Sumatriptan (Imitrex) is used for the rapid relief of headache due to migraine or cluster headache. It belongs to the class of drugs called selective serotonin receptor agonists. Other medications in the same class include:
- Naratriptan (Amerge),
- Zolmitriptan (Zomig),
- Rizatriptan (Maxalt),
- Almotriptan (Axert),
- Frovatriptan (Frova), and
- Eletriptan (Relpax)
Sumatriptan (Imitrex) Uses:
-
Acute treatment of Cluster headache: SubQ (excluding Zembrace):
- It is used for the acute treatment of cluster headache episodes in adults as a single agent or combined with 100% oxygen.
-
Moderate to severe acute Migraine:
- Intranasal, Oral, SubQ: It is indicated for the acute treatment of migraine with or without aura in adults
Sumatriptan (Imitrex) Dose in Adults
Note:
- Limit use to less than 10 days every month to avoid over-medication headache.
- Do not use Triptans within 24 hours of the use of an ergotamine preparation or a different triptan.
Sumatriptan (Imitrex) Dose in the treatment of acute Cluster headache:
Note: As single agent or combined with 100% oxygen. Some experts recommend initial treatment with only 100% oxygen if available.
- SubQ (preferred route):
- Initial: 6 mg once; 3 mg may be just as effective in some patients.
- If initial dose was effective but headache recurs, may repeat a dose (usually same as first dose) after ≥1 hour;
- some experts recommend waiting ≥2 hours before repeat dose.
- Maximum dose: 6 mg per dose; 12 mg in 24 hours.
- Intranasal Solution (alternative route) (off-label):
- Initial: 20 mg administered once in the nostril opposite the headache's side.
- If the first dose worked but the headache returned, you could try again in about two hours.
- 40 mg in 24 hours is the maximum dose.
Note:
- According to some experts, when treating acute cluster headache, following initial treatment for prevention of cluster headaches, patients with ≥2 headaches per day may temporarily receive >2 doses of sumatriptan in one day (either SubQ or intranasal at the usual dose and interval) until prophylaxis becomes effective.
Sumatriptan (Imitrex) Dose in the treatment of Acute moderate to severe Migraine:
Note:
- As single agent or combined with an NSAID (eg, naproxen).
- Administer at first sign of headache.
- When attack is complicated by vomiting or severe nausea, it is prefered to use non-oral preparation.
- Oral: Initial: Usual:
- 50–100 mg all at once.
- The same dose may be given again after around two hours if the first dose was only partially successful or the headache returned.
- 100 mg maximum per dose; 200 mg maximum per day.
- Intranasal:
- Solution: Initial: Usual:
- 20 mg once in a single nostril.
- If initial dose was partially effective or headache recurs, the same dose may be repeated after ≥2 hours.
- Maximum dose: 40 mg per 24 hours.
- Powder, breath-activated:
- Initial: 22 mg once;
- Use a product-specific delivery system to administer one 11 mg capsule through each nostril.
- The same dose may be given again after around two hours if the first dose was only partially successful or the headache returned.
- 44 mg is the maximum dose every 24 hours. Refer to the administration guidelines applicable to the product.
- Spray:
- 10 mg once in one nostril at first.
- The same dose may be given again after about an hour if the first dose was only partially effective or if the headache returned.
- 30 mg is the maximum dose every 24 hours.
- You could also give a dose of another sumatriptan medication at least one hour later (use following another 5-HT agonist is contraindicated).
- Solution: Initial: Usual:
- SubQ:
- Initial: Usual:
- 6 mg once.
- If initial dose was partially effective or headache recurs, same dose may be repeated after ≥1 hour.
- If 6 mg was not tolerated, subsequent doses of 1 to 5 mg may provide sufficient relief with better tolerability.
- Maximum dose: 6 mg per dose; 12 mg in 24 hours.
- Initial: Usual:
Sumatriptan (Imitrex) Dose in Children
Sumatriptan (Imitrex) Dose in the treatment of Migraine:
Note:
- Results of clinical studies are mixed with regards to efficacy, particularly with oral and SubQ sumatriptan doses; a 2004 practice parameter concluded that sumatriptan nasal spray was effective for the acute treatment of migraines in adolescent patients.
-
Intranasal:
-
Children 5 to 12 years: Limited data available:
- Customized dose of 5 mg, 10 mg, or 20 mg administered in one nostril as a single dose as soon as possible after the onset of migraine.
