Is Imitrex Good for Migraines?
Imitrex has become one of the most buzzed-about medications available for treating migraines. If you are thinking about giving it a try for your own head pain, it can be very effective.
That being said, this medication does come with a fair number of potential drawbacks. How big a problem these drawbacks are will depend on your situation.
In this article, I will tell you more about what Imitrex is and how it works to combat migraine pain.
I will then discuss some of the potential issues which could stand in the way of Imitrex being an ideal medication for all patients.
If some of these drawbacks are applicable to you, you can then read on to find some alternatives you can try.
What is Imitrex?
Imitrex® is a proprietary name for sumatriptan succinate. This medication is classified as a selective 5-HT1B/1D receptor agonist, better known as a triptan.
This medication is not used to prevent migraines. Instead, it is taken as a treatment for acute symptoms when they present themselves.
You can use Imitrex effectively regardless of whether you experience aura with your migraines or not.
Migraine.com explains how Imitrex works:
“Imitrex works by binding with 5-HT1B/1D receptors on blood vessels in the brain. It narrows the blood vessels (constriction) in the brainstem. It also reduces the inflammatory substances in the body that can trigger head pain, nausea, sensitivity to light and sensitivity to sound, and other migraine symptoms. Imitrex works best if it is taken as soon as migraine symptoms appear.”
In other words, this medication is a vasoconstrictor. For many migraine sufferers, Imitrex can provide significant relief within two hours or less.
Indeed, there are injections and nasal spray forms which are absorbed more quickly than the oral version of the medication, and which can provide even more rapid pain relief.
There are some side effects associated with Imitrex, but most migraine sufferers probably will not consider them nearly as terrible as the migraine pain they are taking the drug to treat.
These might include fatigue, weakness, tingling or numbness in the extremities, hot or cold hands or feet, or sensations of tightness or pressure, especially in the neck, jaw, throat, or chest. Some people may also experience dizziness, nausea, changes in taste, nasal irritation, skin redness, or vomiting.
Other more severe side effects are possible as well, but thankfully they are not common.
Potential Problems with Imitrex
Now that you know what Imitrex can potentially do for you, let’s take a look at some reasons why it may not be the right option for every migraine sufferer.
1. Many patients abuse Imitrex.
It is common for migraine patients to use Imitrex way too often. Dr. Allan Bernstein explains, ” When you do get relief using Imitrex, it is so dramatic that the tendency is to want to take it every time a headache threatens. People with headaches have been taught to take it at the first sign of a migraine. They have been told once a migraine is full blown, nothing is going to help. So the thought is “this headache is going to be a migraine”, fear of migraine becomes an issue.”
This is more likely to be a problem if the person taking the medication suffers from more than a few migraine attacks each month. One isn’t meant to take Imitrex on a daily basis, or even an every-other-day basis. Indeed, one is not supposed to exceed taking Imitrex ten times a month.
As with any other type of medication, over-use of Imitrex can lead to dependency problems. If your body starts to rely on Imitrex, you could find yourself with rebound headaches when you do not take it.
2. Imitrex is a vasoconstrictor, which may not be ideal with certain co-existing conditions.
Dr. Allan Bernstein writes regarding this aspect of taking Imitrex, “People talk about chest tightness and changes in blood pressure, all of which are transient; but there is a hypothetical risk of heart attacks and strokes. Now, we haven’t seen this a lot, given how long it has been on the market and how many millions of doses have been used. It does appear to be a pretty safe drug. But frequent use raises questions about risk.”
So this isn’t necessarily something you need to be overly “worried” about, but if you do have any conditions which you think might be sensitive to the vasoconstrictor properties of Imitrex, it is something you should definitely talk to a doctor about.
3. It can be expensive to buy Imitrex.
In this article, a doctor named Janice Boughton talks about the cost of Imitrex. She describes a story where she prescribed 30 generic sumatriptan pills to a patient at a dosage of 50 mg.
She explains, “The pharmacy told her it didn’t take her insurance and that the prescription would cost her $550. She didn’t have $550. I called the pharmacy, told them that I meant generic, not brand name, and they told me that they understood that and that the cost was $550.”
In other words, the brand name version of the medication would have been even more exorbitant. This is ridiculously expensive for a medication which you are going to need to use on a regular basis over the long term.
Boughton continues, “I called an independent pharmacist who I know well and asked if this drug was still ridiculously expensive or if there might have been some mistake. She said that her cost for 9 pills (they come in 9 packs for no particular reason) was $6.50. At her pharmacy she would charge an uninsured patient cost plus a dispensing fee. That would be about $30 for 30 pills.”
You can see that this is some seriously wild cost variance! Depending on the pharmacy you use and what type of insurance coverage you do or do not have, your cost could be quite reasonable or it could be downright unaffordable.
If you are in a remote area where you do not have a lot of pharmaceutical options, this could get to be even more inconvenient.
If you are curious why Imitrex is often marketed up so much, it apparently has to do with something referred to as “average wholesale price.”
Boughton explains, “Hiking up the AWP has various benefits to the many players in the pharmaceutical industry. Pharmacies can benefit because their costs are usually much lower than the published price … wholesalers benefit since pharmacies want to buy drugs that they can sell at a substantial profit and pharmaceutical companies that produce brand name products benefit if generic drugs are kept artificially more expensive, since patients will often spring for the brand name original or be willing to pay high prices for new nearly identical brand name drugs.”
Sadly, the AWP is a factor which is beyond your control as a patient. Hopefully you can pull the right strings with insurance or shop around and find a reasonable pharmacy, but you may still find yourself struggling to afford Imitrex.
