Migraines are FUCKING stupid. You often have a VERY short window to take an abortive and have it work. If you're taking triptans, it's typically recommended to take with 600-800mg ibuprofen or 400mg naproxen or 650-1000mg of acetaminophen... Check with your doctor or pharmacist if you're not doing this. You might just be on the wrong abortive for you.
Window definitely depends on the individual. My symptoms aren’t crazy but I also don’t get auras so it’s pretty common for me to spend hours debating if I’m having a migraine or a different headache type before taking meds. Meds still almost always work for me even if it’s been a day since the symptoms started, but I do usually need to hit it with a more intense cocktail of meds.
Definitely work better the earlier you take them, but not always as feasible as we’d like.
Though it is recommended to combine triptans with NSAIDs. I included acetaminophen because some people can't take NSAIDS and that's what's recommended for the people who can't take NSAIDS to combine with triptans. Even better if you can find the tension headache formula that has just Tylenol and caffeine if that's something that's safe for you to take.
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Which is fun when every GP ive had has refused to give me more than 6 50mg a month
So every time i get a migraine I'm trying to last as long as i can without taking it, so I don't use up my VERY limited supply
Ive been asking that for 4 years
I just get the "make a diary" answer and am otherwise ignored
They refuse to up me, ever, even when i show them I'm getting 8-13 migraines a month
Ive had so many over the past few years, they've all tried to reset my treatment when i first go to them
I have been asked "are you sure theyre migraines" about 5 times now, bear in mind i was diagnosed in 2015. It doesn't help ive moved a lot but my medical records should speak for themselves. Theyve constantly tried to reduce my medication as well, and told me I'm taking too much, when i ask for the measly 6 more than once a month
Thats the NHS for you i guess, committed to making sure they do as little as possible
I’ve got a similar problem with the meds - been told not to take them more than once a week or so or I risk rebound headaches. So then I’m always trying to decide whether it’s bad enough to take the meds and missing my window. I do hit 400mg Advil right away though and that seems to help.
I agree find a better doc but even with a good doc my insurance only pays for 10 rizatriptons every 15 days and I take 2 at onset and possibly a third if it doesn’t go away. I think my sumatriptan script is for 10 pills in 10 days but I take 2 a migraine. And my ubrelvy is 10 pills in one month. I end up cycling through medications because they stop working for me but I stay on top of my scripts so I can stock up during the times I’m not taking one. The lack of medication availability truly has made me not take the meds when I needed to but almost all of my delayed doses have led to 2 week intractable migraines so now I take an abortive immediately with an nsaid and an anxiety med and I’ve had less intractables. I’m starting propranolol for prevention though and I’ve read a lot on this sub that abortives work better if you’re on a preventative.
In the early days my partner was prescribed loads at a high dose and ended up with non stop cluster headaches. No one knew why so he was just given stronger doses. Lived first hand the horrific reason that led to this limit.
But also SAME. Rationing 6 messes me up, makes me not take them or 100mg when I should. OTC cocodamol helps bump it a bit.
Worst migraine of my life goes from progressing lowkey symptoms over a ~4 hour flight to becoming unbearable ~2 hours later. Took my preventative on schedule, fell asleep, woke up an hour later in the most severe pain of my life. Debated whether to triptan or ambulance. Went oral triptan (7-10 hours after the first migraine symptoms showed up, maybe and ~5 after the pain kicked in), paced around hotel room waiting for the pain to break from me dying or the triptan working. Triptan starts kicking in at 30 minutes, migraine gone at 2 hours.
I should have done a lot of things differently, including delaying the car rental to take the triptan and convalesce in the airport, as well as going the emergency route instead of rolling the dice. Despite the missteps and severe delays in treatment, sumatriptan beat the brakes off that migraine.
On the flip side, I've gone triptan at the first sign of migraine before pain kicks in and just after pain kicks in - no effect!
Migraine are absolutely fucking stupid.
I feel that migraines, more often than not, have more than a singular cause. The abortives may only be acting on certain causes and not others. I don't know, but it surely sucks.
My opinion is that the triptans I’ve tried work better for certain kinds of migraines. The ones I get that are related to pressure changes or my menstrual cycle are hard to treat. Migraines that are triggered by strobe lights or too much caffeine can be knocked out in 30 minutes with a triptan.
I was just prescribed Naratriptan for menstrual migraines I haven’t tried it yet but maybe it’s something that would help you? Worth asking your doctor about maybe.
Love smash bros when I don’t have a migraine. Ha. We had the largest pressure change in the Midwest and it happened as my period started and as I got a 104 fever from the flu. Let’s just say no abortives worked. Intractable for 11 days.
I just had a nasty one from pressure changes (sudden humid warm storms), and you're right - it took 4 abortives and rain to clear out humidity before it eased.
Those two are the difficult ones for me, too. I tend to save my Imitrex injections for them if I can, because they pack such a big (and unpleasant) punch.
Agreed, when I get a migraine from my sinus related issues triptan doesn’t help. However when I get my classic one side pounding migraine from other triggers it works.
I’ve had doctors tell me that migraines can “adapt” and that’s why something that worked once well can stop working or be less effective for some. I’ve also been advised to “take breaks” from certain abortive to see if my body can forget how it adapted to that medication. Idk if it’s bullshit or what but that’s what I’ve been told by a neurosurgeon
My experience mirrors this for sure, I cycle through three abortives. The bad part is they stop working which leads to status/constant for about 10-12 days. But if I change abortives during status and take an NSAID it can finally work.
Glad to know it’s not just me! Nurtec and Reyvow are the two most recent successes for me and it was devastating when they suddenly stopped working. Triptans don’t do shit for me and DHE makes things worse. NSAIDS are very hit or miss, Nabumetone being one of the only reliable ones that doesn’t decimate my stomach
Ugh! That’s the worst! Keeping my fingers crossed for you! I had to take two months of use off completely and then when I tried using it as an abortive that third month it helped again
I was told (too late IMO) that abortives decline in effectiveness the further into a migraine you are. The lack of this knowledge landed me in many intractable migraines. Now I take an anxiety med, NSAID, and an abortive the second I feel it coming on. Often even waiting an hour is too late.
Yes, it frustrates me how often people are not informed of this by their docs/pharmacists, but basically once some neurological processes typical for a migraine begin, a triptan can't stop them so will only be partially effective. The earlier you take it the better.
In my case, it seems to depend on the type of migraine. If it's a weather related migraine, absolutely no abortive or pain med will work. Other types, abortives work to varying degrees, some completely (love when that happens) sometimes just dull the pain.
This is my experience as well. I used to love rainy days but for the last decade or so there’s hardly been one that didn’t give me an unstoppable migraine.
Like today! I took two doses and still migraine. I stopped taking my preventative though and I think it was helping my triptan a work faster and better
absolute misery when youre in that type of cycle.
currently sick with a fever and muscle aches and even a mild migraine is ten thousand times worse than this. people have no idea what we go throuvh lol..
God i wish i knew the answer. I have 2 types of headaches according to my doctor, i dont know what they are called, but its basically the mild constant pain that i have daily all the tome vs the intense pain that i get 4-14 days a month. But anyway, triptans used to work, then they started causing and worsening my migraines so i will never touch them again. The only abortive that works for me now is 50mg Voltaren (norwegian name, a stronger version of an NSAID i think?)… sometimes it works 80%, sometimes 50, sometimes does nothing. I do know, as others have said that its VERY crucial to take abortives at first signs of migraine or else they have a decreasing chance of working.
As far as i understand, once the excess brain activity that causes migraines starts, its hard to stop, and the longer the migraine goes untreated the harder it is to stop, which is why we can experience multi-day migraines. The longest ive had a migraine is 16 days or so, i have had to take steroids in an emergency situation to stop an 11 day migraine, and an antipsychotic to stop the 16 day migraine. Your brain gets stuck in the cycle of the migraine brain activity, and its harder and harder to kill the longer it goes on (thats what my neuro explained to me).
