I don't have ch, but I do have menstrual migraines and Maxalt is no longer effective (can't take Imitrex any more either and Zomig is out of the question).  Helen (Lelimey) suggested Frova.  Well, doc is reticent, says that higher risk of heart attack/stroke.  I've done the research and can't find where the indication is any higher.

Does anyone have anything that might help me?

'darlin

Maybe Amerge?

For this specific problem, I really need to try the Frova.  I was just wondering if anybody had any info that Frova had a higher risk of causing heart attack/stroke.

Thanks Brew

Not very specific but the only thing I could find in a brief survey of PubMed.
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Expert Opin Pharmacother. 2007 Dec;8(17):3029-33.
Frovatriptan review.

Markus F, Mikko K.

University Hospital Helsinki, Department of Neurology, Haartmaninkatu 4, 00290 Helsinki, Finland.

Frovatriptan belongs to the triptan compounds used for the acute treatment of migraine. Its affinity for the migraine-specific serotonin 5HT1B-receptors is highest in the class. Its long half-life in plasma (26 h) and metabolism by multiple pathways are unique characteristics among the triptans. These features can translate into long duration of action and low risk of interactions with other drugs. Frovatriptan has been effective and well tolerated over a wide range of doses in randomised, double-blind, placebo-controlled acute migraine trials and long-term, open-label trials. The 2.5-mg dose is recommended for both efficacy and a favourable side effect profile for acute migraine treatment. Frovatriptan has the lowest headache recurrence rate of all the triptans. Frovatriptan was better tolerated than sumatriptan in a head-to-head comparison study. Frovatriptan could make its mark especially in slowly progressing migraine attacks and in attacks that are highly predictable. For example, for the short-term prophylaxis of menstrual migraine, frovatriptan is the triptan of first choice.

Publication Types:
Review

PMID: 18001261 [PubMed]
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Eur J Clin Pharmacol. 2007 Aug;63(8):801-7. Epub 2007 Jun 19.
Triptan use and risk of cardiovascular events: a nested-case-control study from the French health system database.

Lugardon S, Roussel H, Sciortino V, Montastruc JL, Lapeyre-Mestre M.

Unité de Pharmacoépidémiologie, EA 3696, Service de Pharmacologie Clinique, Faculté de Médecine, Université Paul Sabatier, 37 allées Jules-Guesde, 31000, Toulouse, France, lapeyre@cict.fr.

BACKGROUND: The use of triptans (5-HT agonists) in the treatment of migraine is associated with a potential increasing risk of cardiovascular events and raises the question of the relationship between overuse and the occurrence of ischemic events. OBJECTIVE: The aim of this study was to examine the association between the intensity of triptan use and occurrence of an cardiac event. METHODS: Using the reimbursed drug prescription database of the National French Health Insurance System in the Midi-Pyrenees area, we identified subjects receiving at least one triptan in the second semester of 2002. From this population, we selected new users and retrieved all reimbursed care data up to 31 December 2003. We estimated the patterns of triptan exposure by calculating the number of defined daily doses (DDD) received per 30-day period. Another reimbursed health care database was used to identify as cases of cardiac outcomes those patients receiving care for the management of a possible heart ischemic event. Each case was randomly matched on age and gender with four controls free of any cardiovascular event before the index date. A conditional logistic regression was performed to assess the relationship between cardiac outcomes and exposure to triptans in the 30 days before the index date. RESULTS: The cohort of new users of triptans included 8625 subjects, 4414 (51.18%) of whom received only one dispensation for triptans during the follow-up period (median duration: 427 days). For the remaining subjects, the peak of triptans delivery was </=8 DDD for 14.68% of the cohort, between 9 and 14 DDD for 22.17%, between 15 and 29 for 10.04% and >/=30 DDD for 1.92%. Fifty-seven users (0.66%) presented a cardiac history and 1388 patients (16.09%) had cardiovascular risk factors. We identified 155 incident cases of cardiac outcomes during the follow-up and compared these to 620 matched controls. Cases were older and presented more frequently with cardiac history or cardiovascular risk factors than the other users of triptans. The distribution exposure to triptans did not significantly differ between cases and controls with an odds ratio for an exposure </=8 DDD in the last 30 days of 0.74 [95% CI (0.31-1.77)] and that for an exposure >8 DDD equal to 1.14 [95% CI (0.58-2.27)]. CONCLUSION: The proportion of patients showing an overuse of triptans (more than 15 DDD for 30 days) reached 12% in this cohort of new users of triptans. HOWEVER, WE DID NOT FIND ANY RELATIONSHIP BETWEEN THE OVERUSE OF TRIPTANS AND CARDIAC OUTCOMES. THIS STUDY ALSO SHOWS THAT SOME PATIENTS WITH CARDIOVASCULAR RISK FACTORS ARE ACTUALLY TREATED BY TRIPTANS. THESE PATIENTS ARE MORE LIKELY TO PRESENT A CARDIAC OUTCOME POTENTIALLY RELATED TO AN ISCHEMIC EVENT AFTER THE INTRODUCTION OF TRIPTAN.

PMID: 17576547 [PubMed]

deltadarlin wrote on Jun 24^th, 2008 at 7:45am:

For this specific problem, I really need to try the Frova.  I was just wondering if anybody had any info that Frova had a higher risk of causing heart attack/stroke. Thanks Brew

Oops. Sorry, Carolyn. I misinterpreted your question. :-[

I can't help with the triptan question, Carolyn... but I wanted to share that my niece has found kudzu 100% effective for menstrual migraines. She takes it for about 2 weeks every month, and it hasn't failed her once.

Just a thought...
Feel better.

hugs, nani

Carolyn,

I hadn't heard the bit about Frova increasing risk of heart attack/stroke, but I'll have to look into it.  Frova is a staple for me - works very very well for both preventing CH and also dropping the severity of my daily migraine.  Before my stim surgery, I was using Frova about twice a week on work days (and using Amerge on the other work days), and it was pretty effective for me.

If you do end up hearing about increase risk, do let me know.  Like I said, I use it pretty regularly, although much less so now that I've gotten my stim.

Hugz,
Carrie