does anyone know anything about chewing imitrex 50mg tablets.  They are all i have right now and as many of you know, they just take way too darn long to become effective.  So i have been chewing them before i swallow them and it seems to work better.  I have also begun chasing it immediately with some kind of energy drink(thanks to this site) and the result have been great.  Been aborting attacks in about 15-20mins instead of 35 so to me, thats a huge improvement. 

P.S. i am about a half hour from my next attack(give or take 20 mins) so if anyone knows anything it would be great to know before i have to take the pill again.  Thank you so much in advance

"splitting, crushing or chewing Imitrex tablets could be potentially associated with adverse gastrointestinal events."

medicaidprovider.hhs.mt.gov/pdf/imitrexplaceintherapy.pdf

Try oxygen using a non-rebreather mask and a high flow rate (15lpm or higher) and you'll be able to kill off a CH hit in a few minutes. Much better than using imitrex tablets.

One of the factors making the pill less effective for Cluster is that stomach acid reduces the functonal dose available to our body as well as the issue of less rapid availability.

If $ is the barrier to using injection, consider talking to the doc about a trial of this one. I've found it to be 100% effective in 10-15 minutes. Several folks have reported excellent results.
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Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.

Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ]

Chewing imitrex tablets is not advisable...  While it will work faster to abort a CH...  it's also a great way to trigger a heart attack...

Depending on your weight, 200 mg. is the maximum total daily dose of oral sumatriptan succinate (imitrex) tablets.  The bioavailability of the tablet form isn't all that great.  See attached.

However, chewing a 50 mg. tablet can easily result in an overdose as too much of the sumatriptan succinate will enter the bloodstream through mucosal membranes in the mouth and under the tongue.  When that happens, watch out for signs of angina and a heavy sensation in the chest.

You're limited to two subcutaneous injections of imitrex at 6 mg. each.  Chewing a 50 mg. imitrex tablet can easily result in serum concentrations four times the allowable dose of two imitrex injections...

Oxygen therapy at flow rates that support hyperventilation is far safer, a lot less expensive, and nearly as fast as an imitrex injection in aborting your CH.  Moreover, you can use it as many times a day as needed.

Take care

V/R, Batch

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