title: Sumatriptan succinate : pharmacokinetics of different formulations in clinical practice.
abstract: BACKGROUND
  Migraine is a common neurovascular disorder characterized by recurrent episodes of disabling headache, autonomic nervous system dysfunction, and in some patients, neurological aura symptoms. Triptans are frequently prescribed drugs for the treatment of the acute migraine attack, considering their capability to provide wide efficacy and tolerability.
  
  
  METHODS
  This review discusses pharmacodynamics and pharmacokinetics of sumatriptan succinate, considering the clinical impact of new drug formulations in the treatment of acute migraine and cluster headache. The data were obtained by searching the following keywords in MEDLINE: sumatriptan succinate, pharmacokinetics, pharmacodynamics, triptans, migraine, new delivery systems, relative to the period 1989 - 2012.
  
  
  CONCLUSIONS
  Subcutaneous sumatriptan has been considered as the most efficacious treatment in the acute phase of migraine both on pain alone as well as on associated autonomic symptoms. Pharmacologically, pharmacokinetic parameters, in particular bioavailability, T(max) and C(max) are responsible for the wide efficacy of the compound and the limited adverse effect (AE) profile. The new drug formulations that are the most similar to the pharmacokinetics parameters of the subcutaneous one are promising because they both improve pharmacokinetic bioavailability bypassing the first-pass metabolism and increase patient compliance.
authors.affiliation: NESMOS Department, Advanced Molecular Diagnostic Unit, Sapienza University, Sant'Andrea Hospital, Via di Grottarossa 1035,Rome, Italy.
authors.forename: Luana
authors.initials: L
authors.lastname: Lionetto
authors.forename: Andrea
authors.initials: A
authors.lastname: Negro
authors.forename: Barbara
authors.initials: B
authors.lastname: Casolla
authors.forename: Maurizio
authors.initials: M
authors.lastname: Simmaco
authors.forename: Paolo
authors.initials: P
authors.lastname: Martelletti
mesh_terms: D000818:Animals; D003027:Cluster Headache / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000378:metabolism; D058825:Serotonin 5-HT1 Receptor Agonists / Q000494:pharmacology* / Q000627:therapeutic use; D018170:Sumatriptan / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D058825:Serotonin 5-HT1 Receptor Agonists; D014662:Vasoconstrictor Agents; D018170:Sumatriptan