Shortages of Medications Used Off-Label for Migraine

Nancy Harris Bonk Health Guide
  • The FDA has recently announced two drug shortages, diazepam (Valium) and magnesium sulfate, which can be used as rescue medications in IV injections or IV infusion to treat Migraine disease. The FDA works hard to prevent drug shortages, working closely with the manufacturers to help resolve the issue. In fact, they may ask the drug manufacturer to increase production if possible in hopes of reducing the effects of the shortage.


    When a Migraine attack doesn't respond to abortive therapy or turns into Status Migrainous, both injectable diazepam and magnesium sulfate can be used as rescue medications in a doctor's office or hospital setting. Status Migrainous may occur when Migraine pain lasts longer than 72 hours without a pain free period of four hours while awake. Being in status Migrainous during this shortage could have a negative effect on certain Migraineurs, like me, who depend on magnesium sulfate to break a particularly difficult Migraine cycle. I've used IV infusion therapy more times than I'd care to count, but at least my Migraine, most of the time, was broken.

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    On the FDA site, it states the reason for the diazepam shortage is due to a manufacturing delay. One delivery was to be in February of this year, and the next delivery in April, 2012. The magnesium sulfate shortage arose because of heavy demand and manufacturing delays. Two out of the three manufacturers of magnesium sulfate cannot and will not anticipate when delivery will be, all current orders are on back order - the medications will be shipped when available. Only one manufacturer is saying it will be delivering magnesium sulfate throughout the year.


    Dr. John Claude Krusz (Ask the Clinician), who uses magnesium sulfate for IV infusion daily in his practice, told Teri Robert that he's been able to have IV magnesium sulfate compounded in sufficient quantities for the patients at his clinics. 


    Where does that leave Migraineurs? Talk to your doctor before you need either of these medications. If your doctor, hospital, our outpatient clinic does IV magnesium sulfate infusions for you, they may want to contact a compounding pharmacy in advance. See if there are any other options available to you in case you need to break a bad cycle. Having a plan in place before you are hit with an unbearable Migraine cycle will make you and your doctor happy. This article, IV Infusion of Refractory Migraines may have some additional options in it you can discuss with your doctor. 




    U.S. Food and Drug Administration. "Current Drug Shortages." Last updated February 7, 2012.


    Interview. Teri Robert with Dr. John Claude Krusz. January 29, 2012.

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    © HealthCentral Network, 2012.
    Last updated February 7, 2012.

Published On: February 07, 2012