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1 What Imigran is and what it is used for

Each Imigran capsule-shaped tablet contains a single dose of sumatriptan, which belongs to a group of medicines called triptans (also known as 5-HTi receptor agonists).

Imigran is used to treat migraine headache.

Migraine symptoms may be caused by the temporary widening of blood vessels in the head. Imigran is believed to reduce the widening of these blood vessels. This in turn helps to take away the headache and relieve other symptoms of a migraine attack, such as feeling or being sick (nausea or vomiting) and sensitivity to light and sound.

2 What you need to know before you use Imigran

Don't use Imigran:

•    If you’re allergic to sumatriptan, or any of the other ingredients of this medicine (listed in Section 6)

•    If you have a heart problem such as narrowing of the arteries (ischaemic heart disease) or chest pains (angina), or have already had a heart attack

•    If you have circulation problems in your legs that cause cramp-like pains when you walk (peripheral vascular disease)

•    If you have had a stroke or a mini-stroke (also called a transient Ischaemic attack or TIA)

•    If you have high blood pressure. You may be able to use Imigran if your high blood pressure is mild and is being treated

•    If you have serious liver disease

•    With other migraine medicines,

including those which contain ergotamine, or similar medicines such as methysergide maleate; or any triptan or 5HTi agonist (such as naratriptan or zolmitriptan)

•    With any of the following antidepressants:

•    MAOIs (monoamine oxidase inhibitors) or if you have taken an MAOI in the last 2 weeks

•    SSRIs (selective serotonin reuptake inhibitors) including citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline

•    SNRIs (serotonin noradrenaline reuptake inhibitors) including venlafaxine and duloxetine

•    For children under 18 years of age.

If any of these apply to you:

^ Tell your doctor, and don’t use Imigran tablets.

Take special care with Imigran

Talk to your doctor or pharmacist before using Imigran.

If you have any extra risk factors

•    If you are a heavy smoker, or using nicotine replacement therapy, and especially

•    If you are a man aged over 40, or

•    If you are a woman who has been through the menopause.

In very rare cases, people have developed serious heart conditions after using Imigran, even though they had no signs of heart disease before. If any of the points above applies to you it could mean you have a greater risk of developing heart disease - so:

*Tell your doctor so that your heart function can be checked before Imigran is prescribed for you.

If you have a history of fits (seizures) Or if you have other conditions which might make it more likely that you'll have a fit - for example, a head injury or alcoholism:

^Tell your doctor so that you can be supervised more closely.

If you have liver or kidney disease

If you have an intolerance to some sugars

If any of these apply to you:

^ Tell your doctor so that you can be supervised more closely.

If you are allergic to antibiotics called sulphonamides

If so, you may also be allergic to Imigran. If you know you are allergic to an antibiotic but you are not sure whether it is a sulphonamide:

^ Tell your doctor or pharmacist before using Imigran.

If you are taking anti- depressants called SSRIs

(Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin Noradrenaline Reuptake Inhibitors)

^Tell your doctor or pharmacist before using Imigran. Also see Other medicines and Imigran, below.

If you use Imigran frequently.

Using Imigran too often may make your headaches worse.

^ Tell your doctor if this applies to you. He or she may recommend you stop using Imigran.

If you feel pain or tightness in your chest after you use Imigran

These effects may be intense but they usually pass quickly. If they don't pass quickly, or they become severe:

^ Get medical help immediately. Section 4 (overleaf) has more information about these possible side effects.

Other medicines and Imigran

Tell your doctor or pharmacist if you’re taking, have recently taken or might take any other medicines. This includes any herbal products or medicines you've bought without a prescription.

Some medicines must not be taken with Imigran and others may cause adverse effects if they're taken with Imigran. You must tell your doctor if you are taking:

•    ergotamine also used to treat migraine, or similar medicines such as methysergide (see section 2 Don't use Imigran). Don't use Imigran at the same time as these medicines. Stop taking these medicines at least 24 hours before using Imigran. Don't take any medicines which contain ergotamine or compounds similar to ergotamine again for at least 6 hours after using Imigran.

