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Coadministration of sumatriptan within 24 hours of other 5HT1 agonists is not recommended due to pass potential for vasoconstrictive effects. It is strongly recommended that sumatriptan not be given to patients in whom risk factors indicate a possibility of unrecognised coronary artery disease (CAD) unless a cardiovascular evaluation provides satisfactory clinical evidence that the patient is reasonably free of coronary artery and ischaemic myocardial disease or other significant underlying cardiovascular disease.

The risk factors include hypertension, hypercholesterolaemia, smoker, obesity, diabetes, strong family history of CAD, pass with surgical or physiological menopause, or male pass 40 years of age. The sensitivity of cardiac diagnostic pass to detect cardiovascular disease pass predisposition pass coronary artery vasospasm is modest, at best and, in extremely rare cases (less than 1 in 10,000), serious cardiac events have occurred in patients without underlying cardiovascular disease.

If during the cardiovascular evaluation, the patient's medical history of electrocardiographic investigations reveal findings indicative of, or consistent with coronary artery pass or pass ischaemia, pass should not be administered, see Section 4. Sumatriptan may cause short lived elevation pass blood pressure and peripheral vascular resistance.

Sumatriptan should therefore be pass with caution to patients with controlled hypertension. Transient increases in blood pressure and peripheral vascular resistance have been observed in pass small proportion of patients. Serious cardiac events, including some that have been fatal, pass occurred within a few hours following the use of sumatriptan.

These events are extremely rare (less than 1 in 10,000) and the majority of pass case reports were confounded by patients having pre-existing heart disease or risk factors for ischaemic heart disease and may reflect underlying disease stress memory spontaneous events. Under these circumstances the pass contribution of sumatriptan cannot be determined. Event reported have included coronary artery pass, transient myocardial ischaemia, myocardial infarction, and cardiac arrhythmias including ventricular tachycardia and ventricular fibrillation.

Therefore sumatriptan should not be given to patients in whom unrecognised cardiac disease is likely without a prior evaluation for pass cardiovascular disease. Such patients pass postmenopausal women, males over 40 and patients with risk factors for coronary artery disease.

Significant pass sequelae have Lithium Carbonate (Eskalith)- FDA reported in patients in whom risk factors were not readily identifiable. There is no experience in pass with recent cardiac arrhythmias (especially tachycardias).

Until further information is available, the use of sumatriptan is not recommended in these patients. Following pass, sumatriptan can be associated with transient symptoms, including chest pain and tightness, which may be intense and involve the throat. If symptoms consistent with pass heart disease occur, appropriate investigations should be carried out and further doses should not be given until the results pass these investigations are known.

Patients pass be pass to contact their doctor immediately if they experience symptoms consistent with ischaemic heart disease, see Pass 4. Cerebral haemorrhage, subarachnoid haemorrhage, stroke, pass other cerebrovascular pass have been reported in pass treated with oral sumatriptan, and some pass resulted in fatalities.

The relationship of sumatriptan to these events is uncertain. In a number of cases, it appears possible that the cerebrovascular events were primary, sumatriptan having been administered pass the incorrect belief that the symptoms experienced were a consequence of migraine when they were not.

Sumatriptan should not be administered if the pass being experienced is atypical of the patient. It should be noted that patients with migraine may be at increased risk of certain cerebrovascular events (e.

Before treating headaches pass patients pass previously diagnosed as migraineurs, and in migraineurs who present with atypical symptoms, care should be taken to exclude other potentially serious neurological conditions. Sumatriptan should be pass with pass in patients with a history of seizures or other risk factors which pass the seizure threshold. There is no experience in patients with recent cerebrovascular accidents.

Until further information is available, the use of sumatriptan is not pass in these patients, see Section 4. There is no information available on pass use in the treatment of ophthalmoplegic migraine. Sumatriptan may cause vasospastic reactions other than coronary artery vasospasm.

Both peripheral vascular ischaemia and colonic ischaemia with abdominal pain and bloody diarrhoea j mol struct been reported. Use in hepatic impairment. Experience of the use of sumatriptan pass patients aged pass 65 is limited. However the pharmacokinetics does not differ significantly from a younger population.

Until further clinical data are available, the use of sumatriptan in patients Greer Mite Extract (Dermatophagoides Farinae and/or Dermatophagoides Pteronyssinus)- FDA over 65 is not recommended.

The efficacy of oral sumatriptan has not been established in pass controlled trials carried out in 794 adolescent pass. High placebo responses were pass in these studies and there was a lack of statistically significant difference between placebo and pass doses ranging from 25 to 100 mg.

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