My History with the Evolution of Imitrex (sumatriptan)

When you have been chronic for about a decade, you eventually run completely out of the usual different types of abortive medications to try because there are only so many out there. You eventually reach a point where you try a different application of a medication you have already attempted in the past. Trust me, I know the local thought process here is if this medication did not work in a pill, will it work in another form? Well you may find yourself very surprised and slightly amused at my progression through the abortive known as Imitrex or its generic name sumatriptan.

The old faithful Imitrex (sumatriptan) pill

This was not my first abortive pill. Although I can say this abortive left me seriously wondering what in the world… It was about as affective for me as taking an Excedrin tablet. So needless to say this was a very short lived attempt at a migraine abortive for me. For some individuals, the pill form of migraine abortive medications may not be the most effective form because of the amount of time it takes for the pill to digest and some individuals have extreme vomiting, which may cause the pill to not stay in their system long enough.

The Imitrex (sumatriptan) statdose injection kit

The first headache associated with this particular version of Imitrex was locating a pharmacy that had the starter kit. See the starter kit came with this carry case, an injector pen, and then a slot for two cartridges of medication. Once we went to the drug store and they called five other semi-local drug stores to locate a starter kit, we were game on with this new administration of the Imitrex medication. Much to my surprise, it actually was effective in assisting with reducing the migraine pain, which by all means was a win. My biggest complaint was that the injector pen never failed to properly reset when I had an extremely bad migraine and my poor husband was not home. So it would be one of those “hi honey, here FIX this” as soon as he walked through the door, especially if it had been long enough that I needed that second dose. This version stuck around for a long time. Despite its tendency for the pen to act up when you were semi brain dead, the medication did do its job and help!

The Imitrex (sumatriptan) pen injections

As medications do, the Statdose Injection Kit was phased out and these new epi-pen style injectors became what you were given when you refilled your prescription. These devices were not bad and have been pretty basic to use. You pretty much pull a cap off of one end of the pen, press it firmly against your thigh, and hit a trigger button on the other end. This releases the medication via a tiny needle which retracts back into the device. For safe disposal, you place the cap back on the pen and throw it away. Over the years, this particular injector has been acquired by several different manufacturers, although none of them implemented major changes to the design of the product itself.

Yet we evolved to the Imitrex Sumavel Dosepro

My question with this product is who seriously made their significant other this  mad at them that this version was invented?!? The selling point on the Imitrex Sumavel Dosepro was that it was needleless and was supposed to feel like being popped with a rubber band. Same concept as the previously mentioned injectors, minus the needle. I had no problems getting the prescription filled and as usual copay cards are a wonderful thing. Where things became interesting is when I used it for the first time, home alone with my over protective dog. So here I am sitting on the side of the bathtub with my bare thigh waiting and mentally wondering how this is going to feel.  So I pop the top and pinch my skin and initiate the self-inflicted torment that followed. Between the horrible noise the device itself made and the noise I made from the pain of this needleless injection, my furry companion grabbed the device out of my hand and ran off with it. This point, I no longer know if I want to cry from the pain or laugh at my dog but I do firmly believe whoever compared this injector to being flicked with a rubber band needs to be smacked! Needless to say I went back to the previously mentioned needle pen device.

Full circle with the new Onzetra Xsail

At my last Botox appointment, we had the discussion that again sometimes the abortive just is not enough to break a bad migraine. Her idea was to try a new nasal spray. Figuring what do we have to lose, she retrieves a sample and sends over the script while I check out and schedule my follow up. My husband is very intently investigating the sample box and pulling up website on his phone. Now let me not mislead you like we were misled at the doctor office; this is not a liquid nose spray but a powdered form of the Imitrex medication that you blow into your nose. While I have spoken to one woman who loves this version of the medication, I have been left very unimpressed. There is an element of me that understand it should work faster by ingesting the powder directly into your nose but the adult in me feels like I am doing something illegal. The results for me have not been better than the needle injector. Obviously you do not have the momentary sting of the tiny needle but the effect for me is not much better than the old fashion pill ever was for me. Although some individuals may find this option more comforting if they have a fear of needles.

Is this progress?

One cannot help but wonder where these drug manufactures acquire their ideas for the various evolutions of these medications. We have gone from a pill, to an injectable, to a needleless injectable, to snorting our migraine abortive. Is this really progress?