4. The amount you get can be severely restricted.
As mentioned before, it is common for Imitrex to be distributed in packs of nine pills. Actually, oftentimes you can only get three or six pills at a time!
What is going on here is the insurance companies are literally rationing triptan distribution. Doctors do it as well. Doctors are worried about overuse; insurance companies reason that most migraine patients (supposedly) do not have but a few severe attacks each month.
Of course, that does not mean that everyone falls into the category of “most migraine patients.” Unfortunately, if you are an outlier, you will have a tough time convincing your insurer to authorize more Imitrex. Even with a doctor trying to get an increase through, your insurance company may reject your plea.
In fact, it is not unheard of for insurance providers to further reduce your monthly allowance of Imitrex if you put in a request!
Can you pay out of pocket for more pills? Sure, if your doctor is willing to prescribe them. Of course, that means that you’ll be paying the uninsured price for those extras, and as you already know, that may not be in your price range.
5. You may not be able to use Imitrex if you are on an SSRI.
Finally, Imitrex does interact with certain medications. One example is SSRIs prescribed for depression (and some other uses). Sometimes being on such a medication might prohibit you from taking Imitrex altogether.
Alternatives to Taking Imitrex
What if you discover you cannot take Imitrex for one of the reasons above, or another not listed here? Let’s go over some of your alternatives now. There is no need to give up on finding a helpful treatment.
1. Try taking an herbal supplement for head pain.
If you cannot use Imitrex, one thing you can consider is taking an herbal supplement which is formulated to help treat head pain. You can either take capsules which contain just one herb, or you can get capsules which contain a combination of herbs.
Some examples of herbs which may be able to help are:
You can also try taking essential nutrients like magnesium, vitamin D and vitamin B12. There is research backing all of these treatments.
In order to bring effective head pain relief, EU Natural has created a supplement called MY BRAIN!
This supplement contains a combination of the ingredients I just mentioned above. If you click through to the page with the product, you can see some of the research behind it.
If you do decide to give MY BRAIN! or other supplements for head pain a try, here are some tips:
- Remember that herbs, vitamins, and minerals for migraines are taken as a long-term preventative treatment, rather than as an acute treatment for an attack underway. Take them daily and do not break away from your treatment schedule. Give them time to work too. It may take weeks before you see the full benefits.
- Make sure that you are taking a high-quality product which contains healthy, pure, natural ingredients. There are a lot of poor-quality products on the supplements market, so it is well worth your time to put some extra effort into picking the right product.
- Do not forget that your mileage may vary. Not every patient will get the same results from every supplement. Take careful notes while you are experimenting with natural treatments so you can identify what is most effective for you.
2. Don’t overlook OTC medications.
Over-the-counter medications may not pack as powerful a punch as some prescription medications, but that does not mean that they cannot be helpful in treating migraines.
Medications such as ibuprofen, aspirin, or acetaminophen can do a lot to fight a migraine. Some migraine medications also include caffeine. They are inexpensive, readily available, and fairly safe to use in most cases so long as you do not exceed recommended dosages.
3. Try other home remedies and lifestyle changes to manage your migraines.
There are a lot of other ways you can try to treat your migraines at home:
- Since caffeine can be helpful with migraines, you can consider drinking more coffee (try not to overdo it though, or you could get rebound headaches).
- Eat a nutritious diet with plenty of electrolytes, and stay hydrated.
- Get regular exercise.
- Sleep on a regular schedule. Try not to go to bed or wake up at drastically different times each day, and do what you can to always get a full night of sleep.
- As an option for treating a migraine attack as it is happening, you can give sexual activity a try (it helps a lot of people, but not everyone).
- Try meditating or practicing cognitive therapy or doing other relaxing activities.
- Think about applying ice to your head during a migraine attack. I have found that cold therapy works best with head pain if you are willing to do it for at least half an hour at a time.
- Consider giving alternative therapies like acupuncture or massage therapy.
- Work on identifying and eliminating migraine triggers.
- If you suspect you may have other types of headaches (like tension headaches, cervicogenic headaches, or cluster headaches), make sure you are treating those too.
While each of these methods may yield results individually, you probably will find that a multi-pronged approach will yield the most powerful outcomes.
4. Ask your doctor about other prescription medications which might work for you.
There are actually a number of different triptans which exist now. If Imitrex does not work for you, you could consider any of the following:
- Almotriptan (Axert)
- Eletriptan (Relpax)
- Frovatriptan (Frova)
- Naratriptan (Amerge)
- Rizatriptan (Maxalt, Maxalt-MLT)
- Sumatriptan (Imitrex)
- Sumatriptan and naproxen (Treximet)
- Zolmitriptan (Zomig)
Triptans are not the only class of migraine medications you can consider either. Some people also use Ergots. If you have gastrointestinal manifestations, you also can take an anti-nausea medication.
In cases where pain is particularly unresponsive to standard prescription treatment options, some doctors may consider giving glucocorticoids in conjunction with other medications. In some cases, opioids may be considered as well.
All of the medications discussed above are in the abortive category. What about preventative prescription medications?
Here, there are a few different classes of drugs your doctor may suggest. You might be given beta blockers, channel blockers, antidepressants, anti-seizure medications, an injection drug called Erenumab-aooe, or a Botox injection.
Conclusion: Imitrex Is Not Your Only Option for Treating Migraines
Imitrex has become a very popular medication for migraines. For those who can afford it and for whom it is a good fit, it can bring swift, powerful relief. If you are thinking about trying it, hopefully that will be the case for you.
If you are not so lucky though, you do not need to despair! You now know that there are a lot of other ways you can tackle the problem of migraines. Even without the help of Imitrex, with the right herbal supplements and other helpful remedies on your side, you should be able to reduce the frequency and intensity of your head pain attacks.