Guidelines for when to recommend sumatriptan

Sumatriptan is a pharmacy only medicine and can be supplied over the counter by a Medicines Counter Assistant. The guidelines below should be used when supplying sumatriptan.

You may supply sumatriptan if you have established that:

  • The patient has been diagnosed as suffering from migraine.
  • They have failed to obtain relief from OTC painkillers.
  • Established pattern of migraine (five of more attacks in 12 months).

Sumatriptan should not be supplied to customers/patients who are:

  • under 18 or over 65 years of age.
  • pregnant or breastfeeding (refer to doctor).
  • diagnosed with heart problems or with a family history of heart problems.
  • in danger of or recovering from a stroke.
  • being treated for any of the following:
    • high blood pressure.
    • kidney, peripheral vascular or liver disease.
    • epilepsy or who are prone to fits.
  • Women taking combined oral contraceptives (refer to GP).

The following symptoms indicate an underlying disease that need to be referred to the GP. These are known as RED FLAG symptoms.

  • Frequent or severe headaches that come on suddenly.
  • Anyone complaining of the following symptoms: unilateral muscle weakness, double vision, tinnitus, clumsy and uncoordinated movement and reduced level of consciousness, weakness of muscles controlling eye movement, along with a headache lasting a week or more.
  • A headache following an accident, in particular a head or neck injury.
  • Anyone experiencing blackouts.
  • Headaches brought on with every cough, sneeze, bend or by standing up.
  • Weakness, numbness or slurred speech.
  • Anyone with a headache lasting longer than 24 hours.
  • Additional features such as seizure-like movements, a rash or a headache confined to the back of the head.
  • Headaches that frequently wake someone from sleep.
  • Anyone whose migraine attack occurs for the first time after 50 years of age.
  • Anyone diagnosed with high blood pressure.
  • Recent marked deterioration in migraine (duration, severity or frequency).
  • Women with migraine using the combined oral contraceptive pill.

 Download our guidance sheet