•    other triptans/5-HT1 receptor agonists (such as naratriptan, rizatriptan, zolmitriptan), also used to treat migraine, (see section 2 Don't use Imigran). Don't use Imigran at the same time as these medicines. Stop taking these medicines at least 24 hours before using Imigran. Don't take another triptan/5-HT₁ receptor agonist again for at least 24 hours after using Imigran.

•    MAOIs used to treat depression.

Don't use Imigran if you have taken these in the last 2 weeks.

•    SSRIs and SNRIs used to treat depression. Using Imigran with these medicines can cause serotonin syndrome (a collection of symptoms which can include restlessness, confusion, sweating, hallucinations, increased reflexes, muscle spasms, shivering, increased heartbeat and shaking). Tell your doctor immediately if you are affected in this way.

•    St John’s Wort (Hypericum perforatum). Taking herbal remedies that contain St John's Wort together with Imigran may make side effects more likely.

Pregnancy and breast-feeding

•    If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. There is only limited information about the safety of Imigran for pregnant women, though up till now there is no evidence of any increased risk of birth defects. Your doctor will discuss with you whether or not you should use Imigran while you are pregnant

•    Don’t breast-feed your baby for 12 hours after using Imigran. If you

express any breast milk during this time, discard the milk and don't give it to your baby.

Driving and using machines

Either the symptoms of migraine or your

medicine may make you drowsy. If you

are affected, don’t drive or operate

machinery.

3 How to use Imigran

5 How to store Imigran

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

When to take Imigran

•    It's best to take Imigran as soon as you feel a migraine coming on,

although - you can take it at any time during an attack

•    Don't use Imigran to try to prevent an attack - only use it after your migraine symptoms start.

How much to take Adults aged 18 to 65

•    The usual dose for adults aged 18

to 65 is one Imigran 50mg tablet, swallowed whole with water. Some patients may need a 100mg dose -you should follow your doctor's advice.

Children under 18

•    Imigran is not recommended for children under 18 years old.

Older people (aged over 65)

•    Imigran is not recommended for people aged over 65.

If your symptoms start to come back

•    You can take a second Imigran tablet if at least 2 hours have passed since the first tablet. Don't take more than 300mg in total in 24 hours.

If the first tablet has no effect

•    Don’t take a second tablet or any

other Imigran preparation for the same attack. Imigran can still be used for your next attack.

If Imigran doesn't give you any relief:

If you take more Imigran than you should

• Don't take more than six 50mg tablets or three 100mg tablets

(that's 300mg in total) in 24 hours. Taking too much Imigran could make you ill. If you have taken more than 300mg in 24 hours:

^Contact your doctor for advice.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4 Possible side effects

Like all medicines, this medicine can cause side effects, but not everybody gets them. Some symptoms may be caused by the migraine itself.

Allergic reaction: get doctor's help straight away

The following side effects have occurred but their exact frequency is not known.

•    The signs of allergy include rash, hives (itchy rash); wheezing; swollen eyelids, face or lips; complete collapse.

If you get any of these symptoms soon after using Imigran:

^ Don't use any more. Contact a doctor straight away.

Common side effects

(affect up to 1 in 10 people)

•    Pain, heaviness, pressure or tightness in the chest, throat or other parts of the body, or unusual sensations, including numbness, tingling and warmth or cold. These effects may be intense but generally pass quickly.

If these effects continue or become

severe (especially the chest pain):

^ Get medical help urgently. In a very small number of people these symptoms can be caused by a heart attack.

Other common side effects include:

•    Feeling sick (nausea) or being sick (vomiting), although this may be due to the migraine itself

•    Tiredness or drowsiness

•    Dizziness, feeling weak, or getting hot flushes

•    Temporary increase in blood pressure

•    Shortness of breath

•    Aching muscles.

Very rare side effects

(affect up to 1 in 10,000 people)

•    Liver function changes. If you have a blood test to check your liver function, tell your doctor or nurse that you are taking Imigran.