- Weight-based dosing regimen:
- Body weight: 20 to 39 kg: 10 mg/dose;
- body weight ≥40 kg: 20 mg/dose;
- however, relatively few children <12 years old were included in the study.
- Intranasal dosages of 20 mg/dose were employed in a short, randomised, double-blind, placebo-controlled research involving 14 kids (range: 6 to 9 years; median: 8.2 years).
-
Children ≥12 years and Adolescents ≤17 years: Limited data available:
- As soon as possible after the commencement of a migraine, 5 mg, 10 mg, or 20 mg should be delivered in one nostril as a single dose; the dosage should be customised.
-
Adolescents ≥18 years: Initial single dose:
- Powder: (Onzetra Xsail):
- 22 mg (11 mg nosepiece in each nostril).
- If dose partially effective or headache recurs, same dose may be repeated if more than two hours have elapsed since initial dose (maximum: 44 mg [4 nosepieces] per 24 hours or 22 mg [2 nosepieces] and one dose of another sumatriptan product [separated by ≥2 hours] per 24 hours).
- It has not been shown safe to cure more than four headaches on average in a 30-day span.
- Solution:
- 5 mg, 10 mg, or 20 mg administered in one nostril as soon as possible after the onset of migraine; the dose should be customized according to patient need.
- A 10 mg dose may be administered as 5 mg in each nostril.
- If dose partially effective or headache recurs, the same dose may be repeated if more than two hours have elapsed since initial dose, not to exceed a total daily dose of 40 mg.
- A higher proportion of patients in clinical trials reacted to first dosages of 20 mg compared to 5 or 10 mg.
- It has not been established that treating more than four headaches on average in a 30-day period is safe.
- Powder: (Onzetra Xsail):
-
-
Oral:
-
Adolescents ≤17 years:
- Limited data available; efficacy results variable; efficacy of oral sumatriptan was not established in five controlled trials in adolescent patients; frequency of adverse events was dose-related and age-dependent (ie, younger patients reported more adverse events)
-
Adolescents ≥18 years:
- Initial single dose: 25 mg, 50 mg, or 100 mg.
- If adequate pain relief not achieved at 2 hours, a second dose may be given.
- Results from clinical trials show that initial doses of 50 mg and 100 mg are more effective than doses of 25 mg, and that 100 mg doses may have increased potential for side effects and are not superior to 50 mg.
- Maximum daily dose (cumulative 24 hours): 200 mg total dose/24 hours.
- It has not been shown safe to cure more than four headaches on average in a 30-day period.
-
-
SubQ:
-
Children ≥6 years and Adolescents ≤17 years:
- 3 to 6 mg single dose. An open-labeled prospective trial of 17 children 6 to 16 years with juvenile migraine used SubQ doses of 6 mg in 15 patients weighing 30 to 70 kg, and 3 mg/dose in two children weighing 22 kg and 30 kg.
- Another open-label prospective trial in 50 consecutive children (ages 6 to 18 years) with severe migraine used SubQ doses of 0.06 mg/kg/dose.
- Relief was reported as good/excellent in 84% of the patients; 16% reported fair to poor relief; additional studies are needed.
-
Adolescents ≥18 years:
- Imitrex, Sumavel: Initial: 6 mg;
- if adverse effects not tolerated use lower doses:
- Imitrex: 1 to 5 mg or
- Sumavel: 4 mg.
- if required repeat ≥1 hour after starting dose;
- maximum dose: 6 mg/dose;
- The total maximum 24-hour dose: 12 mg (two 6 mg injections).
- Controlled clinical trials do not show benefit of a second 6 mg dose in non responders.
- Zembrace: Initial: 3 mg; after 1 hour may repeat dose if needed up to 4 injections separated by at least 1 hour;
- may also administer following the dose of another sumatriptan product if separated by at least 1 hour; total maximum 24-hour dose: 12 mg.
-
Sumatriptan Pregnancy Risk Category: C
- A study that used healthy, full-term human placentas was conducted and found that only a small amount of sumatriptan crossed the placenta.
- Data from September 2012 on 617 pregnancies (including 7 that were also exposed to Naratriptan) was collected.
- Sumatriptan exposure in the first trimester was associated with a 4.2% risk of major birth defects. There was no consistent pattern of birth defect cases.
- A study of data from the Swedish Medical Birth Register between 1995 and 2008 revealed that 5-HT1B/1D anabolic exposure led to pregnancy outcomes.
- Major congenital abnormalities were not increased by the first trimester sumatriptan administration (2.229 mg).
