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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Migranal & Maxalt
        
(Message started by: Robzilla on Apr 10th, 2008, 4:44pm)
Title: Migranal & Maxalt
Post by Robzilla on Apr 10th, 2008, 4:44pm
Has any body used Migranal or Mazalt?  Any info would help, thank

Robert 8)
Title: Re: Migranal & Maxalt
Post by beachmusic on Apr 10th, 2008, 5:43pm
Hey Robzilla,
If I used Maxalt I don't remember  ;) But I did use Migranal DHE the nasal spray.  It was a 5 or 6 day treatment that I did at home and I had very good results.  I was told to use it at approx. the same time everyday or when attack started.  It would pretty much stop my attack within 2-3 min.  Only problem is that it only worked for about 4 days and then it began to wear off.  I will say the cycle started to wear down shortly thereafter but I am not sure if the migranal was responsible or not.  I was indeed thankful for those 4 days though.  Good luck  I will be thinking of you!!
Mary Ann
Title: Re: Migranal & Maxalt
Post by Ray on Apr 10th, 2008, 6:05pm
Robert:

I have used both.  Maxalt is a quick dissolving lozenge and works, but is somewhat slower than a nasal spray or much slower than an imitrex injection.  I would guess 25-35 minutes to abort a hit.

Migranal nasal spray is  DHE and works relatively quickly, about 12-15 minutes for me.  It leaves me totally conjested, however.  I usually find that I have no CH hits for at least 24 hours after the spray.

I have Migranal and will use it when I am getting slammed with multiple hits per night to try to get a good nights sleep.

Don't mix these together closer than 24 hours apart, or BAD things could happen to you.

With best wishes,

Ray
Title: Re: Migranal & Maxalt
Post by brewcrew on Apr 10th, 2008, 6:06pm
Volumes have been written here about both. Have you tried the search function located at the top of the screen?
Title: Re: Migranal & Maxalt
Post by mc_ashes on Apr 10th, 2008, 7:01pm
Robert - I use Maxalt for kip 5+ hits and it works for me!  Takes about 25-30 min to kick-in but, I'm usually good (PF) for the rest of the night.

Mark
Title: Re: Migranal & Maxalt
Post by Superdave on Apr 10th, 2008, 7:30pm
Migranal is my last line abortive before I start banging my head against the table.
It always seems to work in less than 5 min. as long as I don’t use it more than a couple of times a week.
It usually gives me pf time for at least 24 hours and always leaves me congested.
Title: Re: Migranal & Maxalt
Post by sandie99 on Apr 11th, 2008, 3:35am
I've used Maxalt rapitabs, melt in the mouth tabs, with quite nice success.

They ended my hits within 5-8 minutes. But I did get some side effects, including falling into narcotic sleep few hours after taking the med, which wasn't that great.

Before giving energy drinks a go, Maxalt worked the best with me - and faster than any other med tried.

Sanna
Title: Re: Migranal & Maxalt
Post by brewcrew on Apr 11th, 2008, 9:37am

on 04/11/08 at 03:35:48, sandie99 wrote:
They ended my hits within 5-8 minutes.

That's interesting, Sanna. All the literature states that it takes 25-30 minutes to enter the system as it is absorbed in the gut, not through the membranes of the mouth. Those times - 5-8 minutes - are better than oxygen for most.

Could it be that your attack was about to end anyhow?

I just don't want to create any false hope for a new guy. It's always taken about a half an hour anytime I've used it.
Title: Re: Migranal & Maxalt
Post by Karla on Apr 11th, 2008, 10:48am
I  tried the maxalt nasal spray.  It was fast acting but made my ch more intense and I just didn't like that.  After a week of trying I gave up.

I used migranol nasal spray and found it effective as imitrix for me.  However, I like imitrix after taste better and found the potential listed side effects more acceptable to me with the imitrix.
Title: Re: Migranal & Maxalt
Post by superhawk2300 on Apr 13th, 2008, 3:16am
Migrinal seemed to work well for me - i recommend trying it as I did like it very well.
Title: Re: Migranal & Maxalt
Post by coreyo87 on Apr 14th, 2008, 4:45pm
Hey Rob  :)

 I've used maxalt (the dissolvable tablet).  The first times knocked out a CH attack, but lately it has been hit or miss.  Only side effect i experienced from it was a "foggy" kind of feeling.. Hope that helps a little!  

