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Doctors' Answers to "Frequently Asked Questions" - Imitrex

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 07/5/2000]
Question: I have taken Imitrex for migraine when needed for several years and it works well to control migraine.
I was recently diagnosed with clinical depression and have been taking Paxil for about 7 weeks. Is there a chance of the combination of Imitrex and Paxil causing an adverse reaction or side effect?

Answer: None that I'm aware of.

[posted 03/3/2000]
Question: my doctor has put me on propranol for my migraines but he also wants me to try imitrix tablets. i am afaid to take these because i sometimes have pains in my chest.my dad had his first heart attact in his early 30s and 2 open heart surguries before he died when he was 53.do you think it would be safe for me to take them.

Answer: Probably but you could schedule a stress test and remove any doubt, no sense having anxiety about this.

[posted 11/2/1999]
Question: Is Fiorinal contraindicated when taking Prozac, Depakote, Lamictal and Trazadone? When I take Phenergan suppositories I am knocked out the whole next day. Also my internist told me I can't take Imitrex with Prozac and my psychiatrist says I can. I appreciate your reply.

Answer: There is no direct contraindication but you will tend to be sedated on this combination, especially the Depakote, Trazadone, Fiorinal eombo. Imitrex should not be used with ergotamine preparaations or MAO inhibitor anti-depressants. There are reports of weakness, hyhperreflexia and lack of coordination when combinging Imitrex and the SRI antidepressants(like Prozac). Observation for this interaction is the only recommendation-it doesn't seem very common. So there is a potential problem you need to be aware of, but very uncommon and would reverse if the drug were stopped.

[posted 10/17/1999]
Question: I get migraines really bad. My doctor tried midrin, it helped when I could take two at a time but then I would have to sleep. One wouldn't do the trick. So she switched me to Imitrex. I have taken two in two days and it works but my throat, it tightens up, right under my tongue back by my neck. It almost feels like a spasm when I yawn or eat something sweet. Would this be considered a bad side effect?
I am curious on what causes the migraines, minus stress. My doctor ran all the normal tests at our first check-up. Are there any special test that should be ran that can may be a cause for the migraines?
Thank You

Answer: For classic migraines, hard to know the triggers. Patients who have cluster type migraines can often give a list of foods that trigger migraines, