Imitrex (sumatriptan) is a prescription drug that’s used to treat a migraine episode in adults. In addition, Imitrex injection is approved to treat cluster headache in adults.
Like other drugs, Imitrex may have interactions.
Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Imitrex’s possible interactions. And for more information about Imitrex, including details about its uses, see this article.
Certain health conditions or other factors could raise your risk of harm if you use Imitrex. In such cases, your doctor may not prescribe Imitrex for you. These are known as contraindications. The list below includes contraindications of Imitrex.
If you have any of the following conditions, your doctor will likely not prescribe Imitrex for you. This is due to the risks described below. Your doctor can discuss other migraine treatments that may be safer for you.
If you have coronary artery disease or coronary artery spasms. Imitrex can cause heart-related side effects, including serious ones such as heart attack. If you already have coronary artery disease or coronary artery spasms, your risk for heart-related side effects with Imitrex is higher.
If you have Wolff-Parkinson-White syndrome or another problem with your heart’s electrical signal. Imitrex can cause heart-related side effects, including life threatening problems with your heart rhythm. If you have Wolff-Parkinson-White syndrome or another problem with your heart’s electrical signal, your risk of heart-related side effects with Imitrex is higher.
If you have peripheral vascular disease. Imitrex can cause problems with your blood vessels and blood flow, including narrowing your blood vessels. If you have peripheral vascular disease, using Imitrex could worsen your condition.
If you have high blood pressure that isn’t well managed. Imitrex can cause heart-related side effects, including serious ones such as heart attack. Your risk for heart-related side effects with Imitrex is higher if you have high blood pressure that isn’t well managed.
Because of this risk, your doctor will not prescribe Imitrex if you have high blood pressure that isn’t well managed. Instead, they’ll treat your high blood pressure first before deciding whether to prescribe Imitrex for you.
If you’ve had a stroke or transient ischemic attack (“ministroke”). Imitrex can cause stroke or bleeding in the brain. Having migraine (the condition Imitrex treats) also raises your risk for stroke or bleeding in your brain.
If you have hemiplegic migraine or basilar migraine. Imitrex can cause stroke or bleeding in the brain. People with hemiplegic migraine or basilar migraine have a higher risk for these side effects.
Because of this risk, Imitrex is not approved to treat these forms of migraine. Your doctor will not prescribe Imitrex if you have hemiplegic or basilar migraine. They can discuss other treatment options with you.
If you have ischemic bowel disease. Imitrex can cause bowel ischemia (restricted blood flow to your intestines). If you already have ischemic bowel disease (such as ischemic colitis), using Imitrex could worsen your condition.
If you have severe liver problems. Your body depends on your liver to break down Imitrex after you take a dose. If you have mild or moderate liver problems, your doctor will prescribe a lower dose of Imitrex for you.
Doctors generally avoid prescribing Imitrex to people with severe liver problems. This is because severe liver problems can cause Imitrex levels to build up in your body, which raises your risk for side effects. There is not a dose of Imitrex considered safe to take if you have severe liver problems.
If you take or have recently taken a monoamine oxidase inhibitor (MAOI) drug. You should not take Imitrex if you are also taking an MAOI. You should also avoid taking Imitrex for at least 14 days after your last dose of the MAOI. This is because taking an MAOI with Imitrex causes Imitrex levels in your body to greatly increase. This raises your risk for side effects from Imitrex.
For examples of MAOI drugs, see the “Does Imitrex interact with other drugs?” section below.
If you take or have recently taken certain other migraine drugs. You should not take Imitrex within 24 hours of taking a migraine drug that contains ergotamine, such as dihydroergotamine (Migranal). You should also not take Imitrex within 24 hours of using another triptan medication for migraine, such as rizatriptan (Maxalt). Imitrex is a type of triptan medication, which are medications used to treat migraine.
For examples of other migraine drugs that should not be taken around the same time as Imitrex, see the “Does Imitrex interact with other drugs?” section below.
