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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Imitrex tolerance?
        
(Message started by: ErikY on Feb 16^th, 2005, 9:54pm)

Title: Imitrex tolerance?
Post by ErikY on Feb 16^th, 2005, 9:54pm

I just got some 5mg Imitrex nasal spray and I am wondering if this is something that anyone has built up a tolerance too and it loses its affect?

I am wondering because I believe it comes in 20mg as well and if I should ask my doctor for that next time instead of the 5?

The 5 worked fantastic on my last HA, 2-5 min. and it was completely gone. Now that I have experienced that I dont want to suffer through another one again.

Thanks!

Erik

Title: Re: Imitrex tolerance?
Post by Kevin_M on Feb 16^th, 2005, 10:58pm

I've heard of the 5mg n/s but never saw it. Amazing, but that is really fast for the nasal spray. If the 5mg works, cool. Unfamiliar with that dose and fast work.

Tolerance where it loses it's effect? Been many years, not yet for me.

Kevin M

Title: Re: Imitrex tolerance?
Post by Giovanni on Feb 17^th, 2005, 5:36am

Used to take hundreds of injections of the years and never built up a tolerance. If you are taking imitrex, the stat dose injections are much better and faster.

John

Title: Re: Imitrex tolerance?
Post by Langa on Feb 17^th, 2005, 8:10am

HI Erik...when I was given the nasal spray it was 20 mg which did nothing for me. Never even heard of 5mg...so they switched me to the stat dose injections which helped me as they worked much faster.

Glad that 5mg works for you.

Langa

Title: Re: Imitrex tolerance?
Post by ErikY on Feb 17^th, 2005, 9:02am

I actually spoke way too quick about the NS yesterday. I got my usualy 3:00 HA and as soon as I felt it coming on I did one of the 5 mg sprays.

The HA went away so I assumed it was the imitrex working.

Well, 3:00 AM I got another one, popped another 5mg and it did nothing at all. HA lasted 1 hour.

Fell back to sleep and at 5:30 got another one, again tried a 5mg and did nothing.

Turns out my prescription actually was for 20 mg but CVS messed up because they did not have any 20, so they gave me 5. They are ordering the 20 for me but unfortunately it wont be available till tomorrow morning.

I am wondering if I should see if my doctor will prescribe the injections for me, they are seeming to come more frequently and I am not sure how much more I can take.

Title: Re: Imitrex tolerance?
Post by Bob P on Feb 17^th, 2005, 9:40am

From the OUCH Research Library:

Sumatriptan overuse in episodic cluster headache: lack of adverse events, rebound syndromes, drug dependence and tachyphylaxis.

Centonze V, Bassi A, Causarano V, Dalfino L, Cassiano MA, Centonze A, Fabbri L, Albano O.

Dept of Internal Medicine and Public Medicine, University of Bari, Italy.

This observational study was designed to examine the pattern of sumatriptan use in patients with cluster headache using more than the recommended daily dose of subcutaneously injected (s.c.) sumatriptan. Thirteen patients suffering from episodic cluster headache were asked to record the characteristics of their attacks and drug intake for 1 year. All reported a high daily frequency of attacks (more than 3 per day) and the related overuse of s.c. sumatriptan. The results show that the overall incidence of adverse events among patients receiving sumatriptan injections for the treatment of cluster headache is low. The extended administration of this drug in episodic cluster headache did not result in tolerance problems or tachyphylaxis. Only 4 patients experienced minor adverse events and recovered more slowly than the others. They suffered from migraine without aura and cluster headache, and showed a family history of migraine. Even though they must be viewed with caution, due to the observational nature of the study and the low number of patients included, these results suggest that the profile of sumatriptan may differ in cluster headache compared with migraine.

Title: Re: Imitrex tolerance?
Post by Kevin_M on Feb 17^th, 2005, 8:23pm

on 02/17/05 at 09:02:00, ErikY wrote:

Turns out my prescription actually was for 20 mg but CVS messed up because they did not have any 20, so they gave me 5. They are ordering the 20 for me but unfortunately it wont be available till tomorrow morning.