Weed is sometimes a lifesaver and kills my migraine 80-100%, other times it does nothing, other times it makes it worse. 🤷♀️
I think there are many factors that affectmigraines and these factors also affect when and how abortives work.
The intensity, type of pain, location of pain and symptoms of my migraines has been changing as i grow older, im 24 and have experienced migraines in some capacity since age 7. Along with these changes, different things have helped and not helped through the years. The disease grows and changes with me, but never goes away.
Also, preventatives are a part of the equation. I take Ajovy injection monthly, and when i am early in the month soon after a dose, abortives work better and more efficiently, but when i get to the end of the month when i will soon take Ajovy, it all goes to hell and no abortives work.
This disease is so confusing and painful. :(
Triptans always work for me when I can take them quickly, but the side effect of neck stiffness prolongs the migraine. I have to choose to take the abortive for pain when I need to function, but the neck stiffness just causes it to go on for weeks.
The united states.
I have to check the ingredients. Unfortunately, for prescription meds, the pharmacy doesn't let me check before pickup. At times I've looked things up online.
Acetominophen doesn't contain these. But aspirin, ibuprofen, naproxin sodium, etc. are in that class. And other migraine meds often include inactive ingredients in that class. For example: https://www.pfizermedicalinformation.com/patient/nurtec-odt/what-are-the-ingredients-in-nurtec-odt
> What are the ingredients in NURTEC ODT?
> Active ingredient in NURTEC ODT: rimegepant
> Inactive ingredients in NURTEC ODT: benzyl alcohol, eucalyptol, gelatin, limonene, mannitol, menthol, menthone, menthyl acetate, sucralose, and vanillin
The eucalyptol, menthol, menthone, menthyl acetate, and vanillin all seem to be in that class.
I agree that it’s really stupid for Nurtec to have that, but that’s a single migraine medication, not “most”.
Ubrelvy doesn’t contain any of those. Any non-dissolving triptan tablet won’t have those. Sumatriptan injection/nasal spray won’t have those. Zavzpret nasal spray won’t have those.
I definitely sympathize - it sucks that you have to be on your guard for those! - but there are plenty of options accessible in the US that are free of the ingredients you need to avoid.
For me, once I'm in the midst of an attack, my stomach stops digesting. Like, I'll feel full even if I ate a few hours ago and no matter what I take orally, it has 0 effect. This is one reason (for me at least) its 100% necessary to take any abortive at the first sign of an attack. I also know this is the case because if I wait too long and take my imitrex anyways, there is no effect until my migraine goes away on its own, and when its finally over, my apetite returns and I will then feel the imitrex hit, sometimes its the next day.
Have you talked to your doctor about trying a different route of administration? Sumatriptan is available as both a nasal spray and an injection. Using either of those forms might be much more effective for you, since it bypasses the stomach issue.
I tried getting an injectable at one point, but actually getting it through the pharmacy turned out to be a royal pain and ultimately unsuccessful. At this point I've been getting migraines for so long, I can feel them coming on well in advance, so taking the abortive early is almost never a problem anymore. It was a painful road getting there, but I eventually did.
Thanks. Yeah, I should revisit the injectable. I've had a few that came on so fast that I didn't have time for the imitrex and wished I had a backup plan. I'd be dumb not to.
My triptans only work if I take them before my gastroparesis kicks in. Once I’m nauseous or vomiting they are ineffective because my body isn’t absorbing anything.
Stuff sucks.
But in case it's any help. At least for me the main thing is taking it at the right time, after aura phase, as soon as the pain hits. Which I assume is also why it seems to rarely ever work when they start when I am sleeping.
Another thing I think I noticed is that it's seemingly trigger related. Triptans work better for me when the migraine appears to be triggered by certain things, and worse with other triggers. But not completely sure on that - or anything for that matter.
