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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Anyone using Frova?
        
(Message started by: LMVK on Apr 17^th, 2005, 3:30pm)

Title: Anyone using Frova?
Post by LMVK on Apr 17^th, 2005, 3:30pm

I heard yesterday about Frova (frovatriptan succinate).

Has anyone used it yet?

Linda

Title: Re: Anyone using Frova?
Post by Bionic_Daddy on Apr 18^th, 2005, 2:12am

LMVK, I tried Frova about a year ago. Took 2 a day for 2 weeks. Didn't do anything for me, but everyone is different. If it works for you it's suppose to last twice as long as Imitrex. I personally CAN'T use Imitrix, Frova, Maxalt or any other Triptan. Makes my BEAST roar many times LOUDER!
Bionic Daddy

Title: Re: Anyone using Frova?
Post by pubgirl on Apr 18^th, 2005, 1:14pm

Linda

If you can make the search engine work (I never have much luck :() I think the general consensus was that as an abortive it was too slow. The theory that as it had a longer half-life in the body it might have preventive effect didn't hold up in practice, and some people found it gave them a migraine type constant ache in addition to their CH attacks.

There were a few people it helped though, different triptans work for different people.

Hope this helps

Wendy

Title: Re: Anyone using Frova?
Post by Lizzie2 on Apr 18^th, 2005, 1:36pm

Ahhh I happen to like this topic because if my doctor would let me take Amerge preventatively, I'm convinced I could live a quasi-normal life. Here is an article that my first neuro at JHC and basically second father figure did awhile back:

Quote:

1: Cephalalgia. 2004 Dec;24(12):1045-8. Related Articles, Links

Frovatriptan for the treatment of cluster headaches.

Siow HC, Pozo-Rosich P, Silberstein SD.

Jefferson Headache Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA. siow@juno.com

Cluster headaches both episodic and chronic are some of the most challenging headaches to treat. Although effective treatments are now available, some patients continue to be unresponsive to standard therapy. We present 17 patients from our practice whom we treated preventively with frovatriptan, a new triptan with a long half-life. The promising results suggest that this medication may be an useful addition to our ammaterium against this painful disorder.

Publication Types:
Clinical Trial

PMID: 15566418 [PubMed - indexed for MEDLINE]

Title: Re: Anyone using Frova?
Post by pubgirl on Apr 18^th, 2005, 1:46pm

Lizzie

I'm pretty sure people tried and it didn't work.

I think I have managed to delay an attack using a pill form triptan, but the downside was it arrived eventually and I then used Imigran and felt very ill (I know, stupid, dangerous thing to do :-[) the trouble about trying to use any triptan preventively is that you really narrow your options for the attacks when they happen.

The main experts don't advise Triptans being used as prevents, I think because it may not work and also constant vasoconstriction isn't healthy perhaps?

maybe people here have other stories to tell??
There have been a few thread on it which I seem to remember were the usual mixed results story.

W

Title: Re: Anyone using Frova?
Post by Lizzie2 on Apr 18^th, 2005, 1:50pm

I'd have to find the story, but the docs at NECH have been using Amerge preventatively for sometimes over 2 years with no ill effects. The longer but slower acting second generation triptans do not necessarily have the same dangers.

If I take Amerge in the afternoon, I can guarantee a night without CH...and if I get a breakthrough, then for myself I use O2, which is okay to mix with Amerge.

I can't take Imitrex, so no can do any fast-acting abortives like that. I have Zomig NS, but it is so short-acting that by the time I kill the headache that I'm working on, another one comes and I can't use all 6 sprays in one day.

I'll have to dig up the info from NECH. It was very positive. I asked Dr. Volcy about it in our group session in Nashville, and he said there were no ill effects after 2 years. Lori also spoke positively about it.

And also take a look at the authors of that article I posted.... I don't know one of the names, but 2 out of the 3 are world-reknowned headache experts...so I don't discount them too much. :)

Then again, I may be biased. ;)

Title: Re: Anyone using Frova?
Post by Lizzie2 on Apr 18^th, 2005, 1:51pm

I think Roxy was using Relpax at bedtime.

I know there are others, but I forget who exactly!

Title: Re: Anyone using Frova?
Post by Lizzie2 on Apr 18^th, 2005, 1:54pm

Well this one has to do with chronic migraine, but that applies to me which was why I have focused on it so much. Can't convince my current neuro to give it a try. Although, the neuro I saw out at UMDNJ (Dr. Michael Gallagher is the director there) had put me on it for about 14 days or so...very successful. Here's this one:

Quote:

1: Headache. 2003 May;43(5):482-9. Related Articles, Links

Naratriptan in the preventive treatment of refractory chronic migraine: a review of 27 cases.

