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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> Imitrex users
        
(Message started by: ozzman on Feb 13^th, 2004, 9:46am)

Title: Imitrex users
Post by ozzman on Feb 13^th, 2004, 9:46am

Funny thing yesterday. I took my Trex NS, felt it working immediately, tingling sensation on the scalp and then ...
chest pain. Upper left side, going down my left arm and cold sweating. Not really dizzy, but very, very tired.

Before everyone says that Imitrex gives you chest tightness, let me tell you *this was not it*. I have felt that chest tightness before and it was nothing like that.

Call my Dr., he said to go to the ER. I did. Blood work, chest X-rays and EKGs normal all of them. The ER Dr. said that sometimes triptans do that, they just constrict the hell out of the whole vascular system. Told me to see a cardiologist to make sure I can tolerate triptans in the future..

Anyway, anyone relate?

Ozzy

Title: Re: Imitrex users
Post by Bob_Johnson on Feb 13^th, 2004, 10:26am

Clearly, you are taking the right steps with your docs. While waiting for all these exams to guide you, here is a report I posted some months ago.
----
Although this report is concerned with the use of triptans and other meds for migraine, its focus is on the safety of the medication and not the nature of the underlying headache disorder. The data have important relevance for CH because of the widespread use of Imitrex (Sumatriptan) for Cluster. Except where quotations are used, this is my summary.

--------------------------------------------------------------------------------

"Cardiovascular and safety concerns in using triptans in migraine patients", Timothy R. Smith, M.D., R.Ph., in HEADACHE QUARTERLY, V. XII, 2001, Supplement 1.

There has been widely published concern about the use of triptans in patients with cardiovascular disease or uncontrolled hypertension. "Overall, serious cardiac or cerebrovascular events are uncommon--and are extremely rare when the triptans are used appropriately." Supporting this statement is a study indicating, "...the general decline in serious adverse events during the period since Sumatriptan was first marketed. This decline is observed against a backdrop of steadily increasing use of Sumatriptan. We can conclude that physicians are learning to prescribe Sumatriptan more safely and appropriately."

Clinical evidence on triptans other than Sumatriptan are not yet available because they have come on the market relatively recently.

Reports of chest symptoms associated with Sumatriptan turn out not to be signs of heart attack, etc. in most instances. There is some evidence that the cause arises from the esophagus: more work is needed to understand this symptom.

The published concerns about the use of SSRIs (a class of anti-depressants) along with triptans appears to be a theoretical concern not supported by clinical experience. One study followed 1,784 patients using such combinations for one year and found side effects of only 0.8 percent, none of which occurred within 24-hours of receiving Sumatriptan.

The use of MAOs (another class of anti-depressants) and triptans is still an unresolved question. Bottom line: don't mix them. (In general, MAOs are effective anti-depressants but should only be used by a physician with experience. I should never accept them from a family practice/generalist physician.)

The use of triptans along with ergot compounds should be avoided. There are very few clinical studies of the interaction to guide use and there is theoretical reasons to be concerned about mixing them.

Title: Re: Imitrex users
Post by ozzman on Feb 13^th, 2004, 11:00am

Thanks Bob,

I've been a long time Trex user, so I know what to expect. I would suggest that whenever an incident such as this happens to anyone, don't take it lightly, don't dismiss it. Consult your doctor immediately if possible, your Doc will tell you what to do. If not, just get to a hospital....

Ozzy

Title: Re: Imitrex users
Post by Tiannia on Feb 13^th, 2004, 11:26am

on 02/13/04 at 10:26:15, Bob_Johnson wrote:

Reports of chest symptoms associated with Sumatriptan turn out not to be signs of heart attack, etc. in most instances. There is some evidence that the cause arises from the esophagus: more work is needed to understand this symptom.

My husband has GIRD (Reflux disorder) the first time that it seriously acted up, we thought he was having a heart attack. He woke up in the middle of the night feeling like there was a band wrapped around his chest, he could not breathe. Had the pains running down his left arm, all of it. Woke up my daughter and rushed him to the ER. They stuck him on nitro and the whole nine yards. After about 4 hours of tests, they discovered that the acid in his stomach had backed up into his esophagus. Because of that the body reacts just like a heart attack.

My point in that is, could the use of tripans be effecting the valve that lies between the stomamch and the esophagus and that is where the chest tightening comes from? Or could it be effecting the stomach in general because there are many who get the neusious feeling after using Imitrex?

Just my thoughts.

Glad you are ok Ozzy.