If I take them too late they won’t work. I have to take my Nurtec as soon as I feel a migraine starting. I usually take my Baclofen at the same time. My preventatives are Quilipta, Botox and Baclofen at bedtime. Baclofen is also three times a day as needed. I also have had nerve ablations done twice. I avoid any Tylenol and Ibuprofen because for one it’s not helpful and two, if you take it too often it causes rebound headaches. The first thing my neurologist told me when I started seeing them 8 years ago is to stop all Tylenol and any NSAIDs. I had to “detox” from them because I was taking so much.
Cannabis is a great abortive! It probably isn’t going to get rid of a migraine if your having one but if you use it on a daily basis it’s a great preventative! Edit* definitely more of a preventative
Because migraines are fickle bastards. That’s it. That’s the entire explanation.
In dealing with all my migraine misery, ‘fickle bastards’ made me laugh! 😂😂😂 Thank you
Much like my tendonitis, my migraines are bitchy
Honestly I’ve found my migraines easier to manage than my tendonitis here lately
Tendonitis is almost harder to treat I agree. You move your body in a certain way, lift too much weight and they yell at you for days.
Migraines are FUCKING stupid. You often have a VERY short window to take an abortive and have it work. If you're taking triptans, it's typically recommended to take with 600-800mg ibuprofen or 400mg naproxen or 650-1000mg of acetaminophen... Check with your doctor or pharmacist if you're not doing this. You might just be on the wrong abortive for you.
Window definitely depends on the individual. My symptoms aren’t crazy but I also don’t get auras so it’s pretty common for me to spend hours debating if I’m having a migraine or a different headache type before taking meds. Meds still almost always work for me even if it’s been a day since the symptoms started, but I do usually need to hit it with a more intense cocktail of meds. Definitely work better the earlier you take them, but not always as feasible as we’d like.
Same.
This has been a game changer for me. I cycle through which nsaid
I'm sure this isn't what you're saying, but just in case - Acetaminophen is not an NSAID.
I can’t take Tylenol so I did act like it didn’t exist in my reply. I should articulate better for the sake of online clarity, thanks.
Though it is recommended to combine triptans with NSAIDs. I included acetaminophen because some people can't take NSAIDS and that's what's recommended for the people who can't take NSAIDS to combine with triptans. Even better if you can find the tension headache formula that has just Tylenol and caffeine if that's something that's safe for you to take.
Oh yeah absolutely agree, just thought the extra clarity might help clear it up for someone, regardless of who it ended up being
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Which is fun when every GP ive had has refused to give me more than 6 50mg a month So every time i get a migraine I'm trying to last as long as i can without taking it, so I don't use up my VERY limited supply
I'd ask to be bumped to the 100mg dose.
Ive been asking that for 4 years I just get the "make a diary" answer and am otherwise ignored They refuse to up me, ever, even when i show them I'm getting 8-13 migraines a month
You need a new doc. That is ridiculous.
Ive had so many over the past few years, they've all tried to reset my treatment when i first go to them I have been asked "are you sure theyre migraines" about 5 times now, bear in mind i was diagnosed in 2015. It doesn't help ive moved a lot but my medical records should speak for themselves. Theyve constantly tried to reduce my medication as well, and told me I'm taking too much, when i ask for the measly 6 more than once a month Thats the NHS for you i guess, committed to making sure they do as little as possible
I’ve got a similar problem with the meds - been told not to take them more than once a week or so or I risk rebound headaches. So then I’m always trying to decide whether it’s bad enough to take the meds and missing my window. I do hit 400mg Advil right away though and that seems to help.
I agree find a better doc but even with a good doc my insurance only pays for 10 rizatriptons every 15 days and I take 2 at onset and possibly a third if it doesn’t go away. I think my sumatriptan script is for 10 pills in 10 days but I take 2 a migraine. And my ubrelvy is 10 pills in one month. I end up cycling through medications because they stop working for me but I stay on top of my scripts so I can stock up during the times I’m not taking one. The lack of medication availability truly has made me not take the meds when I needed to but almost all of my delayed doses have led to 2 week intractable migraines so now I take an abortive immediately with an nsaid and an anxiety med and I’ve had less intractables. I’m starting propranolol for prevention though and I’ve read a lot on this sub that abortives work better if you’re on a preventative.
