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Sumatriptan

Klassificering: A

Preparat: Imigran, Imigran®, Imigran® Novum, Imigrane, Oriptan®, Sumatriptan 2care4, Sumatriptan ABECE, Sumatriptan Accord, Sumatriptan Actavis, Sumatriptan Apofri, Sumatriptan Aristo, Sumatriptan Arrow, Sumatriptan Aurobindo, Sumatriptan Bluefish, Sumatriptan BMM Pharma, Sumatriptan Bristol, Sumatriptan Copyfarm, Sumatriptan EQL Pharma, Sumatriptan Ipca, Sumatriptan Mylan, Sumatriptan ratiopharm, Sumatriptan Sandoz, Sumatriptan STADA, Sumatriptan SUN, Sumatriptan Teva, Zumo

ATC kod: N02CC01

Substanser: sumatriptan, sumatriptansuccinat

Sammanfattning

En meta-analys har visat att effekten av sumatriptan vid akut migrän är likvärdig hos kvinnor och män. Kvinnor med Hortons huvudvärk svarade däremot sämre än män på behandling med sumatriptan.

Män med hypertension och hereditet för hjärtinfarkt och kvinnor med Raynauds fenomen har i en studie rapporterats ha högre risk för sumatriptan-utlöst bröstsmärta. I en stor meta-analys har dock inga könsskillnader avseende biverkningar påvisats.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pharmacokinetics and dosing

Direct comparisons of the pharmacokinetics in men and women with migraine have not been performed. However, in a comparison of data from different studies, young men without migraine had similar pharmacokinetic profile as young women with migraine [1]. According to the original manufacturer, no pharmacokinetic sex differences in AUC, Cmax, Tmax and half-life of sumatriptan have been observed and no sex differentiation in dosing has been recommended [2].

Effects

A meta-analysis of four randomized, double-blind, placebo-controlled studies (329 men, 2066 women) analyzing efficacy and tolerability of sumatriptan, showed no sex differences in headache relief [3]. Results from the United States Cluster Headache Survey (816 men, 318 women) showed a sex difference in sumatriptan headache relief . In both men and women, the response to injectable sumatriptan was greater than the response to the nasal spray. Although 72% of women with cluster headache had a positive response to injectable sumatriptan, they were less likely to respond to sumatriptan (injectable or nasal spray) than men [4].

Adverse effects

Sumatriptan-induced chest pain was investigated in a Dutch postmarketing study (72 men, 294 women). Chest pain was more common in women than men (84% vs. 16%). Hypertension and a family history of myocardial infarction increased the risk of sumatriptan-induced chest pain in men. In women but not in men, Raynaud phenomenon was a significant risk factor [5].

In the meta-analysis mentioned above [3], incidence of adverse events was similar between men and women.

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

Studies have found that sumatriptan increases plasma growth hormone in healthy men and women. Sumatriptan decreases plasma prolactin in healthy men, but not in women. This suggests that there are sex differences in the 5-HT regulation of prolactin release [6, 7].

Försäljning på recept

Fler kvinnor än män hämtade ut läkemedel innehållande sumatriptan (ATC-kod N02CC01) på recept i Sverige år 2015, totalt 58 300 kvinnor och 16 644 män. Det motsvarar 12 respektive 3 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 40-59 år hos båda könen. I genomsnitt var läkemedel innehållande sumatriptan 3,2 gånger vanligare hos kvinnor [8].

Sumatriptan och zolmitriptan kan köpas utan recept, men cirka 90 % av alla triptaner hämtas ut på recept [9]. Ettårsprevalensen av migrän i Sverige har uppskattats till 16,7% hos kvinnor och 9,5 % hos män [10].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2014-06-04

Referenser

  1. Scott AK. Sumatriptan clinical pharmacokinetics. Clin Pharmacokinet. 1994;27:337-44. PubMed
  2. Imitrex (sumatriptan). DailyMed [www]. US National Library of Medicine. [updated 2013-11-01, cited 2014-06-04]. länk
  3. Ashford E, Salonen R, Saiers J, Woessner M. Consistency of response to sumatriptan nasal spray across patient subgroups and migraine types. Cephalalgia. 1998;18:273-7. PubMed
  4. Rozen TD, Fishman RS. Female cluster headache in the United States of America: what are the gender differences? Results from the United States Cluster Headache Survey. J Neurol Sci. 2012;317:17-28. PubMed
  5. Ottervanger JP, Wilson JH, Stricker BH. Drug-induced chest pain and myocardial infarction Reports to a national centre and review of the literature. Eur J Clin Pharmacol. 1997;53:105-10. PubMed
  6. Boeles S, Williams C, Campling GM, Goodall EM, Cowen PJ. Sumatriptan decreases food intake and increases plasma growth hormone in healthy women. Psychopharmacology (Berl). 1997;129:179-82. PubMed
  7. Herdman JR, Delva NJ, Hockney RE, Campling GM, Cowen PJ. Neuroendocrine effects of sumatriptan. Psychopharmacology (Berl). 1994;113:561-4. PubMed
  8. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-29] länk
  9. von Euler, M, Keshani, S, Baatz, K, Wettermark, B. PP261 - Utilization of triptanes in Sweden; analyses of over the counter and prescriptions sales. Clinical Therapeutics. 2013;8, Suppl(35):e99.
  10. Dahlöf C, Linde M. One-year prevalence of migraine in Sweden: a population-based study in adults. Cephalalgia. 2001;21:664-71. PubMed

Författare: Linnéa Karlsson Lind, Desirée Loikas

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson

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