- The Norwegian pregnancy registry study's data revealed no elevated risk of significant congenital abnormalities.
- The study involved 415 women who had used sumatriptan in the first trimester between 2004 and 2007.
- Sumatriptan might be used to treat cluster headaches in pregnancy.
- For the initial treatment for migraines in pregnancy, other agents are preferable. However, sumatriptan can be used if first-line drugs fail to work.
Sumatriptan can be used during breastfeeding
- Breast milk contains sumatriptan.
- The mean relative infant dose of sumatriptan (RID) was 3.5% according to a study comparing it to a maternal weight-adjusted dose of 6mg.
- When the RID is less than 10%, breastfeeding is generally acceptable.
- Sumatriptan's RID was calculated with a milk concentration of 87.2 mg/L (range 61.9- 112.5 mcg/L).
- The milk concentration was determined after the maternal administration of sumatriptan 6mg SubQ to 5 women (mean length of lactation 22.2 week). Milk concentrations were measured over 8 hour.
- Breast milk had a median half-life of 2.2 hours. Maximum milk concentrations were between 1.7 to 3.5 after maternal dose.
- Manufacturers recommend that you refrain from breastfeeding for 12 hours after oral, subcutaneous or intramuscular administration.
- According to some sources, breastfeeding can be continued if necessary.
Dose in Kidney Disease:
- The manufacturer's label does not disclose any dose modifications (has not been studied).
- Therefore, no dosage modification is anticipated because inactive drugs are extensively metabolised.
Sumatriptan (Imitrex) Dose in Liver disease:
-
Hepatic impairments mild to moderate:
- Oral:
- Liver disease can increase the bioavailability and bioavailability oral sumatriptan.
- Do not exceed 50 mg if treatment is required.
- Intranasal
- The manufacturer's label does not provide any dosage adjustments (has not been tested).
- Due to the extensive metabolism of inactive agents, however, there is no need to adjust the dosage.
- SubQ
- There is no need to adjust the dosage.
- Oral:
-
Severe hepatic impairment
- In severe hepatic impairment, contraindicated formulations for oral, subcutaneous, and intranasal (Imitrex, Zembrace injection) are
- Sumavel should not be used in severe hepatic dysfunction.
Common Side Effects of Sumatriptan Injection:
-
Central Nervous System:
- Tingling Sensation
- Dizziness
- Vertigo
- Feeling Hot
-
Local:
- Injection Site Reaction
- Warm Sensation At Injection Site
Less Common Side Effects Of Sumatriptan Injection:
-
Cardiovascular:
- Flushing
- Chest Discomfort
- Chest Tightness
- Chest Pressure
-
Central Nervous System:
- Burning Sensation
- Feeling Of Heaviness
- Sensation Of Pressure
- Numbness
- Paresthesia
- Sensation Of Tightness
- Drowsiness
- Sedated State
- Local Discomfort
- Headache
- Strange Feeling
- Tight Feeling In The Head
-
Dermatologic:
- Diaphoresis
-
Gastrointestinal:
- Nausea And Vomiting
-
Neuromuscular & Skeletal:
- Asthenia
- Neck Pain
- Neck Stiffness
- Myalgia
-
Respiratory:
- Nasal Discomfort
- Sinus Discomfort
- Bronchospasm
Common Side Effects Of Nasal Sumatriptan:
-
Gastrointestinal:
- Dysgeusia
- Unusual Taste
- Nausea
- Vomiting
-
Respiratory:
- Nasal Discomfort
Less Common Side Effects Of Nasal Sumatriptan:
-
Central Nervous System:
- Localized Numbness
- Nasal Cavity Pain
- Paresthesia
- Dizziness
- Vertigo
- Localized Burning
-
Local:
- Local Irritation
-
Respiratory:
- Rhinorrhea
- Sore Nose
- Nasal Signs And Symptoms
- Sinus Discomfort
- Rhinitis
Less Common Side Effects Of Sumatriptan Oral Tablets:
-
Cardiovascular:
- Hot And Cold Flashes
- Chest Pain
- Chest Pressure
- Chest Tightness
-
Central Nervous System:
- Pain
- Sensation Of Pressure
- Paresthesia
- Fatigue
- Feeling Of Heaviness
- Malaise
- Sensation Of Tightness
- Heaviness Of Chest
- Vertigo
-
Gastrointestinal:
- Sore Throat
-
Local:
- Local Pain
-
Neuromuscular & Skeletal:
- Jaw Pain
- Jaw Pressure
- Jaw Tightness
- Neck Pain
-
Respiratory:
- Pharyngeal Edema
Route Unspecified:
Side effects of Sumatriptan (Imitrex):
-
Cardiovascular:
- Ischemia
- Raynaud's Disease
-
Hematologic & Oncologic:
- Splenic Infarction
Contraindications to Sumatriptan (Imitrex):
- Hypersensitivity to sumatriptan and any other component of the formula (eg, angioedema or anaphylaxis).
