Migraines and fibromyalgia - Imitrex and Cymbalta together?

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Full Question:

I take Cymbalta for fibromyalgia and I still get severe migraines. My doctor prescribed Imitrex. In the past before I started taking Cymbalta, my dose was 100mg. now that I take Cymbalta I have been afraid to take Imitrex even if I get a migraine. I did talk to the pharmacist and she said I could take half of my 100mg Imitrex. My question is if I take Cymbalta in the morning and get a migraine say 8 to 10 hours later is it alright to take half like the pharmacist said or exactly how many hours after taking Cymbalta would it be safe to take half of the Imitrex? Kim.

Full Answer:

Dear Kim;

Taking triptans such as Imitrex and antidepressants such as Cymbalta presents a risk of serotonin syndrome. Taking the two types of medication together is not contraindicated, but there's a warning for patients to know the symptoms so they can report the symptoms to their doctors if they occur. For more perspective on this issue, take a look at Antidepressants, Triptans, and Serotonin Syndrome.

With all due respect to your pharmacist, pharmacists should not suggest that you change the dosage prescribed by your doctor, which is what you pharmacist did when suggesting that you take a half does of Imitrex. If your doctor had wanted you to take only 50 mg, he or she would have prescribed 50 mg tablets.

When you can safely take these medications depends on more than just those two medications. It also depends on all medications you're taking - prescription, over-the-counter, and supplements - and your full medical history. Thus, this is a question you should ask your doctor. A simple call to his or her office should get you an answer.

Good luck,
John Claude Krusz and Teri Robert

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