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Title: Imitrex-how much is too much? Post by Jahras on Feb 13th, 2007, 6:04pm I've been getting episodic CH's since I was 20, about 12 years now. Only recently diagnosed. Imitrex tablets have given me great relief, and I recently started using the nasal spray too (20mg), which is only effective if I catch it very early. The problem i have is that 50mg of imitrex in tablet form takes about 25-28 minutes to go into effect for me, and isn't always sufficient. I've just started a new job and have a very busy schedule, so to avoid losing an hour or more (and more importantly to avoid an hour plus of pain!) i've been taking 100mg tablets with every episode that gets past the nasal spray stage. I think I'm towards the end of my cycle (in week 6 now) and getting 2-3 CHs a day (or rather night and early morning). I'm taking a hefty amount of imitrex and starting to worry about possible damage i'm doing to my body, though i've felt no side effects yet. Will complications sneak up on me, or should there be telltale signs? Also, i've read people talk about imitrex being a cause for CHs, and I'm beginning to suspect that may be the case with me. Is this clinically proven or widely observed? Any insight is welcome. |
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Title: Re: Imitrex-how much is too much? Post by georgej on Feb 13th, 2007, 6:10pm on 02/13/07 at 18:04:20, Jahras wrote:
I'm not aware of any clinical proof, but there have been some anecdotal suspicions of that nature here. I'll defer to others (who take imitrex) to answer this question more fully, as well as your other concerns. Best wishes for pain-free times ahead, George |
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Title: Re: Imitrex-how much is too much? Post by froggy on Feb 13th, 2007, 6:11pm Jahras, Sounds like you're pretty well informed about things. What I do know is that just about every neuro my husband has been to always warns about Imitrex causing a rebound headache pattern. Tony (the husband), when the headaches are really tough, limits himself to taking only 200 mg Maximum per day to avoid the rebounds. Sometimes he will go a full day in between no matter how bad the pain is just to "dry out" a little. Have you tried the Red Bull type energy drinks yet? Tony uses Monster Khaos which works great for him and allows him to break up what medications he has to take for pain. Good luck on your journey |
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Title: Re: Imitrex-how much is too much? Post by BlueMeanie on Feb 13th, 2007, 6:51pm Welcome Jahras, First off, I'd ditch the pills. They take way too long to help. If your going to continue to use Imitrex, you should get the shots. They work within 10-15 minutes. Read the package on the label. It should say how much you can take within a 24 hour time span. For the shots, you can take 2 a day. On the left of the screen is a link that reads Imitrex tip. You can split the shots in 1/2 which they work just as good. As far as rebounds, lots of people will say it happens, I personally get just as many CH's with shots as I do without, so for me, they do not cause rebounds. Just another hit later in the day. Good luck and i hope you cycle is a short one. |
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Title: Re: Imitrex-how much is too much? Post by Redd715 on Feb 13th, 2007, 6:54pm on 02/13/07 at 18:04:20, Jahras wrote:
I want to set the record clear, there is no annecdotal evidence or talk of Imitrex "causing" CH. The annecdotal data is that Imitrex MAY cause Rebound attacks, and/or extend cycles. Pills do take too long to abort a CH. Thats why most people use the injections. |
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Title: Re: Imitrex-how much is too much? Post by Brewcrew on Feb 14th, 2007, 7:27am I would only add to what has been already said that the phrase "too long" is a subjective one. If a person is more terrified of injecting themselves than they are of an individual hit lasting an extra 15 or 20 minutes, then the pills can be a viable alternative. |
