Clustran Injectable (sumatriptan)

Clustran general information

What is Clustran used for?

Clustran injection is used to relieve acute migraine attacks with or without aura, which is the perception of visual disturbances and/or smells and are usually the first sign that a migraine headache is on its way.  Clustran injection should only be used for treatment of a migraine attack to relieve headache and other symptoms, including nausea and sensitivity to light, but they should not be used to prevent migraine headaches from occurring.  You can use Clustran injection at any stage of a migraine attack but it is more effective if taken as soon as possible after the first signs of headache and/or aura.  Clustran injection is also used for treatment of cluster headache, which is a very painful type of headache that occurs in regular cycles or clusters interspersed with periods of remission.  Pain of cluster headache is usually centred over one eye or temple or the forehead.  Clustran injection is not used for treatment of other types of headache and should only be used once a clear diagnosis for migraine or cluster headache has been made.

How does Clustran work?

Clustran injection contains sumatriptan, which belongs to the group of drugs called triptans, and is a serotonin agonist that mimics the action of serotonin (also known as 5-hydroxytryptamine, or 5-HT).  Serotonin is a brain chemical that has many actions including contraction of blood vessels in the brain causing constriction or narrowing of these intracranial blood vessels.  Migraine is thought to be caused by dilatation or widening of blood vessels in the head due to one of many migraine triggers, which in turn stimulates nearby sensory nerves so that you feel pain.  Sumatriptan in Clustran injection binds to and stimulates specific serotonin receptors (5-HT 1 receptors) that are found in these expanded blood vessels causing them to constrict and making them narrow again.  Sumatriptan in Clustran injection is also thought to inhibit trigeminal nerve activity, which helps to relieve the pain of a migraine attack.  Both actions are thought to contribute to the anti-migraine action of Clustran injection to relieve headache and other symptoms of a migraine attack.  Clustran injection delivers sumatriptan directly under the skin where it is rapidly absorbed into the blood.  Sumatriptan in Clustran injection is faster acting than oral administration and is active within 15 minutes of administering and is particularly suitable for patients who suffer nausea and vomiting during a migraine attack. 

What does Clustran contain?

Clustran injection contains the active ingredient sumatriptan succinate (6mg), a serotonin agonist used to treat migraine attack.  It is provided as a pre-filled pen (autoinjector) containing sumatriptan in an isotonic solution of sodium chloride and water.  There are 2 pre-filled syringes per pack.

Treating migraine with Clustran

Clustran injection contains the active ingredient sumatriptan that is used to relieve symptoms of acute migraine, including pain headache, nausea and sensitivity to light.  Clustran injection can be used for migraine attacks with or without aura, which is the perception of visual disturbances and/or smells and are usually the first sign that a migraine headache is on its way, but Clustran injection should not be used to prevent migraine headaches from occurring.  Sumatriptan in Clustran injection is a serotonin agonist that mimics the action of serotonin, which is a brain chemical that has many actions including contraction of blood vessels in the brain causing constriction or narrowing of these intracranial blood vessels.  Migraine is thought to be caused by dilatation or widening of blood vessels in the head due to one of many migraine triggers.  Sumatriptan in Clustran injection stimulates specific serotonin receptors that are found in these expanded blood vessels causing them to constrict and making them narrow again.  Sumatriptan in Clustran injection is also thought to inhibit trigeminal nerve activity, which helps to relieve the pain of a migraine attack.  Both actions are thought to contribute to the anti-migraine action of Clustran injection to relieve symptoms of a migraine attack.  You can use Clustran injection at any stage of a migraine attack but it is more effective if taken as soon as possible after the first signs of headache and/or aura. 

Clustran for cluster headache

Clustran injection contains the active ingredient sumatriptan that is used for treatment of cluster headache, which is a very painful type of headache that occurs in regular cycles or clusters interspersed with periods of remission.  Pain of cluster headache is usually centred over one eye or temple or the forehead.  Sumatriptan in Clustran injection is a serotonin agonist that mimics the action of serotonin, which is a brain chemical that has many actions including contraction of blood vessels in the brain causing constriction or narrowing of these intracranial blood vessels.  Cluster headaches are thought to be caused by dilatation or widening of blood vessels in the head, which puts pressure on the trigeminal nerve causing pain.  However, the cause of these headaches is not fully understood and these types of headache have different symptoms to migraine headache.  Sumatriptan in Clustran injection stimulates specific serotonin receptors that are found in these expanded blood vessels causing them to constrict and making them narrow again.  Sumatriptan in Clustran injection is also thought to inhibit trigeminal nerve activity, which helps to relieve the pain of a cluster headache.  Both actions of Clustran injection are thought to contribute to symptom relief for cluster headache.

What are the side effects of Clustran?

The most commonly reported side effects when taking Clustran injection include transient pain, stinging or burning at site of injection, gastrointestinal upset (nausea, vomiting), dizziness, drowsiness, tingling, loss of sensitivity to pain or touch (hypoaesthesia), sensations of heaviness, pain, sensations of heat or cold, pressure or tightness, weakness, fatigue.

When should Clustran not be used?

You should not use Clustran injection if you:

• are allergic to sumatriptan or any ingredients in Clustran
• have a sensitivity to sulphonamides
• are pregnant or are breastfeeding, without consultation with your doctor have kidney or liver disease
• have had a myocardial infarction (heart attack) or have ischaemic heart disease, angina or Prinzmetal's angina coronary vasospasm, peripheral vascular disease, or a history of cerebovascular accident a (stroke) or transient ischaemic attack (mini-stroke)
• are taking medicines that interact with Clustran injection, including: other serotonin agonist like sumatriptan for migraine, ergotamine or derivatives of ergotamine (including methysergide) for migraine, other serotonin agonist antidepressants like SSRI and SNRI antidepressants, monoamine oxidase inhibitors (MAOIs)

What medications interact with Clustran?

Several medications interact with Clustran injection and should either not be taken while you are taking Clustran or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Clustran injection: other serotonin agonist like sumatriptan and SSRI and SNRI antidepressants, monoamine oxidase inhibitors (MAOIs), ergotamine or derivatives of ergotamine (including methysergide) for migraine, if taken within 24 hours of taking Clustran injection

How should Clustran be taken?

You can take your Clustran injection at any stage of a migraine attack but it is more effective if taken as soon as possible after the first signs of headache and/or aura.  You should use your Clustran injection pre-filled pen device by injecting the entire 0.5ml contents under the skin, usually on the outside of your thigh.  If after your first Clustran injection, your symptoms have improved, you can take another injection if your symptoms return, provided there has been a gap of at least one hour since taking the first injection.  If Clustran injection has not helped relieve your symptoms, you should not take another dose for the same migraine, but you can take another dose if you have another migraine attack in the next 24 hours.  You should not take more than 2 Clustran injections in a 24 hour period.  If you are taking Clustran injection for cluster headache, you should take your injection at the start of each headache, with at least one hour between doses and no more than 2 doses (12mg) in 24 hours. 

How should Clustran be stored?

You should store your Clustran below 25°C in a cool dry place and protect from light.  Needles and syringes may be hazardous and should be disposed of safely and hygienically when you have finished.