Hi, it's been awhile since I've had a cluster, 5 years Thank God! I'm not sure why it's been so long. I've had clusters for over 30 years 1-2 times a year. The last cycle I had was the longest, 5 months, 4-6 headaches a day. The last couple weeks it seems like they are trying to come back and that scares the hell out of me. I have about 12 Imitrex shots left, but they Expired in 2008. I've used expired shots before and they worked, but not any that were over 3-4 months. Any body know if they might work or if they are safe. This stuff is worth more then gold to me. Thanks for being here.   Bob

Useful article at this page (and the site is good source for medication & related information):

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Quote:


What a load...

My specialist IS a clinical pharmacologist.
He is an experienced pain and headache clinician with 700 clinical trials to his name and 80 first in human molecular structures. An ethicist, with no commercial interest to declare (Not a drug company stooge), he is an expert on Triptans particularly, he came up with Zolmitriptan or (Zomig).

I have expired Sumatriptan (Imigran, Imitrex) injections here that he prescribed. Some are out of date.
I asked him if they are suitable to use.
He replied along these lines: "As a general principle, no-one should ever used medications after the expiry date. The expiry date is put there for a reason."

(note to cynics - this reason is not to make money for the huge much maligned drug companies, but to help YOU avoid "harm by prescription pad" - first do no harm...)

Effects of out-of-date medication may be unpredictable; ranging from little/no effect, lessened effect, or perhaps an undesirable or even dangerous effects. Some molecular structures change with factors including; time, environmental exposure (heat, light, cold etc) or they may become inactive, or active as an entirely different compound - very undesirable - in some compounds, perhaps lethal.

I have nearly died from drug contraindications or interactions on at least 2 occasions.
After 34 years of Chronic CH, I know a CH attack will not kill me. Pick the wrong medication, taken out-of-date and it just might.

Ask yourself, Is it really worth the chance?

In 3 hours, after the pain has passed, you will still be here.
I understand the desire to use what you have, all too well.

I will now throw 14 unused , out-of-date Imigran injections in the bin. I will have a new supply prescribed to me.
I hope I set an example in doing so.

Until then I will make do with what other treatments I have, including simply toughing the bastards out, if I have to.

Now I'm walking straight past my out-of-date Imigran injections, off to pop an Imigran 50mg FDT instead, here comes another one again...

Cheers, Ben.

I agree Guiseppi,

Firstly I should fess up, I have used expired drugs, but had problems, so I sought a professional opinion on the idea.

Many people do die under medical supervision and specialist advice. This has nearly happened to me, under supervision of some less than scrupulous, but nonetheless, qualified GPs and Neuros, but not this man. Together with my current specialist I made the "personal", but what I also consider to be "informed" decision, not to use out-of-date medications.

It's the general principle I mentioned in my previous post that I am labouring on here. I've done over 70 drug trials now and would have a pile of expired drugs 6 feet high if I kept them all. I wouldn't want to be seen advising people to circumvent in-built safety mechanisms, then where to we draw the line?

At a particular drug type?
At a specified date after expiry?
Under a certain temperature threshold?
At a particular CH treatment?

Efficacy is one thing, safety another. Can't help it, I was an OH&S officer in an industry where people could die if I had got one thing wrong.

It's a grey area, indeed.

I don't have a monopoly on opinion, let the debate continue!

Cheers.

I have been using mine that expired in 06, with success.

Easter break saw me stiffed on Imigran injections until next week. FDT was off the shelf too, I only had a few left, with 5-6 attacks per day at the moment... Ramping up the D3 regimen, but it has not kicked in yet.

I still take the general advice of my specialist and the FDA's chief Pharmacologist on general principle of expiry dates.
I circumvent safety procedures in this case, with caution and desperation.

The duress of 10/10 CH pain 5 times a day does re-define the subjective meaning of "choice", indeed.
Fine line between choice and duress...

So, you will be happy to know I am here to eat crow, as I dug my Imigran injections (not yet in bin) out, they expired in NOV 2012 and the ampules had been kept in their plastic refill case, inside the cardboard box, inside a double paper (white/brown) bag and stored in the dark at under 30 degrees Celsius. I look after my drugs.

Checked the following info and whacked a couple in my leg, so far. No ill effects to report, they work just fine.

If I am reading this right (and I may not be) the listed active ingredient appears to be degraded by light. If openly exposed to air, at a rate of 1% per 28 days. Mine were packaged as I said above, so use was a calculated risk on my part. Your patient experience helped me make the judgement call too. Thanks peoples.

I know the MSDS is more aimed at the fire brigade, when they come to clean up a chemical spill, used MSDS a lot in work. But, it is the best data on possible degradation I could find, if not totally relevant to the discussion.

From the Imigran Injector MKII MSDS:

PERSISTENCE/DEGRADATION
Hydrolysis

This material contains an active pharmaceutical ingredient that has been shown to be chemically stable in water. Hydrolysis is unlikely to be a significant depletion mechanism.

Half-Life, Neutral: > 1 Years, Measured

Photolysis

This mixture contains an active pharmaceutical ingredient that is likely to undergo photodegradation.

UV/Visible Spectrum: 290 nm

IMITREX INJECTION
110559 Approved/Revised
13-Dec-2011
Material SDS Number Version 12

Biodegradation
This material contains an active ingredient that is not readily biodegradable but is inherently biodegradable (as defined by 1993 OECD Testing Guidelines) and is not expected to persist in the environment.

Aerobic - Ready
Percent Degradation: 1 %, 28 days

Aerobic - Inherent
Percent Degradation: 100 %, 16 days, Modified Zahn-Wellens, primary biodegradation, loss of parent., Activated sludge

Aerobic - Inherent
Percent Degradation: 17 %, 28 days, Modified Zahn-Wellens, DOC removal., Activated
sludge

Aerobic - Soil
Percent Degradation: 32 to 40 %, 64 days, , Soil.

From the Imigran Injection MKII MSDS sheet:
Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Cheers, Ben.