-Corey
Title: Re: Migranal & Maxalt
Post by Becky on Apr 15th, 2008, 2:14pm
I tried Maxalt (disovable tab) it worked but it made me feel really wierd. My heart was pounding and I felt like I was floating,scared the crap outa me. I find Imigran Radis works for me.
Title: Re: Migranal & Maxalt
Post by mezza on Apr 26th, 2008, 8:08am
I've used maxalt- slower acting for me - i gave up on it because it took at least a half hour to feel any relief- not a good abortive for me
Title: Re: Migranal & Maxalt
Post by thebbz on Apr 27th, 2008, 1:14pm
Didn't work for me.
all the best
thebb
Title: Re: Migranal & Maxalt
Post by Chronic on Apr 28th, 2008, 10:13am
As far as Migranal is concerned, my neurologist has prescribed it as a preventative, not an abortive.  Over the 20 years I've had clusters (been Episodic and Chronic), most meds have had varying degrees on effectiveness.  Currently, nothing has been working for me (Varapamil, Topamax, Neurontin, Cartia, Depekote, Prednisone, etc, etc.).

Now, I've been using Migranal as a preventative by taking 1 spray in each nostril 2 - 3 times a day.  It has significantly reduced the number of headaches I have suffered.  The only problem...you can't use Imitrex if a KIP 10 breaks through.  You're only savior is oxygen during those.

I don't know if it is right for you, but Migranal has helped significantly.  Currently it is the only means I have of attempting to break a cycle.

Good Luck
Title: Re: Migranal & Maxalt
Post by Ray on Apr 28th, 2008, 4:27pm

on 04/28/08 at 10:13:43, Chronic wrote:
As far as Migranal is concerned, my neurologist has prescribed it as a preventative, not an abortive.  Over the 20 years I've had clusters (been Episodic and Chronic), most meds have had varying degrees on effectiveness.  Currently, nothing has been working for me (Varapamil, Topamax, Neurontin, Cartia, Depekote, Prednisone, etc, etc.).

Now, I've been using Migranal as a preventative by taking 1 spray in each nostril 2 - 3 times a day.  It has significantly reduced the number of headaches I have suffered.  The only problem...you can't use Imitrex if a KIP 10 breaks through.  You're only savior is oxygen during those.

I don't know if it is right for you, but Migranal has helped significantly.  Currently it is the only means I have of attempting to break a cycle.

Good Luck


Dear Chronic and Clusterville:

There is a warning in the boxed circular about NOT using this medication as a preventative.

"Migranal® (dihydroergotamine mesylate, USP) Nasal Spray is not intended for the prophylactic therapy of
migraine or for the management of hemiplegic or basilar migraine."

"There have been reports of pleural and retroperitoneal fibrosis in patients following prolonged daily use of
injectable dihydroergotamine mesylate. Rarely, prolonged daily use of other ergot alkaloid drugs has been associated with cardiac valvular fibrosis. Rare cases have also been reported in association with the use of injectable dihydroergotamine mesylate; however, in those cases, patients also received drugs known to be associated with cardiac valvular fibrosis."

"In clinical trials, Migranal® (dihydroergotamine mesylate, USP) Nasal Spray has been effective for the acute treatment of migraine headaches with or without aura. One spray (0.5 mg) of Migranal® (dihydroergotamine mesylate, USP) Nasal Spray should be administered in each nostril. Fifteen minutes later, an additional one spray (0.5 mg) of Migranal® (dihydroergotamine mesylate, USP) Nasal Spray should be administered in each nostril, for a total dosage of four sprays (2.0 mg) of Migranal® (dihydroergotamine mesylate, USP) Nasal Spray. Studies have shown no additional benefit from acute doses greater than 2.0 mg for a single migraine administration. The safety of doses greater than 3.0 mg in a 24 hour period and 4.0 mg in a 7 day period has not been established."

Migranal® (dihydroergotamine mesylate, USP) Nasal Spray, should not be used for chronic daily administration.

Please discuss this with your doctor as you are clearly using this medication outside of it's intended dosing parameters and may be doing yourself harm in doing so.

Below is the link to the drug circular and you will need the acrobat reader to read it.

http://prescriptionmigrainerelief.com/HTML-INF/6_0_Prescribing_Info/migranal_PI.pdf

Ray
Title: Re: Migranal & Maxalt
Post by StressFree on Apr 28th, 2008, 8:01pm
Robzilla,