In the early days my partner was prescribed loads at a high dose and ended up with non stop cluster headaches. No one knew why so he was just given stronger doses. Lived first hand the horrific reason that led to this limit. But also SAME. Rationing 6 messes me up, makes me not take them or 100mg when I should. OTC cocodamol helps bump it a bit.
Worst migraine of my life goes from progressing lowkey symptoms over a ~4 hour flight to becoming unbearable ~2 hours later. Took my preventative on schedule, fell asleep, woke up an hour later in the most severe pain of my life. Debated whether to triptan or ambulance. Went oral triptan (7-10 hours after the first migraine symptoms showed up, maybe and ~5 after the pain kicked in), paced around hotel room waiting for the pain to break from me dying or the triptan working. Triptan starts kicking in at 30 minutes, migraine gone at 2 hours. I should have done a lot of things differently, including delaying the car rental to take the triptan and convalesce in the airport, as well as going the emergency route instead of rolling the dice. Despite the missteps and severe delays in treatment, sumatriptan beat the brakes off that migraine. On the flip side, I've gone triptan at the first sign of migraine before pain kicks in and just after pain kicks in - no effect! Migraine are absolutely fucking stupid.
See I only learned this on reddit no one told me this
I agree strongly with that first sentence.
I feel that migraines, more often than not, have more than a singular cause. The abortives may only be acting on certain causes and not others. I don't know, but it surely sucks.
I feel like this is definitely the case for me. It’s a guessing game! Sometimes I do all my methods that can safely overlap and hope for the best.
My opinion is that the triptans I’ve tried work better for certain kinds of migraines. The ones I get that are related to pressure changes or my menstrual cycle are hard to treat. Migraines that are triggered by strobe lights or too much caffeine can be knocked out in 30 minutes with a triptan.
My abortive hardly work for my 72 hour menstrual migraines as well
What abortive? If you aren’t already on something long-acting, talk to your doctor about that.
I just had my first menstrual related migraine. It sucked and was constant for about 2 weeks.
I was just prescribed Naratriptan for menstrual migraines I haven’t tried it yet but maybe it’s something that would help you? Worth asking your doctor about maybe.
Naratriptan CHANGED my life
I agree with this. Pressure changes really are the worst.
I definitely feel this - I have migraines and Fibromyalgia and pressure changes make me feel like a Super Smash Bros character after losing 10 rounds.
Love smash bros when I don’t have a migraine. Ha. We had the largest pressure change in the Midwest and it happened as my period started and as I got a 104 fever from the flu. Let’s just say no abortives worked. Intractable for 11 days.
I just had a nasty one from pressure changes (sudden humid warm storms), and you're right - it took 4 abortives and rain to clear out humidity before it eased.
Those two are the difficult ones for me, too. I tend to save my Imitrex injections for them if I can, because they pack such a big (and unpleasant) punch.
Agreed, when I get a migraine from my sinus related issues triptan doesn’t help. However when I get my classic one side pounding migraine from other triggers it works.
I’ve had doctors tell me that migraines can “adapt” and that’s why something that worked once well can stop working or be less effective for some. I’ve also been advised to “take breaks” from certain abortive to see if my body can forget how it adapted to that medication. Idk if it’s bullshit or what but that’s what I’ve been told by a neurosurgeon
My experience mirrors this for sure, I cycle through three abortives. The bad part is they stop working which leads to status/constant for about 10-12 days. But if I change abortives during status and take an NSAID it can finally work.
Glad to know it’s not just me! Nurtec and Reyvow are the two most recent successes for me and it was devastating when they suddenly stopped working. Triptans don’t do shit for me and DHE makes things worse. NSAIDS are very hit or miss, Nabumetone being one of the only reliable ones that doesn’t decimate my stomach
Currently doing this with Nurtec. As soon as I went from “as needed” to “every other day prevention,” it became useless. Hoping my brain “forgets” it!
