Sunday, January 20, 2013 liandra789 asks

Q: First course of chemotherapy required Ondansetron for nausea which triggered Basilar Migraine

Require help please - I had my first course of chemotherapy recently (FEC) and the main anti-nausea given was (the wonder drug for nausea/chemo) Ondansetron, a 5-HT3 antagonist

Side effects mention a slight headache however it kicked off a Basilar-Type Migraine which landed me in the Emergency department for several days to:

1. Bring down the pain from the migraine which was agonizing, by using a Chlorpromazine drip and

2. Trying to stabilize the nausea from chemotherapy with less effective medication.

My Question: Is there any medication I can take prior to the chemotherapy and/or with the chemo that will act as a preventative, so the Basilar Migraine doesn't even start. I tried sumatriptan without success and if I am unable to tolerate Ondansetron, my treatments are going to be quite difficult.

Note: steroid was also provided at the same time as the Ondansetron to increase it's anti-nausea properties and

Note2: My migraines are normally well controlled with sumatriptan however over the years, the few times that I have been hospitalized has been with this type of migraine

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Answers (1)

Teri Robert, Health Guide

1/20/13 11:20am

Liandra,

Hello and welcome. I hate it that you need to be here, but glad you found us.

Yours is an especially tricky situation, which I'm sure you already know.

People whose Migraines are triggered by exercise can sometimes take something before exercise to prevent those Migraines, so it stands to reason that there should be something for you too. The difference is that it wasn't the chemo or Ondansetron that triggered your Migraine; it was the headache from the chemo.

All of that said, the best thing you can do is talk with the doctor who treats you for your Migraines about this, and get his or her help with this. Some people use indomethacin, a prescription NSAID, before execise to prevent exercise-triggered Migraines, but I'm really not sure what would be appropriate for you. Your full medical history and all medications you use, including over-the-counters and supplements need to be considered. Also, most doctors don't use triptans such as sumatriptan, with basilar-type Migraine, so your doctor obviously has treatment plans and methods for you that aren't typical. It would be helpful for the doctor who prescribed your chemo and your Migraine doctor to consult on this issue and decide together what to try for you.

Will you check with your doctor, and let me know how things are going for you, please? I'll be thinking of you and wondering how you're doing.

Welcome again,

Teri

liandra789

1/20/13 1:02pm

Hi Teri,

Thanks for your reply it is most appreciated

My migraines normally aren't Basilar, they were, many years ago, diagnosed to be migraine with aura and my treatment, at the time, was not a happy process as I do not live in America and my country, so it felt at the time, was years away from understanding migraines

I tried so many medications, Topamax, Depakote (very effective, but couldn't tolerate side effects), beta blockers, and NSAID's that resulted in me being a not very happy camper.

I found that the sumatriptan was the most effective then and now, unless, of course, I end up with a different migraine from my normal which always started as a headache in the base of the neck and then upwards, instead of starting behind the eye.

Yes, I should see a neurologist again, however I have so many treatments with cancer that seeing more doctors is difficult plus this isn't the time to create a new plan for migraine as I need stability while dealing with cancer treatments for the next few months.

I do feel fortunate in that the oncologist I am seeing, a wonderful proactive person, who has rung neurologists here to find out if there was something I could take so I would not be in such difficulty and was told.... sumatriptan

Uggg :(

Mine is a tricky situation, you are quite right that all medications must be taken into consideration, however due to the above, I was hoping to find an idea of what may help in the short term so I don't end up in the ED again

Cheers

Q: First course of chemotherapy required Ondansetron for nausea which triggered Basilar Migraine

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