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I screwed up...now what?

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TeriRobert
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Post  milo Thu Feb 04, 2010 5:47 pm

I had a killer migraine last night, so instead of taking one of my few Gravergol, I took an old maxalt. (Don't ask me why, I was clearly not thinking).

Now I'm brewing another 7-8 and I have no maxalt.

I have other triptans, but no maxalt. Can I take a different triptan almsot 24 hours after the maxalt?
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Post  Richard Thu Feb 04, 2010 5:54 pm

Maybe I am confused .... but why not take a different brand?
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Post  milo Thu Feb 04, 2010 6:08 pm

I thought you could never have two different triptans in a 48 hour period?
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Post  pen Thu Feb 04, 2010 6:21 pm

Well dont quote me but my neuro told me two different ones in a day was a good way to smash a mirgriane.
BUT my GP told me to wait 24 hours as I am so sensitive to medication.....
No wonder we get so stressed.

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Post  milo Thu Feb 04, 2010 6:32 pm

I'm so conflicted....but my brain does not work when I have a migraine.

I'm just going to take a gravergol and hope not to have a stroke....it's an ergot....

I don't have the functionality to call a pharmacy and ask right now. ugh
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Post  Rachel328 Thu Feb 04, 2010 7:21 pm

I've been told never to take two different triptans within 24 hours. In fact, because an ER resident wanted to pull the "I'm the doctor you'll do what I say" card and gave me Maxalt, I was hospitalized for 24 hours until I could get DHE.

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Post  dcook60 Thu Feb 04, 2010 8:46 pm

as someone with a very long history using LOTS of triptans of several kinds (17-18 years i think) i have probably once, or twice, been in desperation and confusion and did take a different triptan within 24 hours. i'm still here, not dead.

i always try to wait 24 hours, however. i can take 3 maxalt within that time, or two amerge. i take one-or-the-other daily. i'm 70 years old, so you see i have done this without damage for a long long time.

i think everyone is too freaked about the heart issue with triptans, but it's VERY important to get one's ticker checked out, and also to NOT take them daily unless one has no other options. i don't. dianne
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Post  AuntieBubbs Thu Feb 04, 2010 8:55 pm

Ok, my experience is that my nuero told me to wait at least 48 hours before taking a different kind of triptan. However, I have taken 2 different kinds within a 48 hour period before. I took a Maxalt one day, and an Imitrex within 48 hours after that.

I am not advocating doing so. I'm just telling you that I've done it, and didn't notice any adverse effects. I took Maxalt, it didn't work, I still had a migraine, so I took Imitrex, which did work.

That's my experience.
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Post  milo Thu Feb 04, 2010 10:56 pm

Still alive...phew (my kid brother died at age 26 on migraine and pain meds all within normal range)

My head is back in it's place, though it took three T3's and a gravergol.

I ran out of 5 htp a few days ago...so I'm wondering if that's what is triggering my head this time.

I'll get my partner to guide me to not take the wrong med next time my head is shot...or maybe write myself a note on the packs.
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Post  Ivy Fri Feb 05, 2010 3:20 am

Triptans do not work for me, so every time I've tried a new brand (with no success), I've had to wait 12 hours and take ergotamine which is another vase-constrictor. I had no problems and I'm still in this world Laughing
So, I guess that 24 hours is safe enough to take a different brand of the same active principle...

Take care
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Post  CluelessKitty Sun Feb 07, 2010 7:51 pm

I am sorry I am too late to help with peace of mind in time,
but I thought an information is still an information, so..

Here goes. I frequently took two different kinds of triptans on the same day and nothing happened.
Just remember what is the dosage in the tablet and
to be sure wait at least TWO hours between the last one and the next.
And check what is the MAXIMUM dosage of the TWO that you are taking. Try take a bit less than that to be sure.

And found an old thread for you:
http://www.migrainepage.com/dcforum/discussion/8456.html
Very Happy

Risa
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Post  TeriRobert Sun Feb 07, 2010 10:07 pm

Each of the triptans binds to different combinations of serotonin receptors. The reason we're not supposed to take two different ones within a 24-hour period is to avoid the possibility of serotonin syndrome.

I certainly wouldn't do it without talking with my doctor first.

Sorry,
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Post  TeriRobert Sun Feb 07, 2010 10:10 pm

Milo,

Have you discussed 5-HTP and triptans with your doctor? They're not supposed to be taken together. Again, it's a possibility of syndrome.

I really don't know how strong the risk is with 5-HTP. Just want you to be safe.



milo wrote:Still alive...phew (my kid brother died at age 26 on migraine and pain meds all within normal range)

My head is back in it's place, though it took three T3's and a gravergol.

I ran out of 5 htp a few days ago...so I'm wondering if that's what is triggering my head this time.

I'll get my partner to guide me to not take the wrong med next time my head is shot...or maybe write myself a note on the packs.

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Post  sherri b Mon Feb 08, 2010 5:18 pm

Oh boy, I am bad at this too. I mix stuff all the time. I have taken different ones in a day just because I was so desperate that I didn't care what happened. I'm still here.

