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        Cluster Headache Help and Support >> Cluster Headache Specific >> Imitrex frequency
        
(Message started by: jwohlman on Feb 28^th, 2007, 2:06pm)

Title: Imitrex frequency
Post by jwohlman on Feb 28^th, 2007, 2:06pm

Hi. I am new to ch.com and this is my first post. Although I have had 1 or 2 cycles before, I didn't know about cluster headaches and thought I was just getting unbelievably intense migraines; I have been getting migraines for many years, but now realize that what I am experiencing now is fundamentally different. My current cycle started about 8 days ago.

I have been having very intense headaches that I now recognize as cluster headaches for the last 8 days. The attacks always come between 11pm and 2am waking me up. They are always in/around my left eye. I have hurt my head banging it against things, pace, moan, place my head in ice water, etc.

Because I get migraines I have 50mg imitrex tablets available. I take one as soon as I wake up from the headache, but it takes from 30-60 minutes to work.

I recently had an MRI to rule out other causes, and now have an appointment with a headache specialist. The earliest appointment is 3 weeks away.

My question is this: My primary care physician who prescribes the imitrex says that i should not take the imitrex more than twice a week. Right now this is the only treatment I have available. I will ask the neurologist about oxygen or other therapies when I see him. But what I need to know is whether it is generally safe to take the imitrex daily at least for the next 3 weeks until I see the neurologist. I really don't have any other choice. I am a smoker of 25 years but I also recently had a cardiac stress test and it came up normal.

Please can someone tell me whether, in theory, and knowing there are no guarantees, is it generally safe to take the 50mg imitrex once a day for a little over 4 weeks??

Thanks

Title: Re: Imitrex frequency
Post by Lobster on Feb 28^th, 2007, 2:28pm

Two Imitrex doses per day is the published limit, I believe.

Ditch the pills for reasons you already know.

Get injections... read up on here about them. Vials and syringes, not the stat dose.
Give yourself about 1/3 of a normal dose... yes, that works for many CHers.
Then technically you should be good to go for about 6 injections a day and still be within the limits.

Title: Re: Imitrex frequency
Post by jwohlman on Feb 28^th, 2007, 2:41pm

Thanks lobster.

I can ask my pcp for the injection rather than pills, but she may tell me to wait until I see the neurologist.

When I do see him I am going to tell him I want to try oxygent therapy. But I will also ask him for the injectible imitrex.

The imitrex has worked every time, it's just that in pill form it takes so long it's torture waiting for the pain to go away. Since it always goes away in about the same amount of time following the pills I do believe that it is the imitrex working rather than just the headache going away.

I will also ask him about velaparil. A lot of people here seem to use it in conjuction with imitrex.

My current primary care doc wants me to try neurontin as a preventive, but I want to take as few meds as possible unless I am relatively sure they will work.

Title: Re: Imitrex frequency
Post by Karla on Feb 28^th, 2007, 4:37pm

Imitrex nasal spray is almost as fast as the shot. It works in about 15 min. or less. Trade off is nasal drainage for no pokes. I used to take 4 20mg ns a day. Now I have a good preventative that I don't need to use an abortive.

Title: Re: Imitrex frequency
Post by daniel96 on Feb 28^th, 2007, 9:00pm

hi there, the imitrex pills a.k.a sumatriptan is limited to 2 pills per day. I am currently on 2 weeks medication of that based on 2 times per day. Going to get my O2 soon to helps to get the pain away faster.

Title: Re: Imitrex frequency
Post by Bob P on Mar 1^st, 2007, 7:07am

If you are using 50mg tabs, you can take up to 4 doses per day.
From RxList:

Quote:

If your symptoms are only partly relieved, or if your headache comes back, you may take a second dose after two hours or as directed by your doctor. Do not take more than 200 milligrams in a 24-hour period.

Title: Re: Imitrex frequency
Post by Bob_Johnson on Mar 1^st, 2007, 10:57am

http://www.headachedrugs.com/pdf/ha2006.pdf Dr. Robbins site. Then explore the entire site by deleting everything following. com/ and then hit enter.
=========================================================================
Here is a link to read and print and take to your doctor. It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S. (2002)

http://www.brightok.net/~mnjday/chtherapy.pdf
--------------------------
Funct Neurol. 2000 Jul-Sep;15(3):167-70. Related Articles, Links

Sumatriptan overuse in episodic cluster headache: lack of adverse events, rebound syndromes, drug dependence and tachyphylaxis.

Centonze V, Bassi A, Causarano V, Dalfino L, Cassiano MA, Centonze A, Fabbri L, Albano O.

Dept of Internal Medicine and Public Medicine, University of Bari, Italy.

This observational study was designed to examine the pattern of sumatriptan use in patients with cluster headache using more than the recommended daily dose of subcutaneously injected (s.c.) sumatriptan. Thirteen patients suffering from episodic cluster headache were asked to record the characteristics of their attacks and drug intake for 1 year. All reported a high daily frequency of attacks (more than 3 per day) and the related overuse of s.c. sumatriptan. The results show that the overall incidence of adverse events among patients receiving sumatriptan injections for the treatment of cluster headache is low. The extended administration of this drug in episodic cluster headache did not result in tolerance problems or tachyphylaxis. Only 4 patients experienced minor adverse events and recovered more slowly than the others. They suffered from migraine without aura and cluster headache, and showed a family history of migraine. Even though they must be viewed with caution, due to the observational nature of the study and the low number of patients included, these results suggest that the profile of sumatriptan may differ in cluster headache compared with migraine.

PMID: 11062845

Title: Re: Imitrex frequency
Post by froggy on Mar 2^nd, 2007, 1:31am

Tony takes up to 200 mg/day max (100mg at a time).