If you have a Dr. who is willing, you might try Maxalt for one day, then take Stadol nasal spray the next, and alternate to keep the CA off balance as well as tollerance to a given medication down. You need to be able to tollerate meds well, and save the stadol for when no need to drive (or do anything actually-can't really do anything during CA anayway). Stadol isn't a pleasant drug, but it did abort many attacks for me last round. The alternating seemed to work well for me. Take the maxalt tab with a glass of hot water. Take a second tab if first one doesn't abort after 20 minutes. This seems to last for a full day once it has kicked in. Only supposed to take 2 total per day I think on those anyway. This regimen I used for break through attacks while taking medium level dosages of VerapamilSR twice a day and a Prednisone Taper. Mild to fairly intense burning sensations usually all that gets through while on the Prednisone, but nothing like a real attack (I'm usually smiling during these shadow type episodes when I'm certain the CA isn't breaking through). The Maxalt and Stadol usually stop an attack cold, though both took about 15 minutes to work for me. I'd hit one or the other at first twinge, but not both. O2 didn't work for me, since the attack would return as soon as I quit breathing the O2. I may try the new mask set up if I need to next time. A TENS electrical pulsing/massage thingy seemed to help throw the Beasts off balance. I'd crank that thing up on my jaw, temple, and or back of neck and experiment with different freqeuncies and sit there and twitch until the abortives kicked in. Almost relaxing actually. I've gone up to 7 years between cycles. It's ben several years again now - thank God. Maybe it's gone for good this time. Wishing the same for everyone here, Rich
Title: Re: Migranal & Maxalt
Post by Chronic on Apr 29th, 2008, 9:44am

on 04/28/08 at 16:27:26, Ray wrote:
Dear Chronic and Clusterville:

There is a warning in the boxed circular about NOT using this medication as a preventative.

"Migranal® (dihydroergotamine mesylate, USP) Nasal Spray is not intended for the prophylactic therapy of
migraine or for the management of hemiplegic or basilar migraine."

"There have been reports of pleural and retroperitoneal fibrosis in patients following prolonged daily use of
injectable dihydroergotamine mesylate. Rarely, prolonged daily use of other ergot alkaloid drugs has been associated with cardiac valvular fibrosis. Rare cases have also been reported in association with the use of injectable dihydroergotamine mesylate; however, in those cases, patients also received drugs known to be associated with cardiac valvular fibrosis."

"In clinical trials, Migranal® (dihydroergotamine mesylate, USP) Nasal Spray has been effective for the acute treatment of migraine headaches with or without aura. One spray (0.5 mg) of Migranal® (dihydroergotamine mesylate, USP) Nasal Spray should be administered in each nostril. Fifteen minutes later, an additional one spray (0.5 mg) of Migranal® (dihydroergotamine mesylate, USP) Nasal Spray should be administered in each nostril, for a total dosage of four sprays (2.0 mg) of Migranal® (dihydroergotamine mesylate, USP) Nasal Spray. Studies have shown no additional benefit from acute doses greater than 2.0 mg for a single migraine administration. The safety of doses greater than 3.0 mg in a 24 hour period and 4.0 mg in a 7 day period has not been established."

Migranal® (dihydroergotamine mesylate, USP) Nasal Spray, should not be used for chronic daily administration.

Please discuss this with your doctor as you are clearly using this medication outside of it's intended dosing parameters and may be doing yourself harm in doing so.

Below is the link to the drug circular and you will need the acrobat reader to read it.

http://prescriptionmigrainerelief.com/HTML-INF/6_0_Prescribing_Info/migranal_PI.pdf

Ray


Thanks Ray, I really appreciate the advice.  It's truly great to know that people really care here.

However, I am well aware of the info on the box.  About four years ago I turned chronic and suffered for two years straight trying to shut them down.  It got so bad I was having 6 to 8 clusters a day.  Absolutely nothing worked.  I was finally admitted to the hospital for 5 days straight to get DHE given to me intravenously.  After the 5 days, the headaches were reduced, but the cycle still didn't shut down.  I stayed on Migranal (a nasal form of DHE) for another week or two and it finally shut down.  I was clear for another 18 months before they started up again recently.

The truth is, many of the drugs we take for Clusters are off label. Some are more hazardous than others.  Migranal as a preventative is very tough of the heart and circulatory system.  In order to try it you should be in good condition w/o any heart problems.  It is definitely not for everyone.  The discussion is one that must be had with your doctor.
Title: Re: Migranal & Maxalt
Post by Ray on Apr 30th, 2008, 2:37pm

on 04/29/08 at 09:44:40, Chronic wrote:
Thanks Ray, I really appreciate the advice.  It's truly great to know that people really care here.

However, I am well aware of the info on the box.  About four years ago I turned chronic and suffered for two years straight trying to shut them down.  It got so bad I was having 6 to 8 clusters a day.  Absolutely nothing worked.  I was finally admitted to the hospital for 5 days straight to get DHE given to me intravenously.  After the 5 days, the headaches were reduced, but the cycle still didn't shut down.  I stayed on Migranal (a nasal form of DHE) for another week or two and it finally shut down.  I was clear for another 18 months before they started up again recently.

The truth is, many of the drugs we take for Clusters are off label. Some are more hazardous than others.  Migranal as a preventative is very tough of the heart and circulatory system.  In order to try it you should be in good condition w/o any heart problems.  It is definitely not for everyone.  The discussion is one that must be had with your doctor.


I'm glad that you're informed about these risks.  Please keep an eye out for these side effects and keep an open dialog with your doctor.

Ray


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