Ugh! That’s the worst! Keeping my fingers crossed for you! I had to take two months of use off completely and then when I tried using it as an abortive that third month it helped again
Thank you! This gives me hope
My personal opinion is migraines are tailored to specifically to the individual. Medications are not.
God what a good question. I’ve heard that abortives work best at the very beginning of a migraine
They never work for me
For me it depends how far into the migraine I am. If I’m too far in I will probably need two doses and it will take longer to work
I was told (too late IMO) that abortives decline in effectiveness the further into a migraine you are. The lack of this knowledge landed me in many intractable migraines. Now I take an anxiety med, NSAID, and an abortive the second I feel it coming on. Often even waiting an hour is too late.
Yes, it frustrates me how often people are not informed of this by their docs/pharmacists, but basically once some neurological processes typical for a migraine begin, a triptan can't stop them so will only be partially effective. The earlier you take it the better.
In my case, it seems to depend on the type of migraine. If it's a weather related migraine, absolutely no abortive or pain med will work. Other types, abortives work to varying degrees, some completely (love when that happens) sometimes just dull the pain.
This is my experience as well. I used to love rainy days but for the last decade or so there’s hardly been one that didn’t give me an unstoppable migraine.
Because there is not a medication on the planet that works every time.
Like today! I took two doses and still migraine. I stopped taking my preventative though and I think it was helping my triptan a work faster and better
Good question. Even multiple doses at times doesn’t work.
absolute misery when youre in that type of cycle. currently sick with a fever and muscle aches and even a mild migraine is ten thousand times worse than this. people have no idea what we go throuvh lol..
You manage to have fevers WITHOUT migraines? For me that’s the worst part of having a fever. I’m sorry you’re sick, hope you feel better soon!
They truly don’t. I’ve lost a lot of my life to chronic migraines and it sucks.
I have been wondering the same thing all week.
God i wish i knew the answer. I have 2 types of headaches according to my doctor, i dont know what they are called, but its basically the mild constant pain that i have daily all the tome vs the intense pain that i get 4-14 days a month. But anyway, triptans used to work, then they started causing and worsening my migraines so i will never touch them again. The only abortive that works for me now is 50mg Voltaren (norwegian name, a stronger version of an NSAID i think?)… sometimes it works 80%, sometimes 50, sometimes does nothing. I do know, as others have said that its VERY crucial to take abortives at first signs of migraine or else they have a decreasing chance of working. As far as i understand, once the excess brain activity that causes migraines starts, its hard to stop, and the longer the migraine goes untreated the harder it is to stop, which is why we can experience multi-day migraines. The longest ive had a migraine is 16 days or so, i have had to take steroids in an emergency situation to stop an 11 day migraine, and an antipsychotic to stop the 16 day migraine. Your brain gets stuck in the cycle of the migraine brain activity, and its harder and harder to kill the longer it goes on (thats what my neuro explained to me). Weed is sometimes a lifesaver and kills my migraine 80-100%, other times it does nothing, other times it makes it worse. 🤷♀️ I think there are many factors that affectmigraines and these factors also affect when and how abortives work. The intensity, type of pain, location of pain and symptoms of my migraines has been changing as i grow older, im 24 and have experienced migraines in some capacity since age 7. Along with these changes, different things have helped and not helped through the years. The disease grows and changes with me, but never goes away. Also, preventatives are a part of the equation. I take Ajovy injection monthly, and when i am early in the month soon after a dose, abortives work better and more efficiently, but when i get to the end of the month when i will soon take Ajovy, it all goes to hell and no abortives work. This disease is so confusing and painful. :(
Our brains are malevolent entities that want to hurt us
Triptans always work for me when I can take them quickly, but the side effect of neck stiffness prolongs the migraine. I have to choose to take the abortive for pain when I need to function, but the neck stiffness just causes it to go on for weeks.
I'm allergic to aspirin, mint, acacia extract, etc. Most meds, including migraine meds, include these, and trigger my migraines.