Have you tried any of these forms of the Imitrex abortive? What was your response and thoughts on them? Have you tried this latest nasal powder?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (32)
  • mindwiped
    8 months ago

    Does anybody else remember the liquid nose spray version? Once it went down the back of your throat, you’d swear you’d just put liquid tire, not immitrex, up your nose?

    Hubby now has, and I’m trying to get, Zembrace. It’s the newest immitrex pen injector. It’s as actual needle, which is a plus. It’s actually half the dose of the other injections. They did a study, and found out it was just as effective, and supposedly has fewer side effects. At least, that’s the marketing info. If you ask to try it, there’s a rebate program, The Promius Promise (I’m not affiliated with it or Zembrace). Hubby gets his completely free through the program! Hope the info can help other migraineurs.

  • chienjouet
    10 months ago

    The advantage of the nasal spray, is that if one is having migraine with aphasia and nausea, the nasal spray would by-pass the stomach, as the nausea is indicating a stomach migraine, also.

  • Marysadigidiva
    10 months ago

    Tried the Sumavel Dosepro and had one of the worst rebound headaches in my life. Pill form of Imitrex was like a Tylenol for me. I tried the nasal inhalation only once…
    It caused me intense, excruciating pain. My neuro says I had an aneurysm from the med. it gave me extremely high blood pressure, tremors, hyperventilating…
    My husband rushed me to the Nero office where he monitored me very closely. After I had effects like tremors (still ongoing) and horrific migraines for about a year. I have reduction in the size of my vessels in my head from taking this inhalation. Also my blood pressure never went back down to normal after this incident. So, I wouldn’t suggest it if you are sensitive to other forms of triptans, based on my experience.

    I no longer take triptans of any kind. I was switched to Migranal which was ok, but didn’t work very well for me. I now use the Cefaly device (not covered by insurance) which has helped a lot. I no longer have abortive meds. Just the Cefaly…but I haven’t had a really horrific migraine since I started the Cefaly which was in Nov 2017. I’d highly recommend it!

  • Dana
    11 months ago

    KatiesZen
    There is an absolute connection between your blood pressure and your migraines. Pain is a key cause for a rise in BP. I run 90’s/50’s, I was in my nuero’s office literally begging for a mercy killing my BP was 140/72. I also know this because, worked in a pediatric hospital/ER, while pursuing my nursing degree and my migraine’s crushed my dreams. I lost my job, dropped out of school and at this point can’t even drive a car. So, to reiterate, pain causes Blood Pressure to increase. Sorry I went off on a tear. I just really, really hate migraines.

  • fazioja55
    11 months ago

    My doc had written 2 different scripts for 2 nasal sprays, I don’t qualify for the “no copay”, the cost for me with my insurance is over $300. I can’t afford this. I didn’t know about the other ways of using imitrex beside pill form. I’m not sure i would be able to afford those either. My chronic migraines last forever.

  • Dana
    11 months ago

    Fazioja55,
    Have you looked into the discount cards, like GOODRX? There are many out there, that’s just the one I use. It has helped me save quite a bit, but I don’t know how helpful it would be on a $300 med, but it’s worth looking into. Try GOODRX.com or google prescription discount cards.
    Good Luck

  • Amanda Workman moderator author
    11 months ago

    There are many generic versions of the needle injections, with my insurance (without coupons) they come out to $10. So they may be worth looking into if your doctor will let you try them. I think all the nose sprays are new, therefore they are expensive but there should be manufacturer coupons that you can you with insurance.
    Amanda Workman

  • KatiesZen
    11 months ago

    I had no idea there was an injection WITH a needle. The DosePro is killing me. I have bruises on both thighs constantly. My poor husband is the one who injects me, he hates it. I will have to look into the spray. Has anyone had any correlation with their migraines and blood pressure? My bp seems to rise when I am in pain, but I don’t know which came first, chicken/egg???