I'm surprised they had the 5mg in stock at all. Haven't heard of the use of it or being prescribed for clusters, the 20mg n/s is standard. When you renew the script, go in a day early or so because it may have to be ordered regularly. After years, my pharm keeps a half order on hand for me, which is fine, I pick the rest up a couple days later.
I use trex n/s, but prefer oxygen as an abortive and the trex for the hits recurring at a stronger level through the night when the hits won't quit playing around with me, and keep trex on hand for at work too. Also, I'm a strong believer in preventives, finding one at a dosage that will curtail the hits. This is worth starting to explore, it took me a long time to find the proper effective prevent. I haven't read you mention a preventative, which will be well worth it to you to inquire about with doc, verapamil being a helpful one for many.
See if the 20mg works and go from there and inquire (beg) about oxygen for abortive use, it works also for many. Prevents though are important.
'Til tomorrow, ice packs can be somewhat handy for enduring, somehow for one night. Keep working the doc for results, see how the 20mg n/s does first and press always for better results.
After many years of abortive only CH treatment, and I'm chalking that up to my ignorance and finally being a rectified situation by continually pursuing for myself things I've read on this sight, an effective prevent is the real long term gold. Start trying to get lucky with that, it's made a big difference getting through extended episodes, big, big difference. Abortives were a lifesaver during the learning process and still are while working up to the effective prevent dose during the first month or longer of a new cycle now. Always kept on hand too.

I'm of course medically inept, but wish I had pursued prevents better years ago.

Kevin M

Title: Re: Imitrex tolerance?
Post by Kris_in_SJ on Feb 17^th, 2005, 9:02pm

Hi Erik,

I've never tried the NS Trex - been an injection girl from the start.

However, it does work for some people, so if I were you I'd at least try the 20mg dose before asking for injections. The injections work wonders, but the fact is, the NS works for some also. Try it before asking for injects - why be a pincushion if you don't have to be?

Second thought - seems to me your pharmacy not only owes you a major apology, it might also owe you some free Imitrex. They screwed up by giving you the wrong dose. Advocate for yourself and do a little bartering for the next batch.

Best Wishes,

Kris

Title: Re: Imitrex tolerance?
Post by Mr. Happy on Feb 17^th, 2005, 9:17pm

on 02/17/05 at 20:23:39, Kevin_M wrote:

This is worth starting to explore, it took me a long time to find the proper effective prevent .......but wish I had pursued prevents better years ago.

That's the real ticket. Prevents. Kev mentioned O2 in passing, the old dog. No CHead worth their salt should be without their O2. (http://www.headachesupportgroups.com/oxygen/oxygen.htm) Get those 20 mg trex snorts, and use `em as needed. I do. And look into the Zomig snorts. They're supposed to work fast and last longer. But it's the prevents that will make or break you. This is a lifetime deal (for the most part.) No matter how long the remission, CH WILL be back. Think about those prevents. Forewarned is forearmed. A little planning doesn't hurt, either.

Kev is right on with everything he said. Hard to believe he can be that lucid, once you've met the guy.....
RJ

Title: Re: Imitrex tolerance?
Post by ErikY on Feb 18^th, 2005, 10:36am

Yesterday morning I went back to the pharmacy and they acknowledged giving me the wrong dosage and were very apologetic. They did not have any 20 at the time but ordered it for me. I got it last night around 6:00.

They did give me a box more than my prescription called for which was good, that should get me to my next allowed refill which is 2 weeks at a time.

Knock on wood, but I have not gotten a HA since I got the Imitrex so I have been fortunate enough not to have to use it yet.

I have been experimenting with the water x3 method, and probably doing more like water x 6 along with the recomendations from the book, prescriptions for natural healing third edition which does include small tidbits about clusters.

I have been keeping my diet down to Almonds, apples, pineaple (fresh), plain chicken breast and broccoli, boring diet but if it keeps the HA's away, I will try it.

It also recomended a bunch of supplements which I tried as well, and I took Melatonin before bed last night, also recomended by the book. I was up every 1/2 hour to go to the bathroom becuase of the water, so I imagine I never got into REM sleep last night, hence no HA last night.

I am completely exhausted but I would be anyway as once I get a HA i have a very hard time going back to sleep.

I am sticking with the water x 6 and diet/supplements, so I am praying that it keeps me from getting too many monsters and can keep me from needing to use too much imitrex. Even the 5 ns gave me some pretty adverse feelings that I did not like too much. Will use the 20 if needed, but I really hope not to have to.

We will see how it go's, I am almost at 24 hours without one, but I do have what I would call shadowing, but I can function with it.

Thanks for all the responses!

Erik

Title: Re: Imitrex tolerance?
Post by ErikY on Feb 18^th, 2005, 11:04am

Regarding the preventive and o2, the previous 3 times I got these bad boys they lasted about 2-3 weeks. I am figuring that the preventives could take that long just to kick in so unless this cycle lasts longer than the previous ones, which I really really really hope it does not, I will probably not do the preventive thing.

As for the 02 my doctor told me if the imitrex did not work she would get it for me, i probably should have asked for it up front but stupid me did not. I have plenty of imitrex for the weekend so if I find that I want the O2 I will hopefully be able to get it on Monday.

Thanks for all the suggestions,
Erik