Rapoport AM, Bigal ME, Volcy M, Sheftell FD, Feleppa M, Tepper SJ.

Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.

OBJECTIVE: To review the efficacy of naratriptan as preventive treatment in 27 patients with chronic migraine refractory to other commonly used preventive therapies. BACKGROUND: The treatment of chronic migraine often poses a major challenge to the clinician. Even when given expert care, patients with chronic migraine may continue to have daily or near-daily headaches. METHODS: Clinical records and headache calendars were reviewed of 27 patients fulfilling the following inclusion criteria: (1) aged 18 to 65 years; (2) diagnosis of chronic migraine (formerly transformed migraine), according to the criteria proposed by Silberstein et al; (3) previous failure of at least 4 preventive medications prescribed as part of a management program that included nonpharmacological measures, preventive medication, acute care medication, and detoxification from overused medication; and (4) have used daily naratriptan for no less than 2 consecutive months. The dose of naratriptan prescribed was 2.5 mg twice daily. We considered the following outcomes: (1) frequency of headache, (2) intensity of pain, (3) number of days per month with severe headache, (4) headache index (frequency times intensity), and (5) proportion of patients who reverted to an episodic pattern of pain after 6 months of treatment. RESULTS: There was a statistically significant reduction in the frequency of headache days 2 months (15.3 days versus 24.1 days at baseline, P<.001), 6 months (9.1 days, P<.001), and 1 year (7.3 days, P<.001) after daily treatment with naratriptan was initiated. There was also a statistically significant reduction in the number of days per month of severe pain at 1 month (5.6 days versus 12.5 days at baseline, P<.01), 2 months (5.7 days, P<.01), 6 months (2.8 days, P<.01), and 1 year (2.6 days, P<.01). Similarly, there was a statistically significant reduction in the headache index at 2 months (33 versus 56.4 at baseline, P<.001), 6 months (19.5, P<.001), and 1 year (17.2, P<.001). Of the 20 patients who continued to use naratriptan daily for at least 6 months, 13 (65%) reverted to an episodic pattern of pain (migraine). At 1 year, 11 (55%) still continued to experience episodic headache, 1 (5%) relapsed to chronic migraine, and 2 (10%) were lost to follow-up. No patients had intolerability to naratriptan during the treatment period, and no one stopped treatment due to adverse events. CONCLUSIONS: Naratriptan may have a role in the preventive treatment of intractable chronic migraine. Prospective, controlled studies should be considered.

PMID: 12752754 [PubMed - indexed for MEDLINE]

Title: Re: Anyone using Frova?
Post by kimmeesue on Apr 18^th, 2005, 2:37pm

I have tried all of the triptans at one time or another and Frova was the only one that did absolutely nothing... I was convinced it was a sugar pill.
But that's just my experience.

Title: Re: Anyone using Frova?
Post by pubgirl on Apr 18^th, 2005, 2:43pm

Lizzie

That's sort of what I did, when I took a Zomig after the first night time attack I am pretty sure it bought me three or four hours sleep.
When I tried taking it before sleep, the first attack came after an hour anyway so it was pointless. When I took nothing I got repeated attacks almost every two hours.

that was enough evidence for me that it was doing something for me.
As long as the 02 is working well I would try it again next cycle, it's if the 02 fails I then have a real problem if I've already Zomigged

I think after this experience I would only do it at cycle peak too, to make sure I'm not using too much triptan

W

Title: Re: Anyone using Frova?
Post by Ueli on Apr 18^th, 2005, 7:22pm

Wendy,
if I remember right, most of the unfavorable reports on Frova came from people whose ignorant doctors jumped on the bandwagon for a new triptan an prescribed Frova as the only abortive/preventative. >:(

I take eletriptan (Relpax) before bed time (20 mg) and I get usually through the night without an attack. I have survived Chinese dinner by taking some Relpax in advance.
[smiley=smokin.gif]

Title: Re: Anyone using Frova?
Post by LMVK on Apr 18^th, 2005, 8:52pm

on 04/18/05 at 13:46:15, pubgirl wrote:

Lizzie
the trouble about trying to use any triptan preventively is that you really narrow your options for the attacks when they happen.

Hi! I'm still a little new at this. My husband is the CH sufferer (I get the migraines). I'm not exactly sure what you mean. I thought that the main job of triptans was to head migraines and CHs "off at the pass", so to speak.

