The intake of this drug has also led to cardiac events within 1 hour of sumatriptan administration. These cardiac diseases are coronary artery vasospasm, cardiac arrest, myocardial infarction, transient ischemia, ventricular fibrillation, ventricular tachycardia and death.  

Some of these effects appeared in patients who had no findings of CAD and appear to signify consequences of coronary artery vasospasm. Yet, so far as domestic reports of serious cardiac effects within 1 hour of sumatriptan use are concerned, almost all of the patients had risk factors predictive of CAD.

No adequate study has been made on the effects of Imitrex on patients having renal problem. But little clinical effect would be anticipated as sumatriptan is largely metabolized to an inactive substance.  

Generic Imitrex Sumatriptan is mainly eliminated by the liver. As a result, it can't be eliminated in patients with liver disease. Based on a small study of hepatically impaired patients (N = 8) matched for sex, age, and weight with healthy subjects, the hepatically impaired patients showed an approximately 70% increase in AUC and Cmax and a Tmax 40 minutes earlier than the healthy subjects.  Another alternative to Imitrex is generic Amerge