  • Amanda Workman moderator author
    11 months ago

    If you are getting spray, your hubby needs to keep the injector flat against your leg and longer. But yes the one with the needle is much less painful, in my opinion.
    Your bp and honestly even blood sugar react to your body being in pain / trauma, so yes your bp will rise when your migraine is bad.
    Amanda Workman

  • Maureen
    11 months ago

    I have used Onzetra and would use it still if it were not so expensive and difficult to get in Delaware. Local pharmacies don’t carry it.
    i have to mail order it. And the discount card reduces the cost from boing! to ouch!
    I found it very effective (although I always had trouble correctly using it, because my migraine brain found the contraption difficult to work, but migraine -proof.) It does taste disgusting, but bad taste is better than pain. Sumatriptan pills were VERY ineffective. I haven’t tried injections or other nasal sprays because these, too, for some reason, are difficult to get in local pharmacies. For now, I’ve gone back to maxalt, which has had spotty effectiveness. that’s why I switched to onzetra. However, the headache of tracking done acute meds drove me to stock mediocre ones rather than to be without. Thankfully, my frequency has been reduced lately.
    I have new insurance this year. Maybe I’ll try again!

  • Dana
    11 months ago

    Just a side note about discount RX cards GOODRX has saved me a ton of money and I found it right in my doctors office. You can also print them from their website.

  • Amanda Workman moderator author
    11 months ago

    For the extremely expensive prescriptions I use the manufacturer coupons that you can print from their own website. When the prescription doesn’t have a generic, the manufacturer has a coupon available.
    Amanda Workman

  • Dana
    11 months ago

    It’s very funny that I saw this today, because yesterday I filled my script for the nasal spray. Now let’s go back….. I did the pill form (hand me a Tylenol why don’t you), I did the shots, the actual… you have to drawl up the solution shots….my poor husband…. I worked in a pediatric hospital for 6 years, the last 2 being in the trauma center and I couldn’t give myself a shot! Those suckers burned and oh I would swear at him and call him names and he would apologize…. the poor guy….. he had nothing to apologize for. Now the spray….. it’s a single use “auto injector” and you have to push really hard and makes a very loud click when the “spray” is administered. I didn’t know it was a powder. And they tell you not to breath in deeply, even though that’s your first instinct. And yes that horrible taste that runs down the back of your throats is horrible. It didn’t work, but it was my first try, so I’ll give it another go. I also didn’t take it at onset, I’m in the midst of a severe and lengthy migraine, I’m actually on a five day course of Zyprexa to try to break it up, now you wanna talk about a nasty drug…..ugh. Hands down one of the worst medications I have ever been on. I was on it years ago for its traditional use as an antipsychotic.

  • deedeevee1
    11 months ago

    I could not afford the co-pay for the nasal spray. But I always wondered if that would have been the one medicine that would have helped. Oral imitrex did nothing for my head pain, the needless pen, helped but only for a very short amount of time. Then they gave me some other type of triptan, omg I thought it was going to kill me!! No thanks. I rather deal with what I already have had for years thanks. Sad but true.

  • Amanda Workman moderator author
    11 months ago

    When the prescription copay is very high, look online for copay assistance cards. When the product is new, the manufacturer will offer discount cards in order to have patients use the product. I definitely used the discount card when I tried the powdered nose spray because it would have been too expensive for me otherwise as well.
    Amanda Workman (moderator and contributor)

  • jtandv
    11 months ago

    I tried the nasal powder once and HATED it. I thought this would be a good option since the pill form can sometimes upset my stomach and often my head will hurt in the area around my nose and eyes. The only time I tried it, I got no relief from the medicine. And the horrible taste it put in my mouth was awful. So no relief to the headache, an awful taste in my mouth and I was unable to take anything else for 2 hours to relieve the headache. I went back to using the pill form of imitrex and the dissolvable maxalt tablets.

  • Amanda Workman moderator author
    11 months ago

    I ended up with the same strange taste in the back of my throat kind of thing. I also did not think it was very effective for the pain.
    Does the imitrex pill and the maxalt dissolvables help you with your pain? I definitely hope those are being affective abortives for you.
    Thank you for sharing your experience with the powdered nose spray version. Other people’s experiences are always appreciated because everyone has such different reactions to treatments.
    Amanda Workman

  • katcal
    11 months ago

    I have tried the Imitrex Sumavel Dosepro but could not tolerate the pain either. Right now I am using the Onzerta Xsail, and/or Sumatriptan tablets and have some Maxalt for back up when these run out.

