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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Questions about Imitrex shots
        
(Message started by: Trooper on Mar 11^th, 2008, 9:21pm)

Title: Questions about Imitrex shots
Post by Trooper on Mar 11^th, 2008, 9:21pm

I currently take the pill form of Imitrex and I have a few of the nasal sprays as well. The good thing about the pill is that I can split them up so they last longer but the down side is I have to wait 45 agonizing minutes for it to take effect. The nasal spray works in about 10 min. but they are very expensive and it is a one shot deal. I go back to the Doc Friday and I am thinking of asking for the shots. From what I gather there are two forms that the shot comes in, pre-loaded syringes and vials? What works best with CH? Does it come in different mgs. like the pills do? What else do I need to know?

Title: Re: Questions about Imitrex shots
Post by Gena on Mar 11^th, 2008, 9:36pm

It's easier to control your dosage with the vial and syringe set-up. Using the preloaded shots can give you too much imitrex and can definately increase your risk of re-bound headaches or actually increasing the frequency, duration and intensity of attacks.

Thomas- posting in drag.

Title: Re: Questions about Imitrex shots
Post by thebbz on Mar 11^th, 2008, 9:53pm

What the fembot said, if your not skeerd of needles the vial is the way to go. I you just want to stab and jab the injectors do the trick better.
thebb
Never mix triptans

Title: Re: Questions about Imitrex shots
Post by Trooper on Mar 11^th, 2008, 9:58pm

Thanks for your help. I have two more questions. what is the average wait time until you get reliefe? and about how many headaches will one perscription abort? I usually take my pill or spray when I get hit and it almost always last me until the next night when I get hit again. Once I start a cycle it is not unusual for me to get hit every night for 3 or 4 weeks so making my scripts last until my insurance lets me re-up is a big issue.

Title: Re: Questions about Imitrex shots
Post by thebbz on Mar 11^th, 2008, 10:07pm

Relief comes quickly with injection. Less than 1 min. up to 5 min., the 6ml injection keeps the beast at bay for about 8 to 12 hours. Sometimes not that long, indicating a possible rebound.
Thats the auto injector. Mileage varies with less.
thebb

Title: Re: Questions about Imitrex shots
Post by DennisM1045 on Mar 12^th, 2008, 8:51am

The auto-injector also comes in 4mg. Typically you don't need 6mg to abort. Using less than 6mg gives you less side effects to suffer through.

Your insurance company may have limits on how many injections they'll cover each month. You'll have to work with your Dr to get past this. If you can't its even more of a reason to use vials. By splitting doses you can get two or three aborts from a 6mg vial.

Blue Cross Blue Shield (my company) has what they call a Quality Care Dosing limitation of 2 injections a month. I had to get my Neuro to fill out a Quality Care Dosing Override form to get this changed. They'll follow whatever your Dr recommends on this form.

http://www.bluecrossma.com/common/en_US/pdfs/Pharmacy_Prior_Authorization_Form.pdf

Here is a link to the dosing limitations for BCBS:

http://www.bluecrossma.com/pharmacy/en_US/pdf_docs/QCDAffectedDrugList.pdf

-Dennis-

Title: Re: Questions about Imitrex shots
Post by Guiseppi on Mar 12^th, 2008, 10:15am

Not to re-direct your thread....but if the imitrex pills give you the longer lasting relief...you should consider combining oxygen with it. I use oxygen with cafergot as my first line abort. Oxygen will have me pain free in 6-8 minutes, the oral cafergot keeps it away up to 12 hours.

I have to do the auto injectors cuz I'm a needle wimp and prefer closing my eyes and pushing a button! within a minute or 2 of injecting headache is on its way out.

Guiseppi

Title: Re: Questions about Imitrex shots
Post by thomas on Mar 12^th, 2008, 10:17am

The shots work pretty quick, 5-10 mins usually for me, but I usually get hit again in 2-4 hours after using imitrex injections, pretty much why I haven't used the stuff in over 4 years. I prefer zomig pills or nasal when it comes to triptans, otherwise good ol O2 is my best friend.

Title: Re: Questions about Imitrex shots
Post by Trooper on Mar 12^th, 2008, 11:16pm

Awesome info! I had no clue my doc. could fill out an override form to extend my script. I usually try to stock up on my scripts throughout the year but I lost insurance last June and just got re-insured last month. I have thought about the O2 but I have heard that like Immitrex, some studies show it prolongs the overall length of the cycle or can cause more rebounds. I wouldn't mind staying with the pills because they work so well for me, they just take sooo long before I get any reliefe.

Title: Re: Questions about Imitrex shots
Post by Ray on Mar 12^th, 2008, 11:35pm

Dear Trooper:

My philosophy is "any port in a storm," but please don't dismiss the oxygen. It helps many of us here. There's information both here and at the OUCH site on it's use.

