New CH.com Forum
http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl
Cluster Headache Help and Support >> Medications,  Treatments,  Therapies >> Zomig usage
http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1263919579

Message started by candid on Jan 19th, 2010 at 11:46am

Title: Zomig usage
Post by candid on Jan 19th, 2010 at 11:46am
Hey
I was wondering what people thought the safe amount of zomig to take was?
My doctor wouldn't care if I took 10mg a day 7 days a week to try to get a handle on this pain.  But I have a feeling that whenever I decide to not take it.. i'm going to pay with a kip10 that lasts all day.
Do a lot of cluster sufferers take zomig everyday? Or would if their insurance covered that much zomig?
Thanks

Title: Re: Zomig usage
Post by Racer1_NC on Jan 19th, 2010 at 1:08pm
Zomig isn't really a prevent......it's an abortive. There are much better meds out there for daily, preventative use.

Try O2 for aborts. If it'll work for you, you'll throw rocks at many other meds.


Title: Re: Zomig usage
Post by candid on Jan 19th, 2010 at 3:42pm
I've been using oxygen for aborting since I got the script 3 years ago.  Lately its not working anymore.  All I have right now is aborts.

Title: Re: Zomig usage
Post by lorac on Jan 19th, 2010 at 8:59pm
hi Candid

I only took Zomig when I got a hit coming on hard and fast,   Usually could tell that the O2 wasn't going to get it fast enough.

   Also be sure to look online for a coupon. I found $35.00 off   usable for 6 times.

Also to conserve ...I spray the nasal dose into a baggie, and using the head of a pin, put 1/2 dose under my tounge...worked for me.

Good luck to ya!                

Title: Re: Zomig usage
Post by 1dallis1 on Mar 26th, 2010 at 3:52pm
Hey candid, I use Zomig as an abortive for my CHs.  It seems to work as long I catch it at the shadows and not much more after that.  If it gets too late, it's no use to me and I usually throw it up anyway.  I know they can get expensive too, and throwing them up is a waste.  I take the 5mg Zomig for mine.  During my peak days (cause I'm an eposodic sufferer) I'll get two CHs and take two a day.  I haven't had to go past 10mg a day.  I haven't had the chance to try anything else yet, as I'm in the military and they do not know much about treatments.  Plus by time they want to try something new, my cluster period ends.  So I stick to Zomig, pacing, dry heaving, ice packs, cold showers, the usual gambit of activities. 

Title: Re: Zomig usage
Post by neuropath on Mar 29th, 2010 at 12:28pm
I believe that you should think about a preventative treatment strategy first before contemplating exclusive use of triptans.

Look up Bob Johnson's recent and very comprehensive post on the risks of triptans but importantly discuss a prevent strategy with your doctor that will render them as a secondary means.

Title: Re: Zomig usage
Post by midwestbeth on Mar 29th, 2010 at 2:41pm
Triptans can bring immediate relief from a ch.  Relying on triptans for every ch and you may end up with rebounds that can bring on the vicious never ending cycle.  BTDT and it is not fun.

02 (with highflow regulator) is the best thing that happend to me.

Title: Re: Zomig usage
Post by 1dallis1 on Mar 29th, 2010 at 4:34pm
Midwestbeth, can you explain to me the 'never ending vicious cycle' you are referring to?  All I have at the moment is triptans (Zomig), and I def don't want a never ending cycle!  I am currently trying to get O2 from doc, but have to wait until the 6th to see her.  Then I have to convince her that O2 is the next step for me.  As I stated before, I'm in the military and they can be hesitant to prescribe treatments they aren't familiar with. 

Title: Re: Zomig usage
Post by Bob_Johnson on Mar 29th, 2010 at 4:53pm
You are saying that you do not use a preventive? That's why you need to much of the abortive.
-----------
Headache. 2004 Nov;44(10):1013-8.   

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.

    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).
========

See pdf file below.
http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?action=downloadfile;file=Mgt_of_Cluster_Headache___Amer_Family_Physician.pdf (144 KB | 27 )

Title: Re: Zomig usage
Post by 1dallis1 on Mar 29th, 2010 at 5:19pm
Mr. Johnson, thank you for that information.  I have been an eposodic sufferer for about 8 yrs on and off.  I have gone a year or two with out a CH period.  I am currently in a period and have come to terms that this may be something I will deal with for a long time.  I am continually learning and educating others around me so they can understand my burden to bear.  I will take this information on Verpamil to my Doc and try to get on a regiment.  It sounds like a promising alternative instead of going straight to the O2.  I usually end up teaching the Docs about CH's as do most of the ppl on CH.com.  I am so grateful for this site and the people that can relate to this condition directly.  Once again, thank you!!! 

New CH.com Forum » Powered by YaBB 2.4!
YaBB © 2000-2009. All Rights Reserved.