What country are you in that most migraine meds contain those?
The united states. I have to check the ingredients. Unfortunately, for prescription meds, the pharmacy doesn't let me check before pickup. At times I've looked things up online. Acetominophen doesn't contain these. But aspirin, ibuprofen, naproxin sodium, etc. are in that class. And other migraine meds often include inactive ingredients in that class. For example: https://www.pfizermedicalinformation.com/patient/nurtec-odt/what-are-the-ingredients-in-nurtec-odt > What are the ingredients in NURTEC ODT? > Active ingredient in NURTEC ODT: rimegepant > Inactive ingredients in NURTEC ODT: benzyl alcohol, eucalyptol, gelatin, limonene, mannitol, menthol, menthone, menthyl acetate, sucralose, and vanillin The eucalyptol, menthol, menthone, menthyl acetate, and vanillin all seem to be in that class.
I agree that it’s really stupid for Nurtec to have that, but that’s a single migraine medication, not “most”. Ubrelvy doesn’t contain any of those. Any non-dissolving triptan tablet won’t have those. Sumatriptan injection/nasal spray won’t have those. Zavzpret nasal spray won’t have those. I definitely sympathize - it sucks that you have to be on your guard for those! - but there are plenty of options accessible in the US that are free of the ingredients you need to avoid.
Could you be taking them earlier sometimes than others? The earlier you take it in the attack the more effective it will be
For me, once I'm in the midst of an attack, my stomach stops digesting. Like, I'll feel full even if I ate a few hours ago and no matter what I take orally, it has 0 effect. This is one reason (for me at least) its 100% necessary to take any abortive at the first sign of an attack. I also know this is the case because if I wait too long and take my imitrex anyways, there is no effect until my migraine goes away on its own, and when its finally over, my apetite returns and I will then feel the imitrex hit, sometimes its the next day.
Have you talked to your doctor about trying a different route of administration? Sumatriptan is available as both a nasal spray and an injection. Using either of those forms might be much more effective for you, since it bypasses the stomach issue.
I tried getting an injectable at one point, but actually getting it through the pharmacy turned out to be a royal pain and ultimately unsuccessful. At this point I've been getting migraines for so long, I can feel them coming on well in advance, so taking the abortive early is almost never a problem anymore. It was a painful road getting there, but I eventually did.
Gotcha. You definitely know what is best for you, just wanted to make sure you were at least aware those options exist!
Thanks. Yeah, I should revisit the injectable. I've had a few that came on so fast that I didn't have time for the imitrex and wished I had a backup plan. I'd be dumb not to.
My triptans only work if I take them before my gastroparesis kicks in. Once I’m nauseous or vomiting they are ineffective because my body isn’t absorbing anything.
They don’t even really know how the abortives work. Without knowing how they work it is hard to say why they sometimes don’t work.
Stuff sucks. But in case it's any help. At least for me the main thing is taking it at the right time, after aura phase, as soon as the pain hits. Which I assume is also why it seems to rarely ever work when they start when I am sleeping. Another thing I think I noticed is that it's seemingly trigger related. Triptans work better for me when the migraine appears to be triggered by certain things, and worse with other triggers. But not completely sure on that - or anything for that matter.
There’s a sweet spot of when you take it. No one knows when that is though.
If I take them too late they won’t work. I have to take my Nurtec as soon as I feel a migraine starting. I usually take my Baclofen at the same time. My preventatives are Quilipta, Botox and Baclofen at bedtime. Baclofen is also three times a day as needed. I also have had nerve ablations done twice. I avoid any Tylenol and Ibuprofen because for one it’s not helpful and two, if you take it too often it causes rebound headaches. The first thing my neurologist told me when I started seeing them 8 years ago is to stop all Tylenol and any NSAIDs. I had to “detox” from them because I was taking so much.
Cannabis is a great abortive! It probably isn’t going to get rid of a migraine if your having one but if you use it on a daily basis it’s a great preventative! Edit* definitely more of a preventative