Mixing triptans

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Mixing triptans

Post  doximom on Fri Jun 12, 2015 1:02 pm

Took a Relpax about 8 hours ago and migraine is back full blast. I am at work. Thinking of taking the only thing I have with me -- Zomig nasal spray (which I should have taken in the first place because it usually works better).

It says do not take 2 different triptans within 24 hours of each other. What the heck is going to happen that's worse than a migraine?!

Also -- Frova is no longer covered by my insurance. Why can't I simply buy it, and pay full price? Why can't I have my medication?!

Thank you all

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Re: Mixing triptans

Post  tortoisegirl on Fri Jun 12, 2015 6:17 pm

Sorry you are suffering. I would call up your pharmacist and ask about the safety of mixing Triptans. You'd figure they have their reasons, but who knows. I guess it could just be because they haven't studied it. As you can take a second dose of the same Triptan two hours after the first, I don't see why it would be different. Here is one article: http://www.nyheadache.com/blog/mixing-triptans/

What reason is your pharmacist giving you as to why you can't pay cash for Frova? Without using insurance, as long as you have a valid prescriptions, there shouldn't be any issue paying cash.

I wonder though, if you pay cash for one Triptan, could insurance deny paying for a different one on the basis you paid cash for one (ie. already have Triptans on hand)? Probably another pharmacist question. Best wishes.

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Re: Mixing triptans

Post  Sara79 on Fri Jun 12, 2015 8:11 pm

technically, if you're paying the cash price, the insurance company won't know what you have on hand, as they never get told what you filled without using them (US, may be different in other countries)

The concern with taking 2 different triptans, as i understand it is that it increases your risk of serotonin syndrome...I've personally taken a maxalt, and then an immitrex shot if the maxalt's not kicking things. My MD knows and is OK with this, but yours may not be

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Re: Mixing triptans

Post  dcook60 on Fri Jun 12, 2015 9:19 pm

i just got home from a 10-hour day (7 working, 3 driving and doing errands).  although i am very tired, and NEED a triptan myself, i'm not going to take one, as the migraine isn't too bad, and i can get to bed in 2 hours. plus i took one this morning, and am always panicky about running out before the end of the month.

just felt i needed to chime in here about mixing triptans.  i have taken daily triptans, alternating two different ones, for 10 years or more.  not because i think it's a great idea, but because there is no other choice for me to get through life and keep working at age 75.

once or twice i have forgotten which i took (usually at 5 a.m., when the pain wakes me up) or i didn't have the right kind with me, when i need to take a second one in a day.  i don't think i'd worry unduly about this, if it happens again.  drugs always have their downside, but since these triptans are closely related chemically, my opinion, for what it's worth, is that it's best to go by the rules, but sometimes we screw up, and that's ok.

dianne
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Re: Mixing triptans

Post  tortoisegirl on Sat Jun 13, 2015 11:35 am

Sara: Thanks for the info, especially that insurance doesn't get told what we pay cash for. I couldn't however find anything about the risk of Serotonin Syndrome from mixing one Triptan with another, only Triptan+ Antidepressant. I could see how the risk could be there though.

I have multiple Triptan prescriptions but don't seem to remember my doctor or pharmacist telling me not to mix them (just reading that in the prescribing info). I've thankfully never needed a second dose within 24 hours (although I take the higher mg dosage of each one). Best wishes.

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Re: Mixing triptans

Post  Sara79 on Sat Jun 13, 2015 9:58 pm

http://www.achenet.org/resources/drug_interactions_in_headache_what_to_watch_for_and_why/

http://www.nyheadache.com/blog/mixing-triptans/

Kinda both sides of the coin...not med pro sites, but both read reputably on a quick glance and are supposedly written by MDs. they both say basically the same thing...the FDA doesn't like this, but we've never seen anybody have a reaction...you may get to become the first if you try it, so be warned.

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Re: Mixing triptans

Post  Migrainegirl on Sun Jun 14, 2015 9:27 pm

I had the same problem. Frova no longer covered by insurance. And it is VERY expensive, I paid $130 for 10 pills with the insurance. About twice that without.

And while theoretically we should be able to pay out of pocket even if our insurance does not cover something, in practice it is almost impossible. It would routinely take at least 3 visits to the Pharmacy and a lot of arguing every time I tried to pay myself for another prescription. Same problem at different pharmacies. I finally just gave up.

I decided to try another triptan my insurance does cover, Maxalt. Good news it actually works better than the Frova and only costs me about $10 per 10 pills. So that may be an option.
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Re: Mixing triptans

Post  30yrsofheadache on Tue Jun 16, 2015 3:23 pm

My Dr. told me as long as you pay attention to the time limits, it is ok to mix triptans. I have done it several times with samples with no adverse reactions.
Hope you are feeling better.
Cindy
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Re: Mixing triptans

Post  Sara79 on Wed Jun 17, 2015 8:48 pm

Migrainegirl-I'm surprised to hear that. The amitriptyline I take as a preventative was cheaper out of pocket than through insurance. I told the Walgreens pharmacist that I wanted to pay the cash price, and ta dah, I'm paying less each month

Sorry to hear your findings weren't as positive.

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