  • Amanda Workman moderator author
    11 months ago

    As far as the injections go, the ones with a needle is way less painful than the needless one. The Onzerta Xsail is effective for you?
    Thank you for sharing!
    Amanda Workman

  • deedeevee1
    11 months ago

    Agreed

  • coni208
    11 months ago

    I only had decent response to Maxalt… Then of course that stopped working… Botox was great at the beginning, so when I get a migraine one Maxalt would work well. I went from 10mg to 5mg. Then of course my doctor cut me off of the Maxell stating it’s not good for me, and a Botox wasn’t working as well. Found out about the daith piercing on the side that I have my migraines. I don’t want to jinx it, but on the rare occasion I start to get a migraine one Motrin works. I want to stop getting Botox, but I’m afraid to stop and start getting bad migraines and then my insurance will tell me I can’t go back to Botox. So I’m doing both, both being the botox with the daith piercing. I can handle taking one Motrin

  • Amanda Workman moderator author
    11 months ago

    Have you considered looking for another doctor? You should be allowed an abortive medication even while doing botox. If you think that you may not be needing botox as much anymore you can discuss with your current or new doctor about moving it out slowly. By this I mean try doing it after 4 months instead of every 3 months and see how you do to that change. I do have a a friend who eventually weaned off botox and is now just episodic. But it’s definitely a decision you made and carry out with your doctor, like she did. It doesn’t hurt to get a second opinion from another doctor. Especially if you feel like you and this doctor are not clicking or on the same page so to say.

    Sending you lots of love, strength and positivity.
    Amanda Workman

  • LostCarcosa25
    11 months ago

    I’ve used all of the above versions of sumatriptan, and I definitely agree with everyone on the horribleness of Imitrex Sumavel Dosepro. For quite sometime, my insurance would only cover the needless injection. There were so many times when I should have used it, but I just couldn’t deal with taking it – it was absolutely nerve-wracking. The pain of the injection wasn’t a big deal, but the trepidation of taking it was (I often didn’t get the entire dose because the pop scared the crap out of me, and it goes right out of my hand, lol). And many of the injections were actually duds, so I had to go through the entire process again.

    Currently, I take both the needle and pill forms. My headache specialist has recently had me start taking 25mg tabs three times a day as a prophylactic. We noticed that my headache patterns had improved (I haven’t had a 5/10 day in well over a year), so he had me titrate up to 50mg tabs three times a day. Unfortunately, my insurance will only cover 9 das out of the month which has led me to pay for the rest out of pocket ($50).

    I use the needle injection for acute migraine flare-ups, but haven’t used them as often as I should. It helps significantly (going from a 8-9/10 to a 6/10) and quickly. However, it makes me extremely drowsy, and have to lie down which always puts me to sleep. If I take it during the day, I’ll wake up in about an hour or so, but then my entire sleep schedule goes out of wack. This then acts as a trigger, and exaserbates my background headache. Definitely a catch 22!

  • lizzietishlizard5566
    11 months ago

    Interesting stuff how these abortive drugs are not without their issues. I recall when imitrex was first introduced and my neurologist at the time wrote the nasal for me. It was like a Godsend! I was at the end of exams my junior year of college and in retrospect experiencing what was most likely an intractable migraine from the ‘let down effect’ of the stress of exams. As the years went by I also tweaked and experimented with different triptans and delivery systems. But one of the greatest barriers to appropriate or the best medication for me has been and seems to still be what insurance will cover. Like the author Amanda I tried the original Imitrex self injection and it was definitely tricky to load and reload. I remember self injecting in awkward situations and times. Injecting yourself in NYC en route to work in the subway or on the ferry got more crazed looks than snorting a medication. ;)) And it was v expensive and I recall my insurance being hesitant to fill it. I have found there is a hierarchy in terms of which triptans work best for me. Zomig is wonderful — a nasal delivery — but the cost is very high. I also like the nasal imitrex (now generic sumatriptan).

    As far as nausea is concerned, bc often this can be worse than pain, I’ve found zofran sublingual is a great option. Especially during times of vomiting. I have also used compazine suppositories. But once again you’re not always in a time or place where administration is easy.

    Best to all!!

  • Amanda Workman moderator author
    11 months ago

    One thing I do want to point out is copay cards for abortive medications that do not have generics. Most of the manufacturer websites will have a copay assistance card you can print and take to your pharmacy to help make the medication more a affordable. I’m currently using one for the Trokendi XR myself.

