).
- Peripheral vascular disease.
- Severe hepatic impairment.
- Concomitant use with ergotamine-containing medications or other triptans.
- Concomitant use with MAOIs (or within 2 weeks of discontinuing MAOI therapy).
Drug Interactions
SSRIs/SNRIs
Increased risk of serotonin syndrome; monitor patients closely.
MAO Inhibitors (MAOIs)
Contraindicated, as MAO-A metabolizes Sumatriptan, leading to increased Sumatriptan levels.
Ergotamine-containing drugs
Contraindicated due to additive vasospastic effects; do not use within 24 hours of each other.
Other 5-HT1 agonists (triptans)
Contraindicated due to potential for additive cardiovascular effects; do not use within 24 hours of each other.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose symptoms may include convulsions, tremor, inactivity, erythema, limb weakness, and decreased respiration. Management is supportive and symptomatic treatment. Continuous monitoring of cardiac and respiratory status is recommended.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Sumatriptan is excreted in breast milk; caution is advised when administered to a nursing woman. Consider temporarily discontinuing breastfeeding for 12 hours after taking a dose.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific expiry date mentioned on the packaging.
Availability
Available in pharmacies
Approval Status
Approved (for Sumatriptan generally)
Patent Status
Patent expired for generic Sumatriptan
Clinical Trials
Sumatriptan has undergone extensive clinical trials demonstrating its efficacy and safety in the acute treatment of migraine. The 5 mg capsule form would be subject to specific bioequivalence and clinical studies if newly introduced.
Lab Monitoring
- No routine laboratory monitoring is required.
- Before initiating sumatriptan in patients with multiple cardiovascular risk factors, a cardiovascular evaluation should be performed.
Doctor Notes
- Always rule out underlying cardiovascular disease before prescribing triptans, especially in patients with risk factors.
- Educate patients on proper use, signs of serious side effects, and the risk of medication overuse headache.
- Start with the lowest effective dose.
Patient Guidelines
- Take the medicine at the first sign of a migraine headache.
- Do not use for prevention of migraine or for types of headaches other than migraine.
- Do not exceed the recommended dose and frequency.
- If you experience chest pain, shortness of breath, or any unusual symptoms, seek immediate medical attention.
Missed Dose Advice
As Imigra is used for acute treatment of migraine attacks, there is no regular dosing schedule. Take a dose when a migraine attack occurs. If symptoms persist or recur, a second dose can be taken after at least 2 hours, not exceeding the maximum daily dose.
Driving Precautions
Imigra may cause drowsiness or dizziness. Patients should be advised to exercise caution when driving or operating machinery until they know how they react to the medication.
Lifestyle Advice
- Identify and avoid migraine triggers (e.g., certain foods, stress, lack of sleep).
- Maintain a regular sleep schedule and reduce stress levels.
- Stay hydrated and eat regular meals.
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