- Ischemic heart disease, signs and symptoms of ischemic cardiomyopathy (coronary arterial vasospasms, Prinzmetal anginas, angina pectoris), MI, silent myocardial infarction.
- History of cerebrovascular Syndromes
- History of basilar or hemiplegic migraine.
- Peripheral vascular disease (including Ischemic Bowel Disease)
- Hypertension uncontrolled
- Use within 24 hours after ingesting ergotamine derivatives.
- coadministration, or within two weeks after stopping MAO type A inhibitors.
- Wolff-Parkinson White syndrome
- Severe hepatic impairment (except Sumavel).
Canadian labeling: Additional contraindications not in the US labeling
- Heart disease causing valve damage
- Significant underlying cardiovascular disease (eg atherosclerotic, congenital heart disease)
- Ophthalmoplegic migraine
Warnings and precautions
-
Anaphylactic and anaphylactoid reactions
- Anaphylactic, anaphylactoid and hypersensitivity reactions (including angioedema), have been observed.
-
Cardiac events
- With 5-HT agonist administration, some of these events occurred within hours.
- If these side effects persist, discontinue sumatriptan.
- Patients experiencing chest pain/pressure/tightness, or other symptoms that suggest angina should be examined for coronary artery disease and Prinzmetal angina. If dosing is recommenced and the same symptoms recur after dosing, ECG monitoring may be recommended.
-
Cerebrovascular events
- 5-HT agonists have been linked to stroke and subarachnoid hemorhage (may prove fatal).
- If a cerebrovascular emergency occurs, discontinue use.
-
Depression in the CNS:
- CNS depression may result in weakness, sleepiness, or vertigo. Both the body and the mind may be impacted by this. Patients should use caution when performing jobs that call for mental clarity (eg driving or operating machinery).
-
High blood pressure
- Patients with no history of hypertension have rarely experienced significant elevations in blood pressure.
- Patients with uncontrolled hypertension are contraindicated
-
Ocular effects
- Use of 5-HT agonist has been associated with partial and permanent vision loss, as well as temporary and permanent blindness.
-
Serotonin syndrome
- Serotonin syndrome can occur when 5-HT agonists are combined with other serotonergic medications. Symptoms (eg., diarrhea, hyperreflexia and hyperthermia), incoordination, mental state changes, nausea, tachycardia and vomiting) usually occur within minutes to hours of starting/dosing up on a serotonergic medication.
- If you suspect serotonin syndrome, discontinue use.
-
Vasospasm-related events
- Five-HT agonists have been shown to cause peripheral vascular ischemia, GI vascular ischemia infarction and infarction, as well as Raynaud syndrome.
-
Coronary artery disease
- Before starting treatment, perform a cardiovascular assessment in patients with 5-HT agonists-naive CAD risk factors (eg, hypertension and hypercholesterolemia; smokers, obese, diabetes, strong family history, menopause, males >40 years old).
- Patients suspected of having CAD should undergo a cardiovascular evaluation. If the cardiovascular evaluation is positive, first dose should be administered in the office of a health care provider (eg monitoring).
- These patients should have their cardiovascular health monitored regularly during long-term intermittent use.
-
Hepatic impairment
- When treating patients who have mild to moderate hepatic impairment, sumatriptan oral formulations should be used cautiously.
- Sumatriptan is administered orally through hepatic first pass metabolism. Patients with hepatic impairment will need to adjust the dose in oral preparation. However, it is not necessary to adjust the dose via Non-oral routes (intranasal, intracutaneous) for patients with hepatic impairment.
- In severe hepatic impairment, Sumavel should not be used.
-
Seizure disorders
- Individuals who have seizure disorders or who have low seizure thresholds need to exercise caution. Even in patients who had never had seizures, sumatriptan-treated patients had experienced seizures.
