You certainly are not the only one who sometimes feels as though the migraines will never improve.  But please don't give up.  Nowadays, there is a great deal that can be done.

If you are having frequent migraines, it may be time to seek out a migraine specialist.  Take a look at this list:

Patient Recommended Migraine and Headache Specialists

In the meantime, ask your doctor why you are only allowed 6 Relpax a month.  You are entitled to an answer.

It's possible your doctor is concerned about Medication Overuse Headaches.  Click on the blue words for more information about this problem.

I hope you will come over to the discussion forum for further information and support.  To get there, hold your mouse at either Manage or Connect at the top of the page, and click on Migraine Forums when the menu comes down.  Registration for the forum is separate from the registration for this page, but you can use the same info to register.  You would find the forum a place where a great deal of reliable information is shared, and a lot of support is given and received.  We would love to have you.

Migraine Mamma

4/ 8/10 4:01pm

All triptans have a warning - for all migraine medications - and that is that patients can only ingest a triptan three times per month.  Why?  most times it is because the pharma companies only have clinical studies to support using a triptan three times per month - which would have been in the original study design.  The pharma companies need to conduct studies that expand the usage times per month to reflect us migrainers that suffer more often - even three times per week.

Teri Robert, Health Guide

4/ 8/10 4:20pm

The prescribing info for the triptans doesn't say that "patients can only ingest a triptan three times a month." It says the safety of treating more than X number of Migraines a month has not been established. Some of them say three Migraines, some say four.

 

Most doctors will prescribe more than six tablets a month, but insurance companies don't want to pay for them. I've talked with many insurance company representatives about this, and they never mention that part of the prescribing information. Some will mention rebound, but most-- when they're being candid -- admit that the cost is the reason they limit triptans.

 

As for the pharma companies conducting the extra studies, it's not going to happen. First of all, adding those studies would drastically increast the wait for medications to be approved by the FDA. Second, trials are too expensive. Conducting more trials would increase the price of the meds, and we all know what problems that would create.

 

The patent for Imitrex has already expired. Other triptan patents are going to be following. Nobody is going to do more trials when the patents are expiring.

 

I totally agree with you that we need that kind of research, but I don't think we can expect the pharma companies to pay for it. Somewhere along the line, we have to find more resources for research.

 

Teri

 

 

smueller

7/ 4/10 5:10am

I am on Medicare for my disabling condition of having Daily migraines of 14 to 18 per month. they generally run incycles of 405 dys per episode.

  My latest Nueronlogist has somehow been ordering me packs of Maxalt containing 14 pills per month and Medicare all of a sudden pays for them, unlike before.

  It may take a "medically necessity" letter from your MD to get these quanties.

 

However, Other studies I read about and my psychiatrist (dor depression) agrees that "too much seratonin in my Prozac and the Maxalt only produces more daily migraines in me. So, he took me off my PRozac and gives me 1000 mg of Depakote and tells me to lay off the Maxalt and take only Advil. we.., he doen't realize how devilitating my migraines are. So my next step is to go see another neurologist and ask her about calcium channel blockers, and magnesium.

   FOr Food that heop my mygraines, I have found that oatmeal, spininch, green peas cooked, lentils, and fresh greensalads help with just a tad of protein of some sort.

manicmigranes

5/ 9/11 1:15pm

If you need to take Relpax more than 3 times a moth, you should be moved to preventative medicine. I luckily only receive migranes about two times a month, on rare occassion 3. I was told by my doctor, if you are having 3 or more a month you should be taking preventative migrane medicine not abortive, which is what relpax it.

