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After oral administration, sumatriptan is rapidly absorbed, 70% of the maximum plasma concentration is reached after 45 minutes. After receiving 100 mg of the maximum concentration in plasma is on average 54 mg / ml. Bioavailability is 14% as a result of the intensive first-pass metabolism and incomplete absorption.Relationship to plasma proteins dianabol side effects. Sumatriptan is metabolized by monoamine oxidase A. The main metabolite – indoleacetic analog output of sumatriptan, preferably in the urine in the form of free acid and glucuronide conjugate.

INDICATIONS
Relief of migraine attacks with or without aura.

CONTRAINDICATIONS

  • Hypersensitivity to any component of the formulation.
  • Hemiplegic, basilar migraine and oftalmoplegicheskaya form.
  • Coronary heart disease (CHD) (including myocardial infarction, myocardial infarction, angina, Prinzmetal), as well as the presence of symptoms to suggest the presence of coronary artery disease.
  • Occlusive peripheral vascular disease.
  • Stroke or transient ischemic attack (in Vol. H. In history).
  • Uncontrolled hypertension.
  • Receiving simultaneously with ergotamine or derivatives thereof (including methysergide).
  • The use of monoamine oxidase inhibitors (MAOIs), or earlier than 2 weeks after the cancellation of these drugs.
  • Severe liver and / or kidneys.
  • Age 18 years and older than 65 years (the safety and effectiveness of sumatriptan has not been established).
  • Pregnancy and lactation.

Carefully:

  • controlled hypertension;
  • diseases in which may change the absorption, metabolism or excretion of the drug (eg, renal or hepatic function);
  • epilepsy (including any condition with a reduction in seizure threshold);
  • in patients with hypersensitivity to sulfonamides (administration sumatriptan can cause allergic reactions, the severity of which varies from cutaneous manifestations of anaphylaxis. Data on the cross-sensitivity is limited, however, caution should be exercised in the appointment of sumatriptan in these patients).

DOSAGE AND ADMINISTRATION
Inside, swallowing the tablet whole and with water. If not indicated differently: the recommended dose is – one tablet of 50 mg. Some patients may need a higher dose – 100 mg. If migraine symptoms do not disappear or diminish after the first dose, then re-take the drug should not be for the relief of the attack dice. However, the drug can be used for subsequent migraine relief.

If the patient has felt the reduction or disappearance of symptoms after the first dose, and then resumed symptoms can take a second dose for the next 24 hours, provided that the interval between the reception of at least 2 hours. The dianabol side effects maximum dose of sumatriptan should not exceed 300 mg for 24- hour period.

SIDE EFFECT

Common
pain, feeling of pressure or heaviness, sensation of heat or tingling in different parts of the body.

Hot flashes, dizziness, weakness, feeling, feeling of tiredness, sleepiness usually are mild or moderate and transient in nature are.

Cardio-vascular system
Lowering blood pressure, bradycardia, tachycardia, a transient increase in blood pressure (observed shortly after administration of sumatriptan). Rarely – cardiac arrhythmias, transient ischemic ECG changes in the type of myocardial infarction, coronary artery spasm. Sometimes develops Raynaud’s syndrome.

On the part of the gastrointestinal tract
Nausea, vomiting, ischemic colitis (but link these side effects with sumatriptan has not been established); dysphagia, abdominal discomfort.

On the part of the central nervous system and sensory organs
Dizziness, rarely seizures (in some cases they have been observed in patients with a history of seizures or in conditions predisposing to seizures, some patients predisposing factors have been identified).Sometimes after taking sumatriptan noted diplopia, flashing before the eyes, nystagmus, scotoma, reduced visual acuity. Very rarely develops partial transient loss of vision. However, it should be borne in mind that visual impairment may be associated with a migraine attack itself.

Hypersensitivity reactions
ranging from cutaneous manifestations (rash, urticaria, pruritus, erythema) to rare cases of anaphylaxis.

From the laboratory parameters
Minor changes in the activity of “liver” transaminases.

OD
reception sumatriptan oral dose of 400 mg did not cause any side effects other than those listed above.

In case of overdose should be observed for the patients’ condition for at least 10 hours and spend symptomatic therapy if necessary. No data on the effect of hemodialysis or peritoneal dialysis on plasma concentrations of sumatriptan.

Interactions with other drugs
not mentioned sumatriptan interact with propranolol, flunarizine, pizotifenom and ethanol.

When concomitantly with ergotamine celebrated long vasospasm.

Sumatriptan may be administered no earlier than 24 hours after administration of preparations containing ergotamine; Conversely, the preparations containing al-gotamin can be administered no sooner than 6 hours after administration of sumatriptan.

Perhaps the interaction between sumatriptan and MAO inhibitors as well as sumatriptan and drugs from the group of selective inhibitors of serotonin reuptake (SSRIs). There are some reports about the weakness of the development, hyperreflexia and poor coordination in patients after administration of sumatriptan and drugs from the SSRI. In the case of co-administration of sumatriptan and SSRIs should be closely monitored condition of the patient.

SPECIFIC NOTES
sumatriptan should dianabol side effects be used only if the diagnosis of migraine is no doubt that when it should be used as soon as possible after the onset of a migraine attack, although it is equally effective when used at any stage of attack.

It can not be used as a preventive measure.

As with other protivomigrenoznyh funds, the appointment of sumatriptan in patients with previously diagnosed with migraine or patients with atypical migraine is necessary to exclude other potentially serious neurological conditions. It should be noted that patients with migraine are at increased risk of certain cerebrovascular events (stroke or transient ischemic attack).

Sumatriptan should not be administered to patients with suspected heart disease without prior examination in order to avoid cardiovascular disease. Such patients include postmenopausal women, men over the age of 40 years and patients with risk factors for coronary heart disease. Although the survey has not always possible to detect heart disease in some patients, in very rare cases, they develop side effects to the cardiovascular system. After receiving sumatriptan may experience transient intense pain and tightness in the chest, extending to the neck.

If there is reason to believe that these symptoms are a manifestation of coronary heart disease, it is necessary to conduct appropriate diagnostic testing. Do not exceed the recommended dose of sumatriptan.

Effects on ability to drive and / or other mechanisms
in patients with migraine may occur drowsiness, associated, with both the disease itself and the reception of sumatriptan, so they need to be especially careful while driving and working with moving machinery. steroids side effects