Sumatriptan: Drug Interaction
Antiemetics (5HT3 Antagonists) |
Could make serotonin modulators' serotonergic effects stronger. Serotonin syndrome might occur from this. |
Antipsychotic Agents |
Serotonin modulators might make antipsychotic drugs more harmful or toxic. Serotonin modulators, in particular, may enhance dopamine blockade, potentially raising the risk for neuroleptic malignant syndrome. Serotonin modulators' serotonergic effects may be strengthened by antipsychotic drugs. Serotonin syndrome might occur from this. |
Droxidopa |
Droxidopa's hypertensive action may be enhanced by serotonin 5-HT1D receptor antagonists. |
Metaxalone |
Could make serotonin modulators' serotonergic effects stronger. Serotonin syndrome might occur from this. |
Methylphenidate |
Serotonin modulators' harmful or toxic effects could be exacerbated. In particular, there may be an increased risk of serotonin syndrome or serotonin poisoning. |
Metoclopramide |
Serotonin modulators may intensify Metoclopramide's harmful or hazardous effects. These could appear as signs of neuroleptic malignant syndrome or serotonin syndrome. |
Opioid Agonists |
Could make serotonin modulators' serotonergic effects stronger. Serotonin syndrome might occur from this. |
Serotonin Modulators |
The negative or hazardous effects of other serotonin modulators might be increased. Serotonin syndrome may start to develop. Nicergoline and Tedizolid are exceptions. |
TraMADol |
Serotonin modulators may intensify TraMADol's harmful or hazardous effects. Seizures may become more likely. The serotonergic impact of serotonin modulators may be enhanced by TraMADol. Serotonin syndrome might occur from this. |
Dapoxetine |
Serotonin modulators' harmful or toxic effects could be exacerbated. |
Ergot Derivatives |
May enhance serotonin 5-HT1D receptor antagonists' ability to constrict blood vessels. The vasoconstrictive effects of ergot derivatives may be enhanced by serotonin 5-HT1D receptor antagonists. Exceptions: Nicergoline. |
Methylene Blue |
Could make serotonin modulators' serotonergic effects stronger. Serotonin syndrome might occur from this. |
Monoamine Oxidase Inhibitors |
May slow down the metabolism of substances that block serotonin 5-HT1D receptors. Management: Naratriptan, eletriptan, or frovatriptan may be suitable 5-HT1D agonists to use if MAO inhibitor medication is necessary. |
Serotonin 5-HT1D Receptor Agonists |
May intensify SUMAtriptan's harmful or negative effects. |
Monitoring parameters:
- Headache severity
- Blood pressure
- Symptoms and signs that point to angina. Before beginning 5-HT agonist-naive people with various cardiovascular risk factors, conduct a cardiovascular assessment (eg increased age, diabetes, smoking, obesity or strong family history of CAD).
- Several cardiovascular risk factors should be considered by patients when monitoring their ECG.
How to administer Sumatriptan?
As soon as possible, administer the medication.
Intranasal
- Powder
- Only for intranasal administration using the Xsail device
- Attach the disposable 11mg nosepiece to the device's body and seal it. To deliver powder to the nostril, press button on white side of capsule.
- To administer the remaining 11 mg, remove and discard the nosepiece.
- Solution
- Each unit comes preloaded with one dose.
- Gently blow your nose to clear the nasal passages
- Keep your head straight and use index finger to close one nostril gently.
- To release the spray, tilt your head back and press the plunger hard on the nostrils.
- Keep your head at eye level for 10-15 to 20 seconds, and then gently inhale through the nose and mouth. Do not take in too much air.
Spray:
- Each unit comes preloaded with one dose.
- Gently blow your nose to clear the nasal passages. Keep your head up and close one nostril with your index finger.
- To release the spray, tilt your head back and press down on the plunger.
- Keep your head at eye level for 10-15 to 20 seconds, and then gently inhale through the nose and mouth. Do not take in too much air.
SubQ
- For IV or IM use only.
- Subcutaneous administration of up to 1 inch of skin from the lateral thigh and upper arm.
Administration without effort (Sumavel DosePro).
- Apply to the abdomen (>2 in. from the navel) or the thigh.
- Avoid IV or IM administration.
- You should not apply to the arm, leg, or other parts of your body.
- This is a one-use device.
Mechanism of action of Sumatriptan (Imitrex):
Selective agonists of serotonin (5–HT-1B and 5–HT-1D receptors) in intracranial blood vessels, sensory nerves of trigeminal system; causes vasoconstriction, decreased neurogenic inflammation and antidromic neuronal transmitting leading to migraine relief
Onset of action:
- Oral: ~30 minutes.
