Imigran Nasal Spray

What is Imigran Nasal Spray?

Imigran Nasal Spray is a medicine used to treat migraine headaches.

How does Imigran Nasal Spray work?

The active ingredient in Imigran Nasal Spray is a triptan called Sumatriptan. This is a painkiller that works by reversing the changes that happen during a migraine, making blood vessels in the brain narrower. Scientists do not fully understand all the causes of migraine, but it is believed the dilation (widening) of blood vessels is part of the process, and therefore by narrowing them it is possible to alleviate migraine symptoms. When it is sprayed into a nostril, the Sumatriptan is absorbed into the bloodstream through blood vessels in the nose.

How long does it take for Imigran Nasal Spray to work?

It takes around 15 minutes for Imigran Nasal Spray to take effect.

How long do the effects of Imigran Nasal Spray last?

In many cases Imigran Nasal Spray can alleviate migraine pain completely, but if symptoms do return you must leave at least 2 hours between doses, and administer no more than 2 10mg doses in any 24-hour period. If the spray has no effect, do not administer another dose as this will not work – try another type of painkiller instead.

Does Imigran Nasal Spray work for ocular migraines and migraines without headaches?

Imigran Nasal Spray should only be used at the onset of a migraine headache. It cannot be used to treat ocular migraines (migraines involving vision loss), hemiplegic migraines (characterised by muscle weakness on one side of the body) or basilar migraines (a migraine with brainstem aura).

How effective is Imigran Nasal Spray?

If regular painkillers are ineffective at treating your migraines, Imigran Nasal Spray or other triptan medicines may be more effective.

A 1998 study explored the effectiveness of sumitriptan nasal spray as opposed to sumitriptan tablets or injections. Patients reported that it had a faster onset than sumitriptan tablets. They reported that it was less effective than the injection, but had fewer side effects.

What triggers migraines?

Migraine triggers are different for every person, but common triggers include stress and anxiety, lack of sleep, bright lights, smoky environments or particular smells. Some people have dietary triggers that they find can bring on migraines, such as caffeine, cheese, alcohol, monosodium glutamate and aspartame.

Active ingredients

The active ingredient in Imigran Nasal Spray is Sumatriptan.

Inactive ingredients

Other ingredients in the spray are potassium dihydrogen phosphate, dibasic sodium phosphate anhydrous, sulphuric acid, sodium hydroxide and purified water.

Imigran Dosage

Imigran Nasal Spray is available in either 10mg or 20mg doses. 20mg is the usual recommended dose for adults, but 10mg may be effective for some people. Adolescents aged between 12 and 17 should use a 10mg dose.

How to use Imigran Nasal Spray

Use Imigran Nasal Spray as soon as you feel the symptoms of a migraine coming on. Blow your nose first if necessary. Remove the spray from the sealed blister packaging and insert it into one nostril as far as is comfortable, while blocking the other with a finger. As you breathe in, press the plunger to spray the medicine into your nostril. Stay upright and breathe in through your nose and out through your mouth for a few seconds after application, to ensure that the spray remains inside your nose.

Imigran Nasal Spray side effects

Some people may experience side effects when using Imigran Nasal Spray.   It’s very common to experience an unpleasant taste in the mouth, but this soon passes quickly.   Other common side effects may include:  

• Pressure, tightness or pain in the chest or throat, or unusual tingling sensations, which pass quickly. If the chest pain does not pass quickly, seek urgent medical help as this could indicate a heart attack.
• Irritation or a burning sensation in the nose or throat
• Nosebleeds
• Nausea or vomiting
• Feelings of tiredness or drowsiness
• Dizziness
• Temporary increase in blood pressure
• Higher blood pressure (this is a temporary side effect that should subside)
• Aching muscles.

  In very rare cases, Imigran Nasal Spray may cause changes to liver function. Seek medical advice if you think this may have happened to you, and always inform your doctor or nurse that you are taking Imigran Nasal Spray if you are having a blood test to check your liver function.   People using Imigran Nasal Spray on a frequent basis may develop ‘overuse headaches’. If this seems to be happening to you, talk to your GP.

Contraindications

Imigran Nasal Spray is not suitable for everyone. You should not take it if:  

• You are under 12 years old
• You are allergic to any of the active or inactive ingredients
• You have pre-existing liver problems
• You have heart disease or uncontrolled high blood pressure
• You are taking medications such as fluoxetine or fluvoxamine to treat depression.

