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Potential Risks of Headache Medication

Nine years ago, Mayo Clinic researchers documented two cases of an intestinal condition they thought to be associated with the use of sumatriptan (Imitrex, Imigran, Imigran Recovery), a medication in common use for the relief of migraine headaches.

Direct Connection

The researchers documented a direct connection between the use of the drug sumatriptan and mesenteric ischemia, and an intestinal condition with symptoms such as acute cramps, abdominal pain, and bloody diarrhea.

The mesenteric arteries supply blood to both the large and small intestines. Ischemia occurs when blood cannot flow or is impeded and the intestines do not receive the oxygen they need to perform as usual. Mesenteric ischemia usually involves the small intestine and occurs when one or more mesenteric arteries narrow or become blocked.  The blockage causes severe abdominal pain. In a short time, the blockage can worsen and cause tissue death in the intestines due to lack of blood flow-the source of oxygen for these tissues.

Possible Link

Earlier, doctors suspected a possible link between the drug and eight cases of ischemic colitis and reported their suspicions to the Food and Drug Administration (FDA). Ischemic colitis is a condition in which part of the large intestine, the colon, becomes inflamed and sustains injury. This condition is less severe than mesenteric ischemia though both are caused by impaired blood flow to the intestines. If left untreated, ischemic colitis may lead to permanent colon damage.

Most people experience ischemic colitis on the left side of the abdomen. Symptoms include urgent bowel movements and bloody diarrhea. It is usual for cases to resolve without intervention, but a physician should be consulted, since the condition has the potential of becoming severe.

Jerry Swanson, M.D., a Mayo Clinic neurologist explained that sumatriptan is one of the more common prescriptions for migraine headache pain. He cited an estimated 6.7 million prescriptions written during the year 1998. Says Swanson, "For most people, this medication offers very effective pain relief. But in rare cases, it can cause some potentially fatal complications."

David Brandhagen, M.D., a gastroenterologist at the Mayo Clinic, and the senior author of this case study stated, "We want to make sure that patients who take sumatriptan for the relief of their migraines are aware of the potential seriousness of these symptoms. Patients who take sumatriptan should discontinue the use of this medication and consult with their physician immediately if they experience abdominal pain and bloody diarrhea.

In April of 2008, the FDA approved a combination of sumatriptan and naproxen, an NSAID, to be marketed under the brand name Treximet.