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Title: Re: Imitrex-how much is too much? Post by Bob_Johnson on Feb 14th, 2007, 8:54am Have you considered using the Imitrex auto-injector? It's the best method for most CH folks, the pill the least effective, the spray variable. Injection will give the fastest relief and your work should not be a barrier as long as you can get five-minutes to yourself for a quick shot. A pill based treatment has clear advantages and some of us have had good results with Zyprexa. Headache 2001 Sep;41(8):813-6 Olanzapine as an Abortive Agent for Cluster Headache. Rozen TD. Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa. OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. The initial olanzapine dose was 5 mg, and the dose was increased to 10 mg if there was no pain relief. The dosage was decreased to 2.5 mg if the 5-mg dose was effective but caused adverse effects. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and two patients became headache-free after taking the drug. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. It alleviates pain quickly and has a consistent response across multiple treated attacks. It appears to work in both episodic and chronic cluster headache. -------------------------------------------------------------------------------- Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ. |
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Title: Re: Imitrex-how much is too much? Post by JohnM on Feb 14th, 2007, 8:56am I agree - ditch the pills and the nasal spray. They take way too long to work. Inj works in less than 10 mins, and if it works once for you then it always works from my experience of trex since 1995 |
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Title: Re: Imitrex-how much is too much? Post by thebbz on Feb 14th, 2007, 3:00pm Quick answer: Do not exceed the recommended amount on the perscription, or as directed by your doctor. CH will not kill you. The drugs to treat it can. Try to use coffee,exercise and other methods of abortion to space out the trex, or other triptans... NEVER MIX TRIPTANS jb trex jabs...no more than one in two hours...no more than 2 in a 24 hour period. Thats the 6mg statdose pen. |
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Title: Re: Imitrex-how much is too much? Post by Chillrmn1 on Feb 15th, 2007, 6:03am Actually I believe there have been clinical studies that did show an increased frequency pattern of recurring CH attacks caused by repeated use of Imitrex. However I do not have the studies to post but have seen them previously posted on CH.com. In my case and when I used to use Imitrex it definately seemed the attacks increased in frequency along with the background headache. |
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Title: Re: Imitrex-how much is too much? Post by Chillrmn1 on Feb 15th, 2007, 6:17am Here is one study that indicates an increase in frequency of CH attacks after Imitrex use: http://www.blackwell-synergy.com/links/doi/10.1111/j.1526-4610.2004.04132.x/abs/ |
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Title: Re: Imitrex-how much is too much? Post by thebbz on Feb 15th, 2007, 1:28pm It's a slippery slope. Sure the trex works, so does the prednisone, but there is always a price to pay, weather it be extended hits from trex,rebounds from trex or caffeine, or bad joints from the prednisone,and a multitude of side effects from chronic use. In this context, any amount is too much,but it beats the pain. Demon bastard anyhow. all the best jb |
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Title: Re: Imitrex-how much is too much? Post by Jahras on Feb 15th, 2007, 1:42pm Thanks for the excellent feedback. this forum is amazingly helpful! |
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Title: Re: Imitrex-how much is too much? Post by Mac_Muz on Feb 16th, 2007, 1:34pm I agree ditch the pils, why wait that long even if it works. I trued them and they didn't do a thing so far as I could tell. I tried a inhaler which failed too.. Then the next step at the time was injectors and these come as a 6 mg dose, which for me was 4 mg's too much. I don't care much about a little prick of pain when I can get rid of the real pain, and in my case this is instant. No sooner has the last 2mg's been injected and I am free... Untill next time. I don't care for drugs in a very general way and avoid them for all I can as well. I got tipped off to welders oxygen which takes more time to abort, but works pretty well for me.... I am episotic (sp) ::) but you get the idea.. I am a mechanic sorta guy too, and get cut on metals almost daily, so it isn't a big deal for the injection.. More or less the demon if allowed likes to play and bang around in my skull for 45 minutes or so, and so then you can see why waiting for a pill becomes moot. As a tech I try the easy way with the least force, and work up into force as I discover whats what.. I discovered by trail and error 2 mg's works for me and 6 is way over the top. Hey thats good right, I can get a 3 for 1 deal, but with a draw back of having to manually deal out a dose. ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; My reason to enter this thread was to see if there was info on "How To" get the auto injector does into a manual syringe. I had a way to do so and forgot. Mac |