    If you are still interested in using the zomig nasal spray look at this link and see if it helps you out with the expense of the medication.

    http://www.zomigsavings.com

    For somebody who does suffer from actually throwing up (not just nausea), you are correct about some of the none pill version of nausea medications; these days you can get them in liquids, the melts, & the suppositories. I know some people can be afraid to try the suppositories but are not a bad experience.

    Thank you so much for reading the article and commenting! Sending you lots of strength and love
    Amanda Workman

  • Pump2Duncan
    11 months ago

    I’ve tried the nasal spray and it worked alright but man, nothing makes me feel more like a drug user than shooting up and snorting my abortive medications. LOL. Since migraine runs in my family, first time I used the nasal spray, my Mom was giving me tips and tricks to deal with the side effects of the spray, like chew gum to deal with the weird after taste. LOL.

    But when the vomiting has set in, I am SO thankful for these non-pill options that at least give me a chance not to have to go to the ER or Urgent Care. Once the vomiting has set in, the pill isn’t staying down long enough to do any good and its money literally down the toilet.

  • Amanda Workman moderator author
    11 months ago

    You absolutely made me laugh because that is exactly how I felt about using the powdered version. I couldn’t help but think so this is what drug users feel. Lol.
    You also have a very valid point when you use the nose sprays or injections, you don’t have to worry about losing the medications if you get sick. They also make phenerghan in a suppository to help with that issue as well
    Amanda Workman

  • Tamara
    11 months ago

    I didn’t know there are another option besides the “needleless injection”!! I have got that one many a times at urgent care and yes it hurts like hell! Out of 6 times only once did they get it on the first, all others they had to get a second one because it failed to work properly. Because of this I have never got a prescription to use at home, why pay the money when they seem to never work properly?

    My favourite triptan was an liquid nasal spray, always worked within 5 minutes, very mild side effects and I loved it. It seemed to not be available in the US though, as per others experience and now is indefinitely back ordered and not available, :'(.

    I have had to switch to zomig nasal spray which is also a liquid (I don’t like the thought of the powder one, too complicated to use when a migraine is on its way). It works about 75% of the time, so not as well as imitrex for me (I also have tried maxalt and axert dissolvable tabs and got very sick on them and no effect on the migraine), because of this I’m scared to play with too many others, I just want something that works.

    Definitely going to look into the needle version of imitrex, that may be a good next step.

  • Amanda Workman moderator author
    11 months ago

    That definitely makes me wonder why the hospital staff is unable to properly use the DosePro on you in the emergency room. I guess they are not ready the instructions or something that come with it. It’s rather straight forward. I’m sorry you have had those experiences.

    I definitely wouldn’t hold your experience with the one without the needle against the one with the needle. I know personally it makes a big difference for me and at this point they are a generic abortive so the copay should not be one of those take your breaths away prescriptions.

    I’m sorry your current abortives only work sometimes. That can be beyond frustrating. Hopefully your doctor will be open to letting you try the one with the needle. Best wishes
    Amanda Workman

  • Mari
    11 months ago

    I have also tried the Sumavel Dosepro (needleless injectio). WOW! Did that hurt!!! I think I spent 10 minutes rubbing the injection site and watching it to see if I was going to get a wely or a large bump. NEVER again. I will stick with the injections (needles) and tablets.

  • Amanda Workman moderator author
    11 months ago

    Yes. That needless one was definitely something else. I’m not sure what they were thinking with administering medicine with a burst of air. Even not being a huge fan of needles, I’ll take the needles too!!!
    Amanda Workman

  • Tachee57
    11 months ago

    I have taken Imitrex since it came out in Alberta, Canada about 1984. I has helped me have a profession and a family. I am now 79 but the migraines are more frequent than before, but I notice their aura more accurately. That means I take them more frequently, but have less pain. Those times I ignore the aura signs, i have to take 2 dosages but two yours apart as prescribed. I get six to eight migraines a month like clockwork, mostly connected to air pressure changes and bright sunlight. I have tried several preventatives over the years. They just make me ill. I have had migraines since childhood with increasing frequency as I aged, I am grateful for Imitrex, but expense is an issue for the elderly. Now I am faced with the prospect of having to use it less. I am looking for something to supplement it. Tachee57.

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