This is a question for those of you who currently use a triptan as part of your acute migraine treatment plan:
Which of the following Triptans do you currently use?
In the comments below, let us know if your triptan is a tablet, an orally disintegrating tablet, a nasal spray or an injection, especially if the triptan is Imitrex, Zomig or Maxalt (as these medications come in multiple delivery methods). Feel free to discuss how satisfied you are with your current triptan medication and if you have any specific complaints, compliments or comments about the treatment. Also, in the comments below, feel free to mention what other triptans you have tried in the past or to discuss triptans you have never personally tried but are still interested in.
For the majority of my migraine headaches, the triptan that I use is Zomig Nasal Spray. I find that of all the triptans I have tried, for me, Zomig works best. I use the 5mg Nasal Spray.
I also have a prescription for Imitrex Injection too, although the Imitrex Injection is to use for my most severe migraine headaches (what I used to call my "suicide headaches" or what I now refer to as a 9/10 headache using the Pain Scale that was recently posted in Pain Management Community Forum). I don't use Imitrex Injection often. Mostly I stick with my Zomig and for the majority of my migraines and the Zomig works. It tends to only be the migraines that wake me up that the zomig just won't work for. Or, sometimes if a migraine comes back on the same day, a second dose of zomig won't work to get rid of it either and it will be much more severe when it comes back. Although, really, over-all, the zomig works the majority of the time.
I do have other medications as part of my acute treatment plan to either help the zomig or to use if the zomig fails, such as naproxen, metoclopramide and strong pain killers... although, the majority of the time, the most I'll have to take on top of the zomig is just the naproxen. I will often take the naproxen at the same time as the zomig just to be sure that I've really knocked the headache out entirely. The medication Treximet is a combination of Imitrex and Naproxen so that is what gave me the idea to start taking the naproxen at the same time as my Zomig... well, actually it was my doctor's idea, because I asked him about Treximet and he told me I could just take my regular triptan and naproxen at the same time. Also, oh, I didn't put Treximet down as an option, I am so sorry!! It's so new that I completely forgot about it! Oops, umm... for anyone taking it just put Imitrex down I guess since that is the triptan in the medication. And then explain about it in the comments? I am really sorry about that!!!
The thing I don't like about Zomig Nasal Spray is the taste... it tastes SO awful!!!!! Sometimes it makes me gag or want to throw up. I think I've even thrown up a couple times because of it... but, I might have thrown up anyway because of the migraine so it's one of those side-effects that I don't really mind since it probably would have happened anyway. The other thing I don't like is that because I have chronic migraines I tend to use it at least 3 times a week if not more... so, when things are really bad and I am using it daily, I will start to get nose bleeds. But, nose bleeds have only ever happened if I've been using it daily for a while.
The thing I love about Zomig Nasal Spray is that it works really well and FAST. If it hasn't worked in half an hour I know that it's failed and I will take my next medication, because if it hasn't worked in half an hour I know that means it's not going to work because Zomig Nasal Spray is FAST. It sometimes works in 10 minutes for me. Sometimes it has taken up to 20 minutes to work... and normally maybe like 15 minutes. But, if I take it at the first signs of a migraine, then it works almost instantly it feels like. The reason why it works so fast is because of what amazing bioavailability it has @ 102%, that means that Zomig Nasal Spray works better than Zomig by intravenous injection. Most oral triptans have a bioavailability of around 40% (so they work about half as fast and as strong as they would by intravenous injection) and a few of them are much less than even that, like oral Imitrex at only 15%. So, as far as bioavailability goes, Zomig Nasal Spray is pretty much the best out there on the market. So, it works really quickly and really well because it gets absorbed into the system really quickly and I really like that. That's probably the thing I like the most about it.
I have also used Maxalt-MLTs. They are orally disintegrating tablets. They also work fast. Not as fast as the Zomig Nasal Spray, but still really fast. Maxalt-MLTs also taste awful!! Other than that, no complaints really. They worked well for me but then stopped working it seemed like after a while. I wouldn't mind trying them again though in the future. I think they are a good triptan.
I have also used Axert. I believe they only come in regular oral tablets, that is what I took anyway. I think my dose was 12.5mg. They sort of worked but it was not an ideal acute treatment plan since they only sort of worked and then the axert just entirely stopped working after awhile. I don't think I had any side effects with the Axert. The one thing that I did notice was that I had a LOT more Migraines with Aura when I was taking the Axert... actually, I have hardly had any since I stopped taking it and I never had a visual scintillating scotoma aura before I started taking the Axert but I had them all the time when I was taking the Axert. But, I don't think that rebound Auras are a side-effect of Axert so I don't think that the auras had anything to do with the medication at all, I think it was only a coincidence. I don't think I would take Axert again though... although mostly just because it didn't provide good pain relief for me and it took too long to work in my case.
I use Zomig when I use anything. It's really hard for me to use abortives correctly, as I have a daily pain level of 6/10 or higher anyway. So I often miss the window in which the Zomig would be helpful because I'm so used to the pain.
I'm also reluctant to use triptans in general because I have a maybe diagnosis of basilar type migraine, and don't want to induce a stroke. That's why I was taken off all abortives for 6 years, before I broke down and asked my neuro for a new script.
Well Zomig seems to be the only one that works for me, I hope it doesn't stop working either. Yes, Dame_Wilbur is right I have to be right on top of it to catch it in time, it has taken me about a year to learn to just take it when I think I have pain, slow learner. LOL
hi I suffer from severe migraines and i have had a migraine for 7 days so i ´ve been taking triptans ( naratriptan) a lot.. 4 in 1 week.. i usually try not to take them but it was a terrible week and i couldn´t stand the pain... so... what should i do?? i feel i am in a rebound cycle but NOTHING takes away the pain but naratriptan... nor naproxen nor ibuprofen etcc... what do you take to avoid taking triptans?? please help!!! tomorrow i will have to deal with this situation again.... Thanks!! s.
It is extremely rare for triptans to cause rebound headaches. You should avoid taking over-the-counter headache medications such as ibuprofen on a regular basis... but there is no reason to avoid taking your naratriptan! It is best to take the naratriptan at the very first sign of the migraine headache. Do not wait until the headache is bad. If you take the naratriptan at the very first sign of the headache, then the headache will not get bad. If the headache gets bad, then you will be much more likely to get caught in a pain cycle. It is important to stop the headaches so that you do not get stuck in a pain cycle. It is much more likely that you are stuck in a pain cycle than a rebound headache cycle right now. I would suggest taking your triptans at the very first sign of the headaches and take them as needed. Do not be afraid to take your triptans!
If you are getting more than 15 headaches a month... and 4 headaches a week sounds like more than 15 a month! Then, preventative medications could be an option. Are you currently taking any preventative medications? There are 3 first-line daily preventative medications: tricyclic antidepressants (specifically Amitriptyline or Nortriptyline); anticonvulsants (such as valproic acid or topiramate); or beta blockers (such as nadolol or propranolol). If none of the first-line treatments work, then there are other preventative treatments as well, such as Botox Injections and Calcium Channel Blockers.
There are also daily supplements that can be taken for the prevention of migraine headaches: Vitamin B2 @ 400mg per day; Magnesium @ 400mg to 600mg per day; Coenzyme Q10 @ 300mg per day. Vitamin B2 and Magnesium have the most scientific evidence proving that they work, whereas it is not as clear if Coenzyme Q10 works as well as the other two. Since Magnesium can cause stomach upset, it's best to start at 400mg and if that does not work to prevent migraine headaches then increase Magnesium to 600mg daily. It is important to check with your doctor before starting these supplements, especially the Magnesium since Magnesium can react badly with certain medical conditions, such as heart disease and diabetes, and certain medications, such as oral diabetes medications, antibiotics and diuretics (just to name a few).
I personally take preventative medications, and so do many people here in this group. My personal preventative treatment plan include the anticonvulsant Topamax, the Beta Blocker Nadolol and Botox Injections. In most cases though, a preventative treatment plan will only include ONE medication from ONE class of treatments. I also take 300mg of Magnesium daily (about as much as my stomach can handle these days) and 300mg of Coenzyme Q10 daily.
I guess I wanted to vote again too, when I just meant to answer you...:)
I actually also tried an herb called Fever Few which works for my sister but not me. So I use a preventative medication, and 800 mg of magnesium (per my Dr) twice a day.
It is much easier to be ahead of the migraines than behind them, trying to catch up. Best wishes and keep us posted,
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