If you’ve had an allergic reaction. If you have had an allergic reaction to Imitrex or any of its ingredients, your doctor likely will not prescribe Imitrex. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start Imitrex treatment, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Imitrex is safe for you to use.
There’s no known interaction between Imitrex and alcohol. But alcohol can cause new or worsening migraine or cluster headache (the conditions that Imitrex treats).
If you drink alcohol, talk with your doctor about how much (if any) may be safe to drink during your Imitrex treatment.
Before you start Imitrex treatment, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Imitrex interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Imitrex?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The chart below lists drugs that may interact with Imitrex. Keep in mind that this chart does not include all drugs that may interact with Imitrex. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| Monoamine oxidase inhibitors (MAOIs) | • tranylcypromine (Parnate) • phenelzine (Nardil) • isocarboxazid (Marplan) | can increase the risk of side effects from Imitrex |
| Migraine drugs that contain ergot or ergotamines | • dihydroergotamine (Migranal, Trudhesa) • ergotamine (Ergomar) | can increase the risk of side effects from Imitrex and other migraine drugs |
| Other triptan drugs | • rizatriptan (Maxalt) • almotriptan (Axert) • zolmitriptan (Zomig) | can increase the risk of side effects from Imitrex and other triptan drugs |
| selective serotonin reuptake inhibitors (SSRIs) | • sertraline (Zoloft) • fluoxetine (Prozac) • paroxetine (Paxil) | can increase the risk of side effects from Imitrex and SSRIs |
| serotonin-norepinephrine reuptake inhibitors (SNRIs) | • duloxetine (Cymbalta) • venlafaxine (Effexor XR) | can increase the risk of side effects from Imitrex and SNRIs |
| tricyclic antidepressants (TCAs) | • amitriptyline • nortriptyline (Pamelor) | can increase the risk of side effects from Imitrex and TCAs |
Learn more about certain drug interactions that can occur with Imitrex.
Interaction with SSRIs and SNRIs
Imitrex may interact with selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These are two groups of drugs used to treat certain mental health conditions, including depression.
Examples of SSRIs include:
Examples of SNRIs include:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
- desvenlafaxine (Pristiq)
- levomilnacipran (Fetzima)
What could happen
Taking Imitrex with an SSRI or SNRI raises your risk for serotonin syndrome. Having a too high serotonin level in your body causes this syndrome. (Serotonin is a chemical your body produces naturally). This interaction can happen because both Imitrex and SSRIs, and SNRIs increase the serotonin level in your body.
Symptoms of serotonin syndrome include:
- nausea and vomiting
- muscle tremors, spasms, twitching, or jerking
- rigid muscles
- excessive sweating
- fast heart rate
- feeling anxious, confused, or restless
- dry mouth
- dilated pupils
- seizure
What you can do
Before you start Imitrex treatment, tell your doctor and pharmacist if you’re taking an SSRI or SNRI.
Call your doctor immediately if you think you’re experiencing symptoms of serotonin syndrome during your Imitrex treatment. But if your symptoms feel life threatening, go to the closest emergency room, or call 911 or your local emergency number.
If you develop serotonin syndrome during your treatment, your doctor will likely have you stop taking Imitrex.
Interaction with tricyclic antidepressants
Imitrex can interact with a group of drugs called tricyclic antidepressants (TCAs).
TCAs are used to treat depression.
Examples of TCA medications include:
- amitriptyline
- nortriptyline (Pamelor)
- desipramine (Norpramin)
- imipramine (Tofranil)
- doxepin (Silenor)
What could happen
Taking Imitrex and a TCA together raises your risk for serotonin syndrome. Having a too high serotonin level in your body causes serotonin syndrome. This interaction can happen because both Imitrex and TCAs increase the serotonin level in your body.
Symptoms of serotonin syndrome include:
- nausea and vomiting
- muscle tremors, spasms, twitching, or jerking
- rigid muscles
- excessive sweating
- fast heartbeat
- feeling anxious, confused, or restless
- dry mouth
- dilated pupils
- seizure
What you can do
Before starting Imitrex treatment, tell your doctor and pharmacist if you’re taking a TCA drug.
If you think you’re experiencing symptoms of serotonin syndrome during your Imitrex treatment, call your doctor right away. But if your symptoms feel life threatening, go to the closest emergency room, or call 911 or your local emergency number.
If you develop serotonin syndrome during your Imitrex treatment, your doctor will likely have you stop using the drug.
Imitrex may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Imitrex.
Does Imitrex interact with supplements?
Before you start Imitrex treatment, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Imitrex and herbs
There are currently no reports of Imitrex interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Imitrex treatment.
Imitrex and vitamins
There are currently no reports of Imitrex interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Imitrex treatment.
Does Imitrex interact with food?
There are currently no reports of Imitrex interacting with food. If you have questions about eating certain foods during your Imitrex treatment, talk with your doctor.
Does Imitrex interact with vaccines?
Imitrex isn’t known to interact with any vaccines. Talk with your doctor or pharmacist if you have questions about receiving vaccines while taking Imitrex.
Does Imitrex interact with lab tests?
Imitrex isn’t known to interact with any lab tests. If you have questions about having any lab tests done while taking Imitrex, talk with your doctor.
Does Imitrex interact with cannabis or CBD?[without cannabis interaction]
There are currently no reports [link to PI] of Imitrex interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Imitrex.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Imitrex. Before starting Imitrex treatment, talk with your doctor about your health history. They’ll determine whether Imitrex is right for you.
When Imitrex shouldn’t be used
If you have any of the following conditions, your doctor will likely not prescribe Imitrex. To learn more, see the “When should I avoid Imitrex?” section above.
- If you have coronary artery disease or coronary artery spasms
- If you have Wolff-Parkinson-White syndrome or another problem with your heart’s electrical signal
- If you have peripheral vascular disease
- If you have high blood pressure that isn’t well managed
- If you’ve had a stroke or transient ischemic attack (“mini-stroke”)
- If you have hemiplegic or basilar migraine
- If you have ischemic bowel disease
- If you have severe liver problems
- If you take or have recently taken a monoamine oxidase inhibitor (MAOI) drug
- If you take or have recently taken certain other migraine drugs
Other health condition interactions with Imitrex
Other health conditions or other factors that might interact with Imitrex include:
High cholesterol or diabetes. Having high cholesterol or diabetes raises your risk for heart disease. If you have one or more risk factors for heart disease, your doctor will likely test your heart health before prescribing Imitrex for you. If Imitrex isn’t safe for you, your doctor can discuss other treatment options.
Tobacco use. Using tobacco, such as smoking, increases your risk for heart disease. If you have one or more risk factors for heart disease, your doctor will likely test your heart health before prescribing Imitrex to you. If Imitrex isn’t appropriate for you, your doctor can discuss other treatments with you.
Pregnancy. It’s not known whether Imitrex is safe to take while pregnant or breastfeeding. If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options.
Breastfeeding. It’s recommended that you don’t breastfeed for at least 12 hours after taking a dose of Imitrex. If you’re breastfeeding or planning to breastfeed, talk with your doctor before starting Imitrex treatment.
Allergic reaction. If you’ve had an allergic reaction to Imitrex or any of its ingredients, your doctor will likely not prescribe Imitrex. This is because taking the drug could cause another allergic reaction. Ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Imitrex. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Imitrex treatment.
It’s also important to understand Imitrex’s
Taking Imitrex exactly as prescribed can also help prevent interactions.
If you still have questions about Imitrex and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Do other drugs for preventing or treating migraine have similar interactions?
- Could I still take Imitrex even if it interacts with a health condition I have?
- Do I need to tell you if I start taking another medication or supplement during my Imitrex treatment?
To learn more about Imitrex, see these articles:
- All About Imitrex
- Dosage for Imitrex: What You Need to Know
- Side Effects of Imitrex: What You Need to Know
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.