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Title: Re: Imitrex-how much is too much? Post by alienspacebabe on Feb 18th, 2007, 1:51am I'd have to say that only your physician and pharmacist can tell you how much is too much. I try to limit myself to 2 vials (12mg) per day. I had one day I exceeded this quite a bit - I believe many of the CHs I had that day were probably rebounds. I was at a football stadium helping to supervise 100 highschoolers, so I couldn't leave, nor could I bring in oxygen. An interesting note: once I finally was able to get oxygen (through the emergency services there), they stopped. The nasal version is great for when you're traveling, or in a meeting you can't leave, etc. The injections can be scary, at least the first few times. Eventually you'll get to the point that you don't even feel them. on 02/16/07 at 13:34:43, Mac_Muz wrote:
Mac, I used the Imitrex vials (empty) and 'auto injected' into them, then used syringes to draw out what I needed. Lizzie |
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Title: Re: Imitrex-how much is too much? Post by Mac_Muz on Feb 18th, 2007, 12:37pm Lizzie, Thanks.. I am the neandertal clutz type it seems these days. Evidently kind of brainless too, since I can't recall how... I think I had a way to dump the auto injector out, but in a way I didn't risk spilling the liquid gold. I am hating the idea of using my supply, but each night it the idea gets harder to not use it... ................................................... About too much: I felt as if I was drowning with the full 6 mg's. For me it was over the top. To me imitrex is a very potent drug, working nearly instantly, which is impressive from my point of view. |
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Title: Re: Imitrex-how much is too much? Post by Lobster on Feb 19th, 2007, 12:11pm Agony-how much is too much? When I have one of those six-slam days, I trex every time. That said, I am one of those that responds to teeny-tiny-doses. I get 3 injections out of one vial, and only need a 2nd injection about 1 time out of 5. So a six-hitter-day will typically only have me at about 2-2.5 full sized doses. Tablets suck ass, and with Nasal or stat-doses you cannot limit your dose. |
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Title: Re: Imitrex-how much is too much? Post by stevec on Feb 19th, 2007, 5:08pm Jahras, Have you tried the Imitrex single dose 6 mg injectible vials? They come in packs of 5. I find that each vial can be used for two or more separate injections and is usually adequate to abort a cluster headache within about 10-15 minutes. Get your doc to prescribe this next time instead of the auto injector Imitrex. Also get him/her to prescribe you three 27 gauge 1ml tuberculin syringes per vial for a total of 15 syringes. Draw up .2cc of Imitrex into the syringe, clense the skin over your thigh with an alcohol prep, pinch the skin, insert the needle to a subcutaneous location, and slowly inject it. Remove the needle, and massage the medicine into the skin. In a few minutes, if you're like me, the cluster may go away. You can also be reassured in knowing that you just used only about one- third of a single recommended dosage, and you can easily repeat it if it doesn't stop the pain. Plus, the 27 gauge needles hardly hurt at all. I have other suggestions for the advanced Imitrex user, but I'll save them for when you are successfully doing the above. Let me know if it works. Lower doses work for some folks and not for others. Steve |
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Title: Re: Imitrex-how much is too much? Post by Mac_Muz on Feb 20th, 2007, 2:15pm I probably should have mentioned what happens to me if I take too much. I feel like I am going to drown. This isn't a very nice feeling to me either. Everything gets slow, my body tends to stop doing anything like breathing. I consider imitrex as a the last resort. Once in another life I abused drugs for fun, and that shows me that imitrex isn't a drug to be toyed with. This stuff injected into body tissue works nearly instantly, and so shows just how potent it is.. |
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Title: Re: Imitrex-how much is too much? Post by jlk on Feb 22nd, 2007, 11:03pm I was concerned about od'ing on trex; my doc said he's not seen any studies indicating long-term harm. This may be really stupid, but how do i start a new topic to talk about a tip that has really worked for me? :-X |
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Title: Re: Imitrex-how much is too much? Post by thebbz on Feb 23rd, 2007, 7:23pm Before you start topics on tips read some of the past posts in the cluster specific area. jb |
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