- Intranasal: Solution: ~15 to 30 minutes.
- SubQ: ~10 minutes.
- Peak effect: Oral: 2 to 4 hours
Protein binding:
- 14% to 21%
Metabolism:
- It undergoes extensive first-pass metabolism after oral administration.
- Hepatic to an inactive indole acetic acid metabolite which then undergoes ester glucuronide conjugation; may be metabolized by monoamine oxidase (MAO).
Bioavailability
- Intranasal: Solution 17%
- Powder19% (compared to SubQ).
- Spray 58% to 87% (compared to SubQ).
- Oral: 15%.
SubQ: 97% ± 16%. Half-life elimination:
- Distribution: 15 minutes;
- Terminal: 2 hours;
- range: 1 to 4 hours
Time to peak, serum:
- Oral 2 to 2.5 hours.
- Intranasal: Powder: ~45 minutes; Spray: Median 10 minutes (range: 5 to 23 minutes).
- SubQ 12 minutes (range: 4 to 20 minutes).
Excretion:
- Intranasal: Urine (42% of total dose as indole acetic acid metabolite;3% of total dose as unchanged drug)
- Oral: Urine (~60% of total dose, mostly as indole acetic acid metabolite; 3% of total dose as unchanged drug); feces (~40%)
- SubQ: Urine (38% of total dose as indole acetic acid metabolite; 22% of total dose as unchanged drug)
International Brand Names of Sumatriptan:
- Imitrex
- Imitrex STATdose Refill
- Imitrex STATdose System
- Onzetra Xsail
- Sumavel DosePro
- Zembrace SymTouch
- ACT SUMAtriptan
- APO-SUMAtriptan
- DOM-SUMAtriptan
- Imitrex
- Imitrex DF
- MYLAN-SUMAtriptan
- PHL-SUMAtriptan
- PMS-SUMAtriptan
- RATIO-SUMAtriptan
- RIVA-SUMAtriptan
- SANDOZ SUMAtriptan
- SUMAtriptan DF
- TARO-SUMAtriptan
- TEVA-SUMAtriptan
- TEVASUMAtriptan DF
- Adracon
- Amigren
- Apigrane
- Cetatrex
- Cinie
- Fermig
- Gesigran
- Imigran
- Imigran aerozol do nosa
- Imigran FDT
- Imigran nasal
- Imigran Nasal
- Imigran Nasal Spray
- Imigran nasal spray
- Imigran Nesespray
- Imigran Neusspray
- Imigran Radis
- Imigran S Nasal Spray
- Imigrane
- Imigrane Nasal Spray
- Imiject
- Imitrex
- Imitrex nasal spray
- Imitrex Nasal Spray
- Micranil
- Migane
- Migragesin
- Migraval
- Na Chuan
- Nograine
- Nomigra
- Rontadol
- Rosemig
- Siagran
- Sitran
- Somatran
- Stopmigren
- Sumagraine
- Sumagran
- Sumalux
- Sumamigren
- Sumatan
- Sumatran
- Sumatridex
- Sumavel DosePro
- Sumavel Pro
- Sumax
- Sumax Uso Nasal
- Sumig
- Sumigran
- Sumitran
- Sumitrex
- Sutagran
- Tebegran
Sumatriptan Brand Names in Pakistan:
Sumatriptan 6 mg Injection in Pakistan |
|
Imigran | Glaxosmithkline |
Sumatriptan 25 mg Tablets in Pakistan |
|
Migrot | Genix Pharma (Pvt) Ltd |
Sumapan | Wilshire Laboratories (Pvt) Ltd. |
Sumtan | Shrooq Pharmaceuticals |
Sumatriptan Tablets 50 mg in Pakistan |
|
Imigran | Glaxosmithkline |
Migrot | Genix Pharma (Pvt) Ltd |
Nimigran | Platinum Pharmaceuticals (Pvt.) Ltd. |
Sumapan | Wilshire Laboratories (Pvt) Ltd. |
Sumatec | Platinum Pharmaceuticals (Pvt.) Ltd. |
Sumig | Hilton Pharma (Pvt) Limited |
Sumtan | Shrooq Pharmaceuticals |
Sumatriptan Tablets 100 mg in Pakistan |
|
Imigran | Glaxosmithkline |
Migrot | Genix Pharma (Pvt) Ltd |
Sumapan | Wilshire Laboratories (Pvt) Ltd. |
Sumig Plus | Hilton Pharma (Pvt) Limited |