You are so right though, who can think when you have a migraine, heck, I have head pain all the time and can't conentrate at all anymore. Scarry isn't it? But I'll bet alot of you feel the same way! It's ugly what we have to go through.

Bless you all!
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Post  LG Mon Feb 08, 2010 5:27 pm

I had a bad day once. I used frova (triptans don't work but when it is so bad I try anyways, what the heck) 2 fioricet w/c. waited 4 hours took another 2 fioricet waited 6 hours took 2 vicodin 10/325's waited 3 1/2 hours then took 3 percocet 5's. I felt like an addict!! I didn't care anymore, I just wanted the pain gone. I feel you Sherri!
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Post  02R96 Tue Feb 09, 2010 12:57 am

As a concerned member please let's not try to play armchair MD's or Pharmacists. Everyone's physiology and issues are unique and what doesn't effect one person can kill another! Shocked

If there is ever a question on meds or combination of meds etc.; if you can't call an MD or Pharmacist, find someone who can.

This thread just freaked me out! affraid

Sorry if I offended anyone.
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Post  TheBookworm411 Tue Feb 09, 2010 1:37 am

My old pharmacist used to be extremely helpful, kind, and supportive. She would always be there to answer these kinds of questions for me like...I took two Vicodan 5/500 and my head still hurts really bad how long do I have to wait before I can take Dilaudid. My new pharmacist is a total freak about all of my migraine medicine. He doesn't even like putting the doctors instructions of allowing me 2 Vicodan 5/500 at the same time on my prescription bottle. I've had a migraine for a year and a half and most of the past 3 years. I kind of got it down now.

Triptans used to work for me. I started with Imitrex for about 2 years. Then Relpax, Maxalt, now Frova. Frova would work about 40% of the time IF the migraine would ever go away so I could take it when my migraine started. I used to hear all of these warnings about triptans from the pharmacists like...only take 2 in a 24 hour period. Only take 9 in a one month period. Only take the same kind or wait for a couple of weeks between changing. But my new Neurologists says that's all overkill. ALL of his patients are headache patients and about 30% are like me with status migrainous or intractable migraine. He's really good and I am so lucky to have finally found him. He promises he won't give up on me live all the rest of the neuros. He says triptans are triptans and I can take whatever I have laying around and its no big deal. I asked him about it directly. He did say they do work differently as far as how long they take to start working and how long they work but that's all. But I don't have any heart, liver, kidney, blood pressure, or other problems that might make the medicine a problem for someone older. I'm 43 years old.

Now I have some questions for you??

Please tell me how this happened so I can try to avoid it. I have never heard of it. (my kid brother died at age 26 on migraine and pain meds all within normal range)

What are these?? T3's and gravergol.

What is this?? 5 htp.

I've taken a lot of different medicine over the past few years and I've learned that they all work very differently for each person. That's why each person's migraine is like a challenging puzzle.
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Post  LG Tue Feb 09, 2010 3:50 pm

5-HTP is an amino acid that increases your production of serotonin. You can get it OTC, but beware..it does interact with some drugs we take for migraines as they too increase serotonin. I would imagine the concern is too much serotonin production and therefore eventual serotonin syndrome (your body only makes a certain amount of serotonin in your lifetime as I understand it..mind you I am no doctor..once you run out, well you get the point) Here's a link for more details.

T3 I don't know much about if they are talking about thyroid medication but if they mean tylenol 3 it is tylenol w/codeine 30mgs. Codeine is similar to hydrocodone(vicodin) but weaker. It is also meaner to your tummy.

Gravergol is an ergot medication. It is similar to a triptan like frova but has a different main ingredient. By similar I mean it isn't a narcotic or NSAID and it works by effecting your vascular system as does triptans. It is given out less because I think it has more severe side effects and more drug interactions. Most of the time when you go to the hospital to break a migraine they will try DHE 45 in an IV. It has the same ingredient as DHE 45 and Migranal. To know more about Ergot, here's a link to wikipedia explaining more.

I agree with you, Dan. Whenever I have a question on mixing medications I usually call a pharmacist. I called him about taking the fioricet with vicodin that very night I took all those meds actually! (You cannot take high doses of narcotics with barbituates because of the reaction of the two together...it can cause respiratory failure as well as overdose considerably faster than had you taken them alone!)

Pharmacists are really great about answering questions and you don't have to call YOUR pharmacist. You can call any pharmacist and ask. My pharmacy is a local small one and has really bad hours so I usually call a 24 hour CVS instead. They don't know my name or info so I never feel bad about calling and they have never denied me information. It is good to have information but we should never "play" doctors or pharmacists. Who knows, apparently if you have basilar migraines you have a higher risk of stroke or aneurysm if you take triptans so obviously taking two in less than 24 hours would be less than ideal advice for those people! If I gave bad advice, I wouldn't want that resting on my shoulders!! Shocked
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