  Remember that Imigran Nasal Spray is designed to treat the symptoms of migraine headache; it cannot be used to prevent migraines before the onset of symptoms, or to treat other types of headache.   This is not an exhaustive list of contraindications, so do check with your GP before beginning to take Imigran Nasal Spray.

Drug interactions

There are certain medicines and remedies that should not be taken with Imigran Nasal Spray. These include:  

• Other types of migraine medicines, including Ergotamine, Methysergide
• Other triptan-based medicines, including Naratriptan, Rizatriptan and Zolmitriptan
• SSRIs and SNRIs that are used to treat depression, including fluoxetine and fluvoxamine
• MAOIs that are used to treat depression
• St John’s Wort.

Imigran and pregnancy

Speak to your GP about using Imigran Nasal Spray if you are pregnant. There is no evidence of any risk to your unborn child, but the research is limited. Breastfeeding women should wait 12 hours after a dose of Imigran Nasal Spray before feeding their baby.

Driving whilst taking Imigran Nasal Spray

Your migraine, or the nasal spray, may make you feel drowsy. If this happens, do not drive or operate machinery.

Imigran and alcohol

Although there are no known interactions between alcohol and Sumatriptan, alcohol is a migraine trigger for some people, and could make any side effects worse.  

Using Imigran with other migraine treatments

Imigran Nasal Spray should not be used alongside other migraine medicines. However, it can be taken at the same time as painkillers such as Paracetamol, Aspirin and NSAID drugs like Ibuprofen.

Is Imigran Nasal Spray prevention or a cure?

Imigran Nasal Spray is an acute migraine medicine, which means it treats the symptoms of a migraine rather than preventing them. It cannot be used to prevent a migraine; only to alleviate the pain after its onset.

Does Imigran work for other headaches?

No, Imigran is not designed as a general headache treatment. Its active ingredient, Sumatriptan, specifically works to reverse the particular biological effects of a migraine headache. When used to treat a migraine, it can often alleviate symptoms other than headache, including nausea, vomiting and light sensitivity.

Would Imigran help a posterior stroke?

A stroke happens when the blood supply to the brain is cut off, either by a blood clot or a bleed. A posterior stroke is one that affects the function of the back part of the brain, and symptoms can include loss of co-ordination, vision problems and dizziness. A stroke is a medical emergency: do not attempt to treat it using any type of medication. Instead, call 999 immediately for urgent medical attention.

Imigran Nasal Spray vs Imigran Tablets

Sumatriptan can be taken as a nasal spray or in tablet form, and Imigran Nasal Spray and Imigran Tablets are branded versions of these medicines. One study reported that Sumatriptan spray is quicker to work and is more user-friendly than the tablets, which can have a bitter taste.

Alternatives to Imigran Nasal Spray

For those who want to use Sumatriptan to alleviate migraine symptoms, alternatives to Imigran Nasal Spray are Imigran tablets or a Sumatriptan injection.   Other triptan-based medicines are also available. These use medicines in the same triptan group, such as Zolmitriptan and Rizatriptan.   Alternatives to triptans include regular painkillers like paracetamol, aspirin and ibuprofen, and anti-sickness medicines. Some migraine medicines combine a painkiller and anti-sickness ingredients in one single dose.

Lifestyle changes that can help alleviate migraines

Although it’s thought that genetics have a large part to play in the onset and symptoms of migraines, lifestyle factors make a difference, too. These will differ for every individual, but can include getting more sleep, avoiding certain foods or drinks and steering clear of triggering environments such as bright lights. Keeping a diary can help you to identify which circumstances tend to bring on migraines for you. You may find that it is a combination of factors that seems to cause your migraines – such as drinking alcohol when you have not slept well.

Is Imigran Nasal Spray a painkiller?

Yes, Imigran Nasal Spray works by blocking the transmission of pain to nerves in the head and face.

Sources

• NHS > MIgraines
• Migraine Trust > Migraine with brainstem aura
• Migraine Trust > Hemiplegic Migraine
• Migraine Trust > Acute Medicines
• Cephalagia > How does sumatriptan nasal spray perform in clinical practice?
• All About Vision > Ocular Migraine
• Brain and Spine > Migraine
• Allina Health > Posterior Stroke