Rescue meds - need an opinion

My M pattern has changed - now I'm not complaining. I went from every single stinking day to having episodes that last 72 hours often with at least a day, if not more, between episodes. Hooray for that!

My problem is that it seems that no matter what I do I can't stop it from lasting the full 72 hours. At first sign I take a Maxalt (I've tried adding naproxen to this as well) and it will make the day tolerable - still dealing with s/e and some minor symptoms. Day 2, I take another - can survive the day but more miserable ie taken edge off but still not great. Day 3, given up on the Maxalt and depending on what I need to do, take Fioricet. This helps dramatically but I have to re-dose it if I took it earlier in the day as it wears off between 4 and 5 hours later.

I know few of us have MD behind their name but this is driving me nuts! I know the thing is going to last 72 hours and get progressively worse and I can't seem to do a darn thing about it. So my question is, given that the triptans are only masking the problem, should I jump straight to Fioricet at the first sign? Or are there other suggestions out there. I'm just at a loss as to what to do. I'm currently M free but know it is only a matter of time before I get another one.

My migraines almost always last 72 hours without fail. I wish I could offer you a magical solution, but I can't. I just try to do a lot of activities to take the edge off for a while. For instance, a scalding hot bath with my head wrapped in ice, in the dark. I try to just relax and think to myself, "let go of the pain, let go of the pain". Sometimes I can give myself a few hours of relief doing this (though it's not gone, just lessened).

Ever try midrin? I can't get through a migraine without it.

Unless your Doctor has specificaly told you not to, try taking the triptan and the fioricet at the same time.

The majority of the H/As that I get last for 3 days (72 hours), a few have been as short as 2 days, and 1 or 2 have been for as long as 4 days, but I would say that over 90% last for 3 days.

I have found that:
A fioricet taken at the beginning of a H/A will relieve about one-third of them.
A Zomig-zmt (triptan) taken at the beginning of a H/A will relieve about one-third of them.
A fioricet plus a triptan plus additional acetaminophen (equivalent of two 325 mg pills) taken at the beginning of a H/A will relieve about two-thirds of them.

Of course, this still leaves one-third of the H/As where nothing works.

Also, remember to drink plenty of water.

Thanks for the responses. It's just that my vision gets all weird during these things and means that I'm confined to the house unless I absolutely have to go somewhere (and then I find a driver). Very frustrating when you know what's coming.

There is no reason that I can't take things together. I'm young enough and have no other health issues at this point. I guess I just resist taking Fioricet when I'm working as it makes me so darn loopy (I work from home but still have to be cognizant). Although I maybe need to adjust my attitude about it, because if it would stop it from lasting 3 days...1 day shot as opposed to 3 days would be worth it.

I was taking 1 fioricet at a time and getting noo results at all. I didn't check this with the dr., but decided to try taking 2 at a time to see if I got better results, and I did. I take 2 and it helps, although I usually still have to take a triptan a couple of hours later if the m is bad. I've been able to abort them with just the 2 fioricet if its not, though.
I'm going to run this by my dr. when I go back next, I just haven't been back since I started taking 2 instead of 1. My fioricet are without codeine, btw.
Hope that helps.

Although I would run it by your doctor, the Fioricet dose information I looked up says 1-2 pills every 4 hours as needed, not exceeding 6 pills a day. They have 325 mg of Acetaminophen each, so 6 a day still puts you well below the 2,000 mg max daily dose of Acetaminophen. I would however be very very careful not to take these more than 2-3 days a week (less if you take anything else with Acetaminophen), as this med especially is associated with rebound as it has the combo of Acetaminophen, Caffeine, and Butalbital. I found just the plain Tylenol w/ Codeine to be much more helpful (I wanted the Fioricet w/ Coedine without Caffeine, so my doctor prescribed Butalbital and Tylenol w/ Codeine, and one day I didn't take the Butalbital with it and realized that part wasn't needed for me). I've since moved on to much stronger stuff unfortunately. Best wishes.

I take 2 fioricet (just the straight one, no additions or subtractions to it) at a time and it's usually only once a day. My doctor told me not to use it unless I have to but nothing is really touching most of them. I did end up taking a cocktail yesterday and took it much earlier than I normally would. I slept for 3 hours and actually didn't feel too bad when I woke up.

I don't take tylenol otherwise because it does zilch for me.

HL, interesting. My dr. started me on a lower dose than two at a time, hmmm. I don't feel so bad upp'ing the dose to two at a time after reading what you and t-girl have to say though. Thanks, you've helped me!
I don't take more than 6 in a day, the most I've taken is 4. I have taken 4 3 times this sweek though, so I'll have to keep an eye on that. I can try to take advil instead with my triptan and see if that helps, it often does. I really think my migraines are getting worse because of Treximet - rebounds which I never used to get with other meds.

Anyway, sorry to hijack your thread, HL

Bubbs,

No apologies needed. This is how we learn and get insight into dealing with this dratted disease. My doctor wrote on the Rx to take 1 or 2 as needed every 4-6 hours. Well I tried 1 and it did nothing so I take 2 and it works. I've not taken more than 4 in a day either. If things are that bad, I end up going to bed early anyway.

Interesting thread. I dont think we have Fioricet in the UK.
Wonder what we have instead. Sure someone will put me straight.

P

Fioricet maximum dosage is 6 tablets per week not per day with a maximum of 2 tablets per headache, as printed on my bottle.

Well, everybody's prescriptions are written by their individual doctors for their individual needs. My bottle doesn't have that maximum dosage information. And going by the dosage information on my bottle, max weekly dosage would not be 6.

Pen - per the wacko neurologist, Fioricet has been banned in Europe (not sure if this extends to the UK or not but maybe a reason you can't get it). This was his reasoning for not wanting to give it to me as it can cause rebounds (but what can't according to them anyway) and it can be abused. The barbituate in it leaves a lovely feeling of not caring about things (which is why it's wonderful) and gets rid of that fear/agitation about pain. My doctor warned me not to take it unless absolutely necessary for these reasons. I fully understand this and I wouldn't want this feeling unless necessary. But I can see if you are trying to escape things how it could be abused (sort of like alcohol).

Bubbs and MK - I think it does depend on the prescribing physician. I can take mine every 4-6 hours as needed and there is no limit on how often in a week I can take it. My doctor would like less often rather than more but if I'm having a horrid week, I can use it as often as needed. To put it in perspective, my script lasts several months and there are either 30 or 60 pills per (I think 30 but don't have the bottle in front of me).

HL, yeah, that's how mine lasts me too.
Have to say though, I've never experienced feelings of not caring about anything, etc. etc. I don't feel any different than if I'd taken advil, except advil gives me better pain relief. LOL