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Title: Trex question... Post by justthe2ofus on Nov 28th, 2007, 7:16pm This is the 2nd cycle I have used Imitrex. I've been having these HA's since I was a child, but only around 5 yrs ago was I finally diagnosed. My question is...How many Trex shots are safe to use daily? I use 2 a day, everyday. I have been a little worried that I use too many. Is that amount safe? :-/ |
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Title: Re: Trex question... Post by chewy on Nov 28th, 2007, 10:29pm Read the imitrex tip to the left. |
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Title: Re: Trex question... Post by Ray on Nov 28th, 2007, 10:33pm I'll attempt to answer this question. First of all, I'm NOT a doctor, just another person who's used Imitrex for a long time and for parts of that time, used it often. The circular that comes in a box of ampules states that you may use 2 6mg shots per day, no closer than 1 hour apart. I've taken to dividing my doses to 3 mg, or a little less, so that I can use it up to 4x per day. Doing this, I do not exceed the maximum per day. That being said, there have been no long term followup studies of "heavy users" of Imitrex (I'll volunteer for that study!). There are indications in the circular that there are cornea changes in animal studies at higher dosages than are recommended for humans. My suggestion is to use as little as possible, aborting hits with O2, energy drinks, Ice, heat, whatever may work. That's my take on it, your milage may vary, Ray |
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Title: Re: Trex question... Post by Bob_Johnson on Nov 29th, 2007, 7:54am Headache. 2004 Feb;44(2):178-82. Frequent triptan use: observations on safety issues. Robbins L. Department of Neurology, Rush Medical College, Chicago, Ill. 60062, USA. OBJECTIVE: To examine the safety of frequent triptan use over extended periods. For a small group of patients with refractory migraine plus chronic daily headache, triptans are effective. METHODS: This retrospective study primarily evaluated the cardiac safety of daily triptan use in 118 patients and, in addition, hematologic tests were assessed. Each patient had utilized a triptan for a minimum of 4 days per week for at least 6 months. Patients with rebound headache had been withdrawn from the triptans. Most patients (97 of 118) averaged 1 tablet daily; most would occasionally go for several days without a triptan. Forty patients had taken a triptan for 6 months to 2 years, 37 patients from 2 to 4 years, and 41 for 4 or more years. RESULTS: Routine hematologic tests were performed periodically on all patients, and no abnormalities were attributable to triptans. Almost all patients had an electrocardiogram, and no abnormal electrocardiograms were felt to be related to triptans. Cardiac echocardiography was performed in 57 patients. The 10 abnormal echocardiograms were not due to triptans. All 20 cardiac stress tests revealed normal findings. Adverse events were minimal; 9 patients described fatigue due to triptans, and 5 had mild chest tightness. CONCLUSION: This long-term study of 118 patients indicates that frequent triptan use may be relatively safe. PMID: 14756859 [PubMed ] ==================================================================== Funct Neurol. 2000 Jul-Sep;15(3):167-70. 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 |
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Title: Re: Trex question... Post by jillemain on Nov 29th, 2007, 8:56am Hi there. I'm not a CH sufferer, nor by any means an expert. Just a supporter for my husband who is episodic but was chronic for a time in the last 30+ years. (We've only been married 5 years.) Now that he is getting older, (64), his cycles are getting further and further apart and less predictable. They use to be pretty seasonal and now, well, just no rhyme or reason, what so ever. I just wanted to let you know that with his Rx, we get 15 bxs for a 30 day period. So rest assurred 2 a day is okay. For my husband, nothing works (most of the time) accept the trex inject.... He has tried everything, 02, tons of meds, caffeine, redbull, ice, etc.... for him imitrex is it. Once in a while, when the cycle is starting up and he is getting shadows, the cold Maine air aborts it but only for a bit and the beast hits hard. Scary and risky as it is, there have been times, that he had taken 4 to 5 shots in a 24 hour period. Because there were days like this, he tried to forego the shot a few times... and endure the pain. I watched him literally show signs of his body going into shock. Not good. The risk of stroke is not good either but the alternative, of going unconcious and choking on your own vomit is worse. (Sigh).... Just letting you know, that he has done it with 5 shots in one 24 hour period. He's never had any sign of a stroke that we know of. Anybody out there check my post "extra imitrex". PFDAN, Jill |
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Title: Re: Trex question... Post by ccbiggsoo7 on Dec 2nd, 2007, 3:10am ive did 6 shots in one day a couple of times and didn't have any problems but Neuro told me another one of his patients did this and had traces on her brain of having little minor strokes all over. Would not recommend doing more then prescribed. Try breaking them up into 2 or 3 doses per shot. 1/3 shot might work for you it does a lot of people on here. I use half every time. Might take a little bit longer to work but still should knock it w/ no problem. |
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Title: Re: Trex question... Post by E-Double on Dec 2nd, 2007, 7:52am not a doc! ;) Many of us utiize theimitrex tip (see menu bar onthe left) or ge vials instead of statdose. For the most part if I need to use a jab I fnd that I can literally abort wth a trickle just as quickly as a full dose so it was never worth taking a full shot. That being said I can stretch one stat-dose syringe or up to 4 attacks= 1 kit= 8 attacks sometimes more. I tend to only use in an absolute emergeny in public since I absolutely hate it. Good luck and if really concerned have your heart monitored regularly. E PS many find that there is an increase in frequency of attacks if using too often. There is actual research suggesting the change. |
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Title: Re: Trex question... Post by justthe2ofus on Dec 4th, 2007, 2:49pm thanks for the help and repilies...I am still using 1-2 a day, except for a few days ago, I ended up using 4 in the 24 hr period, but I was being hit pretty hard, seemed like soon as one ended, I was getting another hit. I ended up riding the last hit out, took about 3 hrs for it to finally go completley away, but I got a break that night and the next day, didn't get any hits at all. I was shocked (and relieved), not to mention I was totally worn out. It seems the shot does cause me to get more hits than I would normally but I find it very difficult NOT to use one when I am in agonizing pain and I know within minutes I could just pop myself and it would all be over with... :-/ As for the trex tip and stretching my dose, I am going to give it a shot (pardon the pun) as soon as I can get some needles. I have no experience in that area, so I'm a bit scared of messing up (and of needles). I have no insurance anymore, so anytime I go to doc its out of pocket and I have to make every visit count, cramming all I can into those short 15 minutes. I'm lucky to have a GREAT doc though, he does try to spend a lil extra time in with me, knowing my situation. He tried to get me on O2 when I did have ins. coverage but they just kept denying me, saying it isn't approved for Cluster headache therepy... ::) |
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