Some patients may get the following

side effects but it is not known how

often they occur

•    Seizures/fits, tremors, muscle spasm, neck stiffness

•    Visual disturbances such as flickering, reduced vision, double vision, loss of vision, and in some cases even permanent defects (although these may be due to the migraine attack itself)

•    Heart problems, where your heartbeat may go faster, slower or change rhythm, chest pains (angina) or heart attack

•    Pale, blue-tinged skin and/or pain in your fingers, toes, ears, nose or jaw in response to cold or stress (Raynaud’s phenomenon)

•    Feeling faint (blood pressure may go down)

•    Pain in the lower left side of the stomach and bloody diarrhoea

(ischaemic colitis)

•    Diarrhoea

•    Pain in the joints

•    Feeling anxious

•    Excessive sweating

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report any side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

By reporting side effects, you can help provide more information on the safety of this medicine

Keep out of the sight and reach of children.

Do not use Imigran after the expiry date shown on the carton. The expiry date refers to the last day of that month.

Do not store above 30°C

Medicines should not be disposed of via waste water or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6 Contents of the pack and other information

Manufactured by: Glaxo Wellcome S.A., Avda.de Extramadura, 3, 09400 Aranda de Duero, Burgos, Spain

Procured from within the EU and repackaged by the Product Licence holder: B&S Healthcare, Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK

Imigran® 50mg tablets PLPI: 18799/0240

Leaflet date: 09.07.2014

1 What Sumatriptan is and what it is used for Each Sumatriptan capsule-shaped tablet contains a single dose of

sumatriptan, which belongs to a group of medicines called triptans (also known as 5-HTi receptor agonists).

Sumatriptan is used to treat migraine headache.

Migraine symptoms may be caused by the temporary widening of blood vessels in the head. Sumatriptan is believed to reduce the widening of these blood vessels. This in turn helps to take away the headache and relieve other symptoms of a migraine attack, such as feeling or being sick (nausea or vomiting) and sensitivity to light and sound.

2 What you need to know before you use Sumatriptan

Don’t use Sumatriptan:

•    If you’re allergic to Sumatriptan, or any of the other ingredients of this medicine (listed in Section 6)

•    If you have a heart problem such as narrowing of the arteries (ischaemic heart disease) or chest pains (angina), or have already had a heart attack

•    If you have circulation problems in your legs that cause cramp-like pains when you walk (peripheral vascular disease)

•    If you have had a stroke or a mini-stroke (also called a transient ischaemic attack or TIA)

•    If you have high blood pressure. You may be able to use Sumatriptan if your high blood pressure is mild and is being treated

•    If you have serious liver disease

•    With other migraine medicines,

including those which contain ergotamine, or similar medicines such as methysergide maleate; or any triptan or 5HTi agonist (such as naratriptan or zolmitriptan)

•    With any of the following antidepressants:

•    MAOIs (monoamine oxidase inhibitors) or if you have taken an MAOI in the last 2 weeks

•    SSRIs (selective serotonin reuptake inhibitors) including citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline

•    SNRIs (serotonin noradrenaline reuptake inhibitors) including venlafaxine and duloxetine

•    For children under 18 years of age.

If any of these apply to you:

Tell your doctor, and don’t use Sumatriptan tablets.

Take special care with Sumatriptan Talk to your doctor or pharmacist before using Sumatriptan.

If you have any extra risk factors

•    If you are a heavy smoker, or using nicotine replacement therapy, and especially

•    If you are a man aged over 40, or

•    If you are a woman who has been through the menopause.

In very rare cases, people have developed serious heart conditions after using Sumatriptan, even though they had no signs of heart disease before. If any of the points above applies to you it could mean you have a greater risk of developing heart disease - so:

■^Tell your doctor so that your heart function can be checked before Sumatriptan is prescribed for you.

If you have a history of fits (seizures) Or if you have other conditions which might make it more likely that you’ll have a fit - for example, a head injury or alcoholism:

■^Tell your doctor so that you can be supervised more closely.