Tiannia

Title: Re: Imitrex users
Post by Kevin_M on Feb 13^th, 2004, 11:29pm

Ozzman,

I was being cared for by an md, who sent me to a neuro, who sent me back to the md. Basically they could not find a preventative that helped. I was prescribed nasal imi by the md, some fiorcet and nortryptiline as a preventative. This is not an effective combination, but it got me through work and life, however the imi prescription had gotten to 2 six month prescriptions for three a day. I saved them during the interim and used as many as five or six during cycle.
Originally my blood pressure was about 112/72. By the end of cycle it was 140/84.
I have gone to a new headache clinic and they were concerned about the amount of imi, however, I didn't have any out of whack vital signs which alarmed them.
Of course now, this new doc got me off the fioricet, prescribed O2 for home use and a better preventative.
Essentially what I am saying is that this new doctor was concerned that I could not keep facing the beast the way I had. Though there was no apparent signs of emminent danger, I felt I was on the path that way. Obviously, she felt this is not healthy for anyone. I have pushed the imi usage to the limit for three to four months at a time because I simply did not have better care.
I would say, for me though it was a safe drug because I overused it without an adverse affect, but I believe it may have affected my CH eye in some way. BUT, I am single, job secure and may experience less stress than a person who has a life. Anyone coping with more of a life may become adversely affected. Or anyone who may have some blockage, I have very low cholesteral due to the way I eat.
I feel lucky, but I definitely could not see my father (passed), brother, other brother or very busy sister doing anything like what I did. They, I think would be adversely affected. One brother has blockage, as my father did, the other brother has job concerns and three little children and my sister is a crazy busy schoolteacher.
I would not suggest leaning on imi too much in most all instances, but I have found it to be a safe drug, however, the feelings you say you felt, I am not comfortable with (as I am sure you are not either). Perhaps the imitrex should be reassessed and O2 looked at more closely. I know to go without an effective abortive is unthinkable, but think about using O2. Not everyone reacts the same way over the long run, and as far as I know, CH is for the long run.
Depending on how other aspects of your life are going, imitrex may leave you wondering what will happen next time. That fear should not come with any abortive, and a fear that may antagonize the situation.
I am quite sure you have more of a life than I have.
The one remaining thing is that when the doctors said that sometimes triptans do that, well, I've found them to not be inconsistant. I am no doctor, but of all the many thousands of imi nasals I've taken over the years, I've not found that to be an adequate explanation. I would delve further with tests, or this was a message your body is telling you about imi use.
I in no way wish to worry you, I was just responding as a person who has overused imi greatly in the past and have not had the effect of which you speak. I personally am not willing to press my luck further though.
The best to you Ozzman and take care.

Kevin M

Title: Re: Imitrex users
Post by ozzman on Feb 14^th, 2004, 10:14am

Thank you all for your words. I do use O2 and works very well for me, I just need to get refilled.

The experience was a bit unnerving and made me think about my wife and kids, the mortgage, etc (well the mortgage would've been taken care of ;;D)

I will pursue the cardiologist's route and see what he says.

I have taken many, many Trex NS over the years, with no prob.

Will see what happens.

Ozzy

Title: Re: Imitrex usersin
Post by eyhavhedaches on Feb 14^th, 2004, 10:43am

I use Imitrex Injections and have experianced some real heavy side effects as well. The chest pain, real tired, and cold sweats. Been on them since January. I have used about 8 injections since I have started them. It's a very uneasy feeling U get with this med, thats for sure. Starting my remmision period as of now, thank god!!! Went to the neuro Jan 26th he was useless, ordered another MRI which would make it only the third one in the last 8 years, I'm glad they think money grows on tree's. Going to my primary on the 26th of this month, he has been so much better than any of thie specialists I have gone to, he shows a concern and expresses his intent on learning about ch with me. I am going to tell him ixnay on the xray dude! I have had it, I am going to tell him what we are going to do! The best part about it he will go along with it(I hope). Going to get o2, which in turn will hopefully lessen the use of the Imitrex, Imitrex is a great abortive for me so I am not fully ready to give it up completely. I am going to have him raise my verapimil from 120 mg's a day to 240, thus increasing if need be, I will now only take my verapimil only during my cycles instead of taking it year round! Not sure what to do about my depakote though, not only do they use it to treat my headaches but it also is for my bipolar, level 2. I will need to discuss this with him. However the depakote is pretty much useless for my headaches. There is a headache docter of 22 years just south of me. Need to call his office and see if I need a refferal or if I can just make an appointment.