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MarkOsAz
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Hi Im new here just a question
« on: Oct 17th, 2007, 2:35pm »
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Hi my name is Buffy My husband Mark suffers with clusters. He has been pain free for about 2yrs , But they are back worse than before, We are only able to get 4 Imitrex injection per month, but we recently tried a sample of Maxalt 10mg tablet it seemed to work at least twice. Problem is last night around  6pm Mark took a injection of imitrex, about 11pm the beast came back Mark took a Maxalt, then 10am today its back again. The instructions in the box say no more than 2 in a 24 hr period for both. And Dr said if your going to mix (imitrex and maxalt) wait 4 hrs between doses. Now cant get ahold of Dr and Mark wants to take  a shot. Well wanted too but the beast is gone for now . Does anyone know is he allowed to take imitrex and Maxalt both twice in a 24 hr period, Dr didnt really clarify, and what i read i assume no . Also i read the trick about getting 2 shots out of one really good info . Do i store the shot the same , and how far would i put the needle in his arm ? Im sorry any info would be helpful. Thanks to all . Buffy
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Guiseppi
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Re:  Hi Im new here just a question
« Reply #1 on: Oct 17th, 2007, 2:58pm »
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A smarter person then me will come along and hopefully answer that question. I know enough to know you do have to be careful because too much of one type of med can cause cardiac issues so please get some good advice before proceeding.
 
That being said, do you have oxygen yet? going on 30 years with these things it's still my first line abort. Only rarely do I have to resort to imitrex for a killer the 02 won't bust down. Much cheaper, no limit to how often you huff and no side effects.  
 
By the way, bless you for being such an active supporter. My supporter, (wife!) of 25 years found this board and saved my sanity!  
 
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MarkOsAz
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Re:  Hi Im new here just a question
« Reply #2 on: Oct 17th, 2007, 3:18pm »
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Thank you for replying , We did try o2 with the last cycle, we couldnt set our tank to the setting some recommended i cannot remember what that was but, he didnt get any relief. What med causes cardiac problems? , I read about the verapamil, Mark takes 480 mg a day but i didnt hear about the Imitrex or Maxalt. I just recently read about the Verapamil and we dont go to the Dr until December. Mark WILL NOT stop taking verapamil EVER he swears that it keeps him headache free but i read that it should only be used during a cycle mark has been taking for 2.5yrs. Well thanks again for the reply i appreciate any suggestions Thanks  
 Buffy
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Ray
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Re:  Hi Im new here just a question
« Reply #3 on: Oct 17th, 2007, 4:06pm »
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Dear Buffy:
 
I AM NOT A DOCTOR, SO DO NOT TAKE THIS AS MEDICAL ADVICE:
 
In general, and in every case that I know of, patients are instructed NOT to take 2 different triptan medications within 24 hours of each other.  They increase dramatically the risk of heart problems if used together.
 
Please look up the drug information circular and in particular the interaction information for both imitrex and maxalt:
 
http://www.merck.com/product/usa/pi_circulars/m/maxalt/maxalt_ppi.pdf
 
Quote:
MAXALT should not be used within 24 hours of treatment with another 5-HT1 agonist** such as
sumatriptan (IMITREX®), naratriptan (AMERGE™) or zolmitriptan (ZOMIG™); or ergotamine-type
medications such as ergotamine (BELLERGAL-S®, CAFERGOT®, ERGOMAR®, WIGRAINE®),
dihydro-ergotamine (D.H.E. 45®), or methysergide (SANSERT®).

 
http://us.gsk.com/products/assets/us_imitrex_injection.pdf
 
Quote:
IMITREX Injection and any ergotamine-containing or ergot-type medication (like dihydroergotamine or methysergide) should not be used within 24 hours of each other, nor should IMITREX Injection and another 5-HT1 agonist.

 
With Pain Free wishes,
 
Ray  (Edited to fix a typo)
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Re:  Hi Im new here just a question
« Reply #4 on: Oct 17th, 2007, 4:35pm »
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on Oct 17th, 2007, 3:18pm, MarkOsAz wrote:
Mark WILL NOT stop taking verapamil EVER he swears that it keeps him headache free but i read that it should only be used during a cycle mark has been taking for 2.5yrs.

 
I took Verapamil (480) everyday for nearly fourteen years an then stopped taking it for fourteen months because my HA's went away, Im back on the same dosage now but only because of high blood pressure.
 
 
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Re:  Hi Im new here just a question
« Reply #5 on: Oct 17th, 2007, 5:11pm »
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Hi Buffy and Mark
 
  When I first came here (in agony), I subsequently went to the doc who had (unsuccessfully) treated me for over a year. I requested Imitrex, 02, and Verapamil.  He relented on the Verapamil and gave me a script for 02.  He refused (rightly so) to give me a script for Imitrex without a stress test (had previous heart issues), which led to a heart cath, which showed some arterie blockage . . . not enough for a stint . . .but enough to rule out Imitrex as an abortive for me . . . I'll try and explain why:
 
    I am obviously not  a doc, but this is the explanation I got when I first came here.     CH is an inflamation related condition.  For some reason the hypothalmus (believed to be the culprit) sends an incorrect signal and dilates the blood vessels on the affected side, putting pressure on the nerves which run beside them . . . causing the pain . . . and these vessels can dilate up to 20 times normal which is why our pain levels hit such high peaks.  Imitrex and the other triptans mentioned above are constrictors, which reduce dilated vessels, taking pressure off the nerves ... . pain goes away.  Problem is, if you have arterie blockage . . . especially arround your heart . .. can be VERY dangerous.
 
   Now back to 02.  When you inhale 100% 02 at 12-15 lpm, you kind of trick your brain . . . the brain says, "whoa, too much oxygen" . . . and shuts down JUST the dilated vessels, taking pressure off the nerves . . . pain goes away. . . . . for about 70% of us.
 
   You were probably given an 8 lpm regulator.  I was at first and that was with a nasal canula (the little nose thingy).   THAT WON'T get the results you're looking for.  You need a 15 lpm regulator and a non-rebreather mask . . .the one with the bag . . . to be effective.  Even more effective is the Clustermasx, designed with us in mind . . .. works great.
 
    The real pros will be along I'm sure to give a more technical answer to my ramblings above, but I hope that helps and convinces you to try 02 again . . . when you get the right regulator and mask, we'll be more than happy to walk you through the proper use of same.  02 is my only abortive and I go nowhere without it.
 
   Be Safe,   PFDANs
 
     Richard
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