Wishing you the best,

Ray

Title: Re: Questions about Imitrex shots
Post by schlags on Mar 12^th, 2008, 11:43pm

Don't want to be a killjoy, but the override is not automatic for the Imitrex. I had my neurologist fill one out with Blue Cross on a Friday; didn't hear back from them until the next Friday via the mail with a rejection of the override. (they put an "urgent" process on the fax). I was in the process of trying a new calcium channel blocker and it wasn't working, so was getting hit 3 or 4 times a day with bad ones and at least as many during the night. Needless to say I was in a bit of a panic that the weekend was coming up, (can't contact the neuro on the weekend) oxygen was not helping and I was not going to have enough Imitrex to help me through. And go ahead, call me stupid, but didn't even think until reading on this message board about going to urgent care for help.
I am damn lucky that my cycle is coming to an end and I don't need it now, but you can bet I'm going to be stocking up over the next 6 or 8 months (my pharmacist said that the stuff he has on the shelves now expires Aug. 2009).

Title: Re: Questions about Imitrex shots
Post by darknight on Mar 13^th, 2008, 8:37am

Hi Trooper,

Seriously dont dismiss the Oxyegen.
Before i tried it i was dancing with the devil relentlessly and thanks to this site i asked for stronger meds and Oxygen.
I received the Oxyegen and imigran injector but have never used the injector as the Oxygen works a treat and knocks the beast away. Whenever i feel one coming on i head to the Oxygen better than any med for me and would advise you to try as most would on this site!!!

02 02 02 02 02!!!
Then if the 02 doesnt work at least you will of tried it!!

Title: Re: Questions about Imitrex shots
Post by DennisM1045 on Mar 14^th, 2008, 3:21pm

Hey Schlags,

I just got confirmation on my QCD Override today. 8 shots a month! Not that I think I'll need that much but it sure beats stockpiling and having expired meds in the closet!

How much were you asking for?

-Dennis-

Title: Re: Questions about Imitrex shots
Post by coach_bill on Mar 14^th, 2008, 9:12pm

8 a month same as me, but when i was in cycle i could go thourgh 8 shots in 3-4 days, big insurance is the one who told me how many headaches i could get, then i got right with my 02, its the 1st line of defence for me. coach bill

Title: Re: Questions about Imitrex shots
Post by schlags on Mar 14^th, 2008, 11:32pm

on 03/14/08 at 15:21:08, DennisM1045 wrote:

Title: Re: Questions about Imitrex shots
Post by schlags on Mar 14^th, 2008, 11:36pm

on 03/14/08 at 15:21:08, DennisM1045 wrote:

whoops, sorry about the double quote, too fast on the trigger! All I asked them for was to be able to fill out the rest of the 10, which would have been 4 more from the six they gave me. Joke's gonna be on them (at least I hope)...found out that the local clinic here keeps it on hand, will just go in and get a shot from them if I need it, then they can pay for a dr. visit AND the shot. I imagine they might reconsider after that....
Things have mostly leveled out though, am done with the awful nimodipine and back on the verapimil...still gettin' visits but not as big or long. Oxygen has been killing them nicely lately!

Title: Re: Questions about Imitrex shots
Post by Trooper on Mar 15^th, 2008, 1:52am

Got the script today for the shots. Pharmacy said I can get 3 vials for $40 and after 3 days I can re-up. I am sure that will be my allotment for the month though. Doc. said I need to go to a Nuero for the O2 though. He just is not that familliar with it.

Title: Re: Questions about Imitrex shots
Post by seasonalboomer on Mar 15^th, 2008, 5:42am

not to beat a dead horse, but.... time spent relenting with your doc, printing out information on CH treatment to educate your doc on O2 is worth it.
If you're going to go only with abortives (which is what I do), this will allow you to spread out your imitrex usage.

Scott

Title: Re: Questions about Imitrex shots
Post by Annette on Mar 15^th, 2008, 6:09am

Many here also reserve the imitrex shots for higher kip hits, for those lower hits like a kip 4 or 5 try red bull, strong coffee, lots of water, ice on the head and neck ... and of course OXYGEN !!

Using too much triptans can cause rebounds :(

Title: Re: Questions about Imitrex shots
Post by Trooper on Mar 15^th, 2008, 9:24am

Doc told me no last year and this year on the O2. He has a few other cluster patients but none have it as bad as I do. (at least not yet) He told me he would prefer I go to a Nuero for the O2. He expressed some concern with my level of CH, he is just not comfortable doing any more than what he is doing now. I totally respect him for that and think that overall he is a great doc. Always pulls out the PDR and takes the time to look up meds and options with me. Unfortunantly he is not comfortable administering all options.

As far as the Trex goes, I usually take a half or even a third of a 100mg pill and it will do the trick. On the big ones I use my nasal sprays because it works faster but it does not seem to work as good as the pills. I usually can tell from the onset how bad the ha is going to be and I treat it accordingly. I always try to go easy on the Trex but only b/c of limited supply. I think what you say about the rebounds is very true though and all the more reason to find a better abortive option.