Do you mean that ... uhm... whadda ya mean?
:)
Linda

Title: Re: Anyone using Frova?
Post by E-Double on Apr 18^th, 2005, 9:03pm

on 04/18/05 at 20:52:57, LMVK wrote:

I think this refers to the fact that we can only take limited amounts of triptans in a specified timeframe because of the potential dangerous side effects and if using them for a brief reprieve @ night you are outta luck possibly to use it again as an abort......

I may have misinterpreted that though.

Title: Re: Anyone using Frova?
Post by LMVK on Apr 18^th, 2005, 9:08pm

Thanks to everybody for the information! I actually came onto the site two years ago, when my husband first started experiencing the beastly headaches. Thanks to you guys and all your info, I managed to convince our family doctor to look more deeply into his condition. That led us to a neurologist that confirmed that his symptoms were definitely due to CHs.

You guys are the best.
:)

Linda

Title: Re: Anyone using Frova?
Post by purpleydog on Apr 18^th, 2005, 9:10pm

on 04/18/05 at 21:03:34, E-Double wrote:

I think you got it right, Eric, I'm sure that is what Wendy meant. Triptans are limited in their use, because of the problems they can cause if you take too much. If you take a triptan for a preventative, say one pill a day, then that is one less pill you can take when you need to use it as an abortive.

Frova never worked for my CH, it takes too long to kick in. Works great for my migraines, though.

Title: Re: Anyone using Frova?
Post by Lizzie2 on Apr 18^th, 2005, 11:22pm

Even more so,

you cannot mix triptans which further limits them. If you take imitrex tonight at 9pm...you cannot take Zomig before 9pm tomorrow night. DO NOT mix triptans within a 24 hour window.

Just ask Roxy if you want a reason why you should NOT do that.

Wendy -- maybe the zomig is just too short acting for you to have it last long? It's one of the shortest. I like Amerge because it works 6-8 hours or so, but Frova did nothing for me, unfortunately.

I believe it is an excess of 15 triptan doses a month which leads to rebound. I know people here would dispute that fact, but I believe that's the current "law of the land." ;)

Lizzie :)

Title: Re: Anyone using Frova?
Post by Karla on Apr 20^th, 2005, 2:02pm

I tried frova but found it only to keep me plain free for 2 hours and no longer than what imitrix should do so I went back to using imitrix ns since its faster acting.

Title: Re: Anyone using Frova?
Post by Bob P on Apr 20^th, 2005, 2:15pm

The premiss is that trex has a half life of about 2 hours (in 2 hours it's lost 1/2 it's strength and continues to loose 1/2 it's remaining strength ever 2 hours).

Amerge has a half life of about 4 hours.

Frova has a half life of 25 hours. Thinking is that if you took 1 Frova a day, in a couple of days you would have at least a full strength Frova in your system all the time.

Title: Re: Anyone using Frova?
Post by Roxy on Apr 22^nd, 2005, 1:32pm

I've used all the triptans that are being discussed here.

Relpax worked great, and I was using it as a preventative. I started out quartering a 20mg pill (5 mg), and that would hold me through the night (except for the first REM hit and I have 02 for that). Over a three month period I built up a tolerance to the drug, so at the end I was taking a 40mg pill, with no effect at all.

They then moved me to Frova, also as a preventative, one tablet twice a day. It worked pretty well, holding me to only two or three hits a day, this at least made work bearable.

In January, they moved me to Amerge. I am very, very selective as to when I use Amerge. I take half a pill on evenings when I need to go out or something. This will hold me through the evening, and sometimes through the night. I'm only getting 9 pills a month. Of course, being the intelligent doctors that they are, they also prescribed Zomig NS at the same time.

Last week I ended up using the Zomig, and it seems to have the longest residual effect than all of the above. Doesn't make sense, but if I use it for a ch in the evening, I will go pain free all night. I've used it four or five times now, and the lasting effect has stayed the same.

None of these triptans have had the effect of imitrex. With trex, the more I used, the more hits I got.

Roxy

Title: Re: Anyone using Frova?
Post by pubgirl on Apr 22^nd, 2005, 7:09pm

That's really, really interesting Roxy, makes a bit of a mockery of the half-life theory in your case doesn't it?

I only happened to have the Zomig because it is what I use for migraines (ooooopss, said the word) and thought I would try it.

I'm never going to have another cycle ever again ( :D) but if I do I'm going to try and stay with just 02 and Zomig and stay away from Imigran completely and see what happens

Wendy

Title: Re: Anyone using Frova?
Post by Bob P on Apr 29^th, 2005, 9:46am

I can say I am using it now.

Took 1 tab yesterday at 2pm and another at 7:30pm. Have had no attacks since taking it. Will continue to take 1 tab at bedtime for next couple of weeks and see how it works as a preventative for me. Looks promising!