If you have liver or kidney disease

If you have an intolerance to some sugars

If any of these apply to you:

4 Tell your doctor so that you can be supervised more closely.

If you are allergic to antibiotics called sulphonamides

If so, you may also be allergic to Sumatriptan. If you know you are allergic to an antibiotic but you are not sure whether it is a sulphonamide:

Tell your doctor or pharmacist before using Sumatriptan.

If you are taking anti- depressants called SSRIs

(Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin Noradrenaline Reuptake Inhibitors)

■^Tell your doctor or pharmacist before using Sumatriptan. Also see Other medicines and Sumatriptan, below.

If you use Sumatriptan frequently.

Using Sumatriptan too often may make your headaches worse.

Tell your doctor if this applies to you. He or she may recommend you stop using Sumatriptan.

If you feel pain or tightness in your chest after you use Sumatriptan

These effects may be intense but they usually pass quickly. If they don’t pass quickly, or they become severe:

4 Get medical help immediately. Section 4 (overleaf) has more information about these possible side effects.

Other medicines and Sumatriptan

Tell your doctor or pharmacist if you’re taking, have recently taken or might take any other medicines. This includes any herbal products or medicines you’ve bought without a prescription.

Some medicines must not be taken with Sumatriptan and others may cause adverse effects if they’re taken with Sumatriptan. You must tell your doctor if you are taking:

•    ergotamine also used to treat migraine, or similar medicines such as methysergide (see section 2 Don’t use Sumatriptan). Don’t use Sumatriptan at the same time as these medicines. Stop taking these medicines at least 24 hours before using Sumatriptan. Don’t take any medicines which contain ergotamine or compounds similar to ergotamine again for at least 6 hours after using Sumatriptan.

•    other triptans/5-HTi receptor agonists (such as naratriptan, rizatriptan, zolmitriptan), also used to treat migraine, (see section 2 Don’t use Sumatriptan ). Don’t use Sumatriptan at the same time as these medicines. Stop taking these medicines at least 24 hours before using Sumatriptan. Don’t take another triptan/5-HTi receptor

•    MAOIs used to treat depression.

Don’t use Sumatriptan if you have taken these in the last 2 weeks.

•    SSRIs and SNRIs used to treat depression. Using Sumatriptan with these medicines can cause serotonin syndrome (a collection of symptoms which can include restlessness, confusion, sweating, hallucinations, increased reflexes, muscle spasms, shivering, increased heartbeat and shaking). Tell your doctor immediately if you are affected in this way.

•    St John’s Wort (Hypericum perforatum). Taking herbal remedies that contain St John’s Wort together with Sumatriptan may make side effects more likely.

Pregnancy and breast-feeding

•    If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. There is only limited information about the safety of Sumatriptan for pregnant women, though up till now there is no evidence of any increased risk of birth defects. Your doctor will discuss with you whether or not you should use Sumatriptan while you are pregnant

•    Don’t breast-feed your baby for 12 hours after using Sumatriptan. If you express any breast milk during this time, discard the milk and don’t give it to your baby.

Driving and using machines

Either the symptoms of migraine or your

medicine may make you drowsy. If you

are affected, don’t drive or operate

machinery.

3 How to use Sumatriptan

5 How to store Sumatriptan

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

When to take Sumatriptan

•    It's best to take Sumatriptan as soon as you feel a migraine coming on,

although - you can take it at any time during an attack

•    Don't use Sumatriptan to try to

prevent an attack - only use it after your migraine symptoms start.

How much to take Adults aged 18 to 65

•    The usual dose for adults aged 18

to 65 is one Sumatriptan 50mg tablet, swallowed whole with water. Some patients may need a 100mg dose - you should follow your doctor's advice.

Children under 1

•    Sumatriptan is not recommended for children under 18 years old.

Older people (aged over 65)

•    Sumatriptan is not recommended for people aged over 65.

If your symptoms start to come back

•    You can take a second Sumatriptan tablet if at least 2 hours have passed since the first tablet. Don't take more than 300mg in total in 24 hours.

If the first tablet has no effect

•    Don't take a second tablet or any

other Sumatriptan preparation for the same attack. Sumatriptan can still be used for your next attack.

If Sumatriptan doesn't give you any relief:

If you take more Sumatriptan than you should

• Don't take more than six 50mg tablets or three 100mg tablets

(that's 300mg in total) in 24 hours. Taking too much Sumatriptan could make you ill. If you have taken more than 300mg in 24 hours:

^Contact your doctor for advice.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4 Possible side effects

Like all medicines, this medicine can cause side effects, but not everybody gets them. Some symptoms may be caused by the migraine itself.

Allergic reaction: get doctor's help straight away

The following side effects have occurred but their exact frequency is not known.

•    The signs of allergy include rash, hives (itchy rash); wheezing; swollen eyelids, face or lips; complete collapse.

If you get any of these symptoms soon after using Sumatriptan:

^ Don't use any more. Contact a doctor straight away.

Common side effects

(affect up to 1 in 10 people)

•    Pain, heaviness, pressure or tightness in the chest, throat or other parts of the body, or unusual sensations, including numbness, tingling and warmth or cold. These effects may be intense but generally pass quickly.

If these effects continue or become

severe (especially the chest pain):

^ Get medical help urgently. In a very small number of people these symptoms can be caused by a heart attack.

Other common side effects include:

•    Feeling sick (nausea) or being sick (vomiting), although this may be due to the migraine itself

•    Tiredness or drowsiness

•    Dizziness, feeling weak, or getting hot flushes

•    Temporary increase in blood pressure

•    Shortness of breath

•    Aching muscles.

Very rare side effects

(affect up to 1 in 10,000 people)

•    Liver function changes. If you have a blood test to check your liver function, tell your doctor or nurse that you are taking Sumatriptan.

Some patients may get the following

side effects but it is not known how

often they occur

•    Seizures/fits, tremors, muscle spasm, neck stiffness

•    Visual disturbances such as flickering, reduced vision, double vision, loss of vision, and in some cases even permanent defects (although these may be due to the migraine attack itself)

•    Heart problems, where your heartbeat may go faster, slower or change rhythm, chest pains (angina) or heart attack

•    Pale, blue-tinged skin and/or pain in your fingers, toes, ears, nose or jaw in response to cold or stress (Raynaud’s phenomenon)

•    Feeling faint (blood pressure may go down)

•    Pain in the lower left side of the stomach and bloody diarrhoea

(ischaemic colitis)

•    Diarrhoea

•    Pain in the joints

•    Feeling anxious

•    Excessive sweating

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report any side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

By reporting side effects, you can help provide more information on the safety of this medicine

Keep out of the sight and reach of children.

Do not use Sumatriptan after the expiry date shown on the carton. The expiry date refers to the last day of that month.

Do not store above 30°C

Medicines should not be disposed of via waste water or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6 Contents of the pack and other information

What Sumatriptan contains

•    The active substance is Sumatriptan (50mg)

•    The other ingredients in the tablets are lactose anhydrous, lactose monohydrate, microcrystalline cellulose, sodium croscarmellose, magnesium stearate, hypromellose, titanium dioxide (E171), red iron oxide (E172) and triacetin.

What Sumatriptan looks like and contents of the pack

Sumatriptan 50mg Tablets are pink, film-coated, capsule shaped tablets, plain on one face and engraved '50' on the other face. Sumatriptan is available in pack sizes of 4 tablets in a blister strip.

Manufactured by: Glaxo Wellcome S.A., Avda.de Extramadura, 3, 09400 Aranda de Duero, Burgos, Spain

Procured from within the EU and repackaged by the Product Licence holder: B&S Healthcare, Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK

Sumatriptan 50mg tablets PLPI: 18799/0240

Leaflet date: 09.07.2014

^Ask your doctor or pharmacist for

advice.