Zembrace® SymTouch® (sumatriptan succinate)
Reviewed by: HU Medical Review Board | Reviewed April 2022 | Last updated: August 2022
Zembrace® is a serotonin (5-HT1B/1D) receptor agonist (triptan) indicated for the acute treatment of migraine, with or without aura, in adults who have a clear migraine diagnosis. It is administered by subcutaneous injection (under the skin). It comes in a 3-mg prefilled, ready-to use, single-dose disposable autoinjector called the SymTouch.
Zembrace works in as little as 10 minutes and generally within 2 hours. It is intended to reduce acute migraine symptoms. It is not intended to be used as a prophylactic therapy to prevent the onset of migraine.
Overuse of acute migraine drugs can cause medication overuse headaches. Overuse is considered dosing on more than 10 days per month for 3 months or longer. Symptoms of overuse may need to be treated and detoxification from migraine medications may be required.
What are the ingredients in Zembrace?
The active ingredient in Zembrace is sumatriptan.
How does Zembrace work?
Zembrace is believed to work by binding with 5-HT1B/1D receptors on blood vessels in the brain. It narrows the blood vessels (constriction) around the brain. The effect is to reduce inflammatory substances in the body that can trigger head pain, nausea, sensitivity to light and sound, and other migraine symptoms.
What are the possible side effects of Zembrace?
Many clinical trials evaluated the safety and efficacy of Zembrace. The most common side effects experienced by those taking Zembrace include:
- Injection site reactions
- Tingling or numbness in the fingers or toes
- Flushing (warm red skin or face)
- Discomfort or stiffness in the neck
- Feeling weak, drowsy, or tired
This is not an exhaustive list of all potential side effects of Zembrace. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Zembrace, contact your doctor or healthcare provider immediately.
Things to note about Zembrace
Zembrace comes in a prefilled autoinjector. Before starting Zembrace talk with your doctor if you:
- Have a history of hypersensitivity to sumatriptan succinate
- Have a history of coronary artery disease (CAD), angina or heart attacks
- Have a history of Wolff-Parkinson-White syndrome or arrhythmias, or conduction pathway disorders
- Have a history of stroke or transient ischemic attack (TIA)
- Have a history of hemiplegic or basilar migraine which may be at increased stroke risk
- Have peripheral vascular disease (circulation in the extremities)
- Have ischemic bowel disease
- Have a history of uncontrolled hypertension
- Have taken a ergot-containing medication or another triptan within the 24 hours prior to migraine
- Have take a MAO-A inhibitor within 2 weeks prior to migraine
- Take anti-depressant medicines including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs)
- Have severe hepatic (liver) impairment
- Are pregnant or planning to get pregnant, as there is limited information on the use of Zembrace in pregnancy. It should be used only if the potential benefit of Zembrace therapy exceeds risk to the fetus.
Individuals with the above conditions should be monitored closely while taking Zembrace.
If there is no response to the first migraine attack treated with the Zembrace SymTouch, a physician should reconsider the migraine diagnosis prior to using the medication in any subsequent attacks.
A cardiovascular evaluation should be performed on patients who have never taken a triptan medication but who have multiple cardiovascular risk factors (e.g. increased age, diabetes, hypertension, smoking, obesity, strong family history of CAD) before starting Zembrace. The first Zembrace injection for those with a cardiac history should be administered in a medically supervised setting, and electrocardiogram (ECG) should be performed immediately following the injection.
A healthcare professional should train patients or caregivers in the proper technique for administering subcutaneous injections. Typical injection sites are the abdomen, back of the upper arm, and thigh. Sites should be rotated to minimize the chance of injection site reactions. Injections should not be administered where the skin is bruised, irritated or red, infected, or scarred. Safe disposal practices should be used for the autoinjectors.
You should begin no medication or supplement without first checking with your health care provider and should let them know of any other prescriptions, OTCs, and herbals you are taking to ensure there are no interactions.
For additional details, read the full prescribing information of Zembrace.