title: Activation of pain by sumatriptan.
abstract: OBJECTIVE
  To demonstrate that sumatriptan may induce activation or aggravation of pain at sites of inflammation caused by trauma or disease.
  
  
  METHODS
  Case reports from the national pharmaco vigilancecenters of 2 countries, The Netherlands and New Zealand, are presented. These reports come from programs that use 2 methodologies to monitor drugs for adverse reactions: spontaneous reporting and a prospective observational cohort study. The potential mechanisms for pain production by sumatriptan are discussed in detail.
  
  
  RESULTS
  Thirteen case reports of activation of pain by sumatriptan following injury and 8 associated with inflammatory diseases are presented. Most patients had one or more positive rechallenges. This type of reaction occurred at a higher rate with the subcutaneous formulation than with the oral preparation. Pain mostly was severe but short-lasting; pain was prolonged in some patients with inflammatory disease.
  
  
  CONCLUSIONS
  A strong association has been demonstrated between the use of sumatriptan and the production of pain at sites of inflammation, and there is a plausible pharmacological mechanism for this reaction. Pain activation may be a class effect of the selective serotonergic agonists used in the treatment of migraine.
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced* / Q000503:physiopathology; D011446:Prospective Studies; D012008:Recurrence; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D018170:Sumatriptan / Q000008:administration & dosage / Q000009:adverse effects*; D014947:Wounds and Injuries / Q000503:physiopathology
chemical_list: D017366:Serotonin Receptor Agonists; D018170:Sumatriptan