Hey Ronda-

I can only get 12 relpax every 25 days per my insurance company.  The insurance is through my husband's employer and this is how it is written in the plan they purchased.  No is, ands, or buts.  But my doctor gives me a prescription for Relpax and Imitrex and I get them filled at different pharmacies, a couple of weeks apart.  Hopefully, the insurance wont catch the 2 RX's for different migraine meds.  Relpax definitely works the best for me, but the Imitrex I can take in a pinch and usually it is enough for a month- depends on the month.  I was also on Topamax- 2 different times.  The first time, for 3 months, it didnt work.  Then I was prescribed Depakote and it worked great until I developed tremors in my hands and gained 10 lbs.  So we tried Topamax again.  This time it worked, but after a year, I lost my taste bud sensation and was sleeping soooooo much.  I had quit my job and went into a state of deep clinincal depression.  I was taking 2 hour naps in the morning, then 2 hour naps in the afternoon and almost 12 hours at night.  It is called somnolence and, come to find out caused by the Topamax.  Because of the loss of interest in anything sweet, sour, savory,salty  and a known side effect of decrease in apetite, I lost 15 lbs in 8 wks.  So, being down to a size 2 from a size 6 and none of my clothes fitting, I had to change meds.  Now I am on Namenda and it is working ok- not great, but ok.  so, until I can convince my husband's HR department to buy a better plan (maybe next year) all I can get is 12.  Call your insurance company and ask them how many you are allowed per month.  I have also heard of situations where you can get a case manager assigned to you who can authorize extra tablets if you got into an emergency situation.  My insurance will not do this; I tried. 12 every 25 days- that is it.  But I have heard of other companies that do this.  So you may have to make some phone calls, but you may find out you can get 12 a month, yet your doctor only prescribed 6 because that is what she thought they would cover.  That was my case, until I made a phone call.  Now I refill every 25 days whether I need them or not.  Now I have a little stockpile if I dont have to use them all.  And with my doctor playing around with my horomones, I never know when I will need more one month and less the next.  Plus, the back up of Imitrex helps mentally with the anxiety that I may get stuck with nothing and end up in the ER.  Hope this helps-

Cheryl

ImNoGumby

2/ 9/08 2:41pm

Some insurance companies will make exceptions if your doctor completes a form requesting an exception to the limitation. I asked my doctor to do so for my limitations for Imitrex and any related drugs, such as Relpax, Axert, etc. He was nice enough to give me samples on each visit of Imitrex and Axert. BUT, you also need to be aware that some of these meds should not be used together (on the same day). I would only use the Axert when I ran out of Imitrex (because it didn't work as well), but it was nice to have as a back up (instead of nothing). 

 

I do agree that you should call your insurance company to find out what exactly your limitations are. Mine was something strange like 50 pills in a 72 day period - so I to would refill often and stockpile. Since there are so many  different  Prescription plans, you need to be your own advocate- and it helps if your doctor is also willing to meet you halfway. Most of them have samples of meds- so ask them if you can try some of the others, to see if they work. It's nice to have something else on hand as back up. 

Hi Ronda:

If you arn't yet seeing a neurologist who specializes in migraine, find one. Your Dr. should be prescribing 12 Relpax per month. That's a dosage of 4 rescue meds per week which is all you should take to avoid rebound, which I'm sure you know is something you don't want.  If your Dr. won't prescribe that much, find out why and without a good explanation, I'd find another Dr.  My Neurologist started me on Topamax in December. At first, I hated the side effects of memory loss and peripheral neuropathy, but it was helping with the severity of my daily migraines.  The last time I saw the Dr. I was up to 100 mg per day of the topomax and taking Relpax as a rescue med 4 x per week but still suffering 3 days per week with migraines I rated at a 7 on a scale of 1 - 10.  The Dr. has increased my dose to Topamax to 200 mg. and I am a different person.  I no longer wake up every day with a headache.  I still get headaches in the afternoon but they are rated at a 3 or 4 instead of 7 or 9.  The 7 or 9 headaches only come  once or twice a week now. But be careful with the Topamax. You have to eat a balanced diet. It really does take away your appetite. I needed to loose weight and it has helped me to do that, but I wanted to do it the healthy way and when nothing sounds good, you really don't want to eat, but you have to and you need to do it the right way. Do not starve yourself or you'll be in for some really big trouble.  But, there is hope for your headaches.

-Ask your Dr. why he/she is only prescribing 6 rescue meds when you clearly need more, if only 3-4 per week are taken will not cause rebound(Do not take any other pain medication as this will cause rebound as well)

-Ask your Dr. if increasing your dosage of Topamax would be a good idea for you.

Good luck,

Bryn Nick

Migraine sufferer, Living with it

thatsmisskitty2u

3/28/08 8:53pm

I wanted to ask you how quickly you began to notice the side effects of Topamax. I was just prescribed it today, and I, too, take Relpax as a rescue med. From all that I have read online, people experience memory and appetite loss. How soon did those side effects begin? Was it as soon as you started your 25 mg. doses or when they increased?

Thank you.

Bryn Nick

3/30/08 5:39pm

I honestly don't remember, but some of the side effects have subsided somewhat. I would say they began fairly soon after I started the 25 mg. But once I got up to the 100 mg, they were readily apparent. I am at 200 mg now and have been for about 2 months.  I still have trouble with my memory and the weight is still coming off, just slower, which is good. The headaches though have really subsided. I'm getting fewer and fewer and the severity is not as bad as it has always been. I still get a whopper or two around my period but they are fairly well controlled by the Relpax. Hope this helps.

my doctor prescribed two boxes at a time for me. it might just be an individual decision made by your doctor.