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Topic: Question? Imitrex limit. (Read 272 times) |
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brad1215
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Question? Imitrex limit.
« on: Mar 19th, 2004, 1:44am » |
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 I was hoping someone could shed some light on a problem my wife and I just encountered. About 2 weeks ago I went to my med. facility to get a prescription for Imitrex nasel spray, he gave me one and I picked it up. In the box it contains 6 (20mg) sprays. Well that lasted for about 5-6 days. I then went back to the same place and saw a different doctor( he owns the facility) and he prescribed me 3 refills. Mind you this is an after hours emergancy facility, I can never see my regular doctor they are toooooo... busy (but never too busy to collect my insurance money). Well I refilled my prescription and went home about 6-7 days later while during an attack my wife went to fill my prescription and they did. Now I am down to 1 spray left and we went to fill my last prescription and they declined it. Even though I had 1 left. When my wife called the insurance company and asked about it the replied taht the FDA says it is against the law for them to allow me to take more than 6 sprays in 30 days. On the package insert it says that dosages are as follows : take one spray if headache continues take another spray no sooner than 2 hours after previous use and not to exceed 2 sprays in 24 hours. Also that there is no study on persons who have suffered more than 4 episode in 1 month.
Has this happened to anyone else?
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Kevin_M
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Re: Question? Imitrex limit.
« Reply #1 on: Mar 19th, 2004, 1:55am » |
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Brad,
I have heard others mention that six a month limit. It is impractical for clusters. I do not know why that is. Some though have no problem getting more. Don't know what the deciding factor is. I think T H B knows stuff about medical functioning, perhaps others too.
Sorry no explaination from me, but I do get more than that. I don't know why and I don't ask.
Kevin M
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Damon
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Re: Question? Imitrex limit.
« Reply #2 on: Mar 19th, 2004, 2:23am » |
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Sounds like a lot of pharmacy BS to me.
I get more than that because my neuro got a medical neccessity ins. override. The only problem I've had is that the pharmacy dosen't have enough on hand, they give me what they have and I pick up the rest later.
See if you can get an override letter, it makes a big difference.
MPFDAN,
Damon
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pubgirl
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Re: Question? Imitrex limit.
« Reply #3 on: Mar 19th, 2004, 3:25am » |
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Brad
We were told over here that the main reason this silly limit exists- it happens here too (apart from cost of course) is that like many of the drugs Imitrex started out as a migraine drug.
Since migrainers often get sporadic and infrequent attacks (often 1-2 per month), and triptans often block further attacks for 24 hours, the recommendation appears to stem from the drug companies and doctors seeing this a suitable amount to prescribe for migraine sufferers. Yet again, CH gets no recognition.
We were told to explain this to whoever is prescribing and insist that this limit is utterly wrong for CH and to explain that we can have 6 attacks in 24 hours, never mind a month!
Hope you get what you need
Wendy
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Giovanni
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Re: Question? Imitrex limit.
« Reply #4 on: Mar 19th, 2004, 5:44am » |
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Wendy's right, they're basing the information on migraine episodes rather than individual attacks of cluster headaches. I get 9 boxes of stat dose imitrex injections per month or 18 shots. When out of cycle, I save like crazy and stock up because this is not enough when in cycle.
Your emergency doctor's diagnosis needs to reflect cluster headaches not migraine as far as insurance purposes. This should free up additional meds from the insurance company. Also, an "over-ride" on the quantity from the physician directly to the insurance company stating the amount you really need.
John
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UN_SOLVED
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Re: Question? Imitrex limit.
« Reply #5 on: Mar 19th, 2004, 11:11am » |
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on Mar 19th, 2004, 5:44am, Giovanni wrote: When out of cycle, I save like crazy and stock up because this is not enough when in cycle.
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Great advice. I did that too (w/ injections) when I was epesodic. Never know when you'll need a few hundred !
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Karla
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Re: Question? Imitrex limit.
« Reply #6 on: Mar 19th, 2004, 1:25pm » |
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My dr perscribed me imitrix ns 20mg to take at onset and may repeat in 2hrs. Not to take more than 4 a day. I was able to get a box of 6 20mg and 6 10mg every 3 days as my insurance allowed. My dr had to write a letter stating the need for the high amount of need for usage. Then I had no problems. The medical pd book states not to use more than 40mg of imitrix in 24 hours. However I have used 40-80 a day for years and the only problem I have noted is anxiety caused by high imiitrix use.
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Karla
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Lizzie2
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Re: Question? Imitrex limit.
« Reply #7 on: Mar 19th, 2004, 3:21pm » |
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Hey Brad,
If I'm remembering correctly from my reading on triptan limitations, if the reason they gave you is based on the FDA...it is bullshit! The FDA has NOT placed limitations on the use of triptans. (per month that is....there are limitations on how many doses you can take in a day, however) That is your insurance company trying to use a cop-out.
I'm going through a similar situation right now. My doctor prescribed Amerge for me to take twice a day for 1-2 weeks in an attempt to break cluster cycle and either break or at the very least calm down my chronic migraine. He prescribed 18 pills, and I was told last night at the pharmacy that I could only get 9. I actually had two drug problems last night at the pharmacy, and I honestly wanted to wring her neck....but it really wasn't the pharmacist's fault. It's the freaking insurance company.
So today I called my doctor and they are going to send a letter to the insurance company. Based on the response from that, I will determine what action I need to take next. It is WRONG that they make up lies to deny people the medications they need, and that makes me so angry!!
Anyhow...best of luck. Call your doc first and see if their office has any suggestions or can do anything. If they can't, there are definately some processes you can take with the insurance company..but unfortunately..none of it produces very speedy results.  Take care!
Lizzie
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| « Last Edit: Mar 19th, 2004, 3:22pm by Lizzie2 » |
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vangogh71
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Re: Question? Imitrex limit.
« Reply #8 on: Mar 22nd, 2004, 11:27pm » |
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Here in Canada I have been getting a box of 6 doses every three days and I have 6 refills on file with the pharmacy. The most frustrating part is that the pharmacy has run out in the past and I had to travel around the city to pick up my "fix."
I really feel sorry for the Americans on this site having to fight for a truly basic necessity.
My only insurance struggle is the disability people at my work asking what my limitations are and when I can go back to work. I asked the Rep what people would think of me bashing my head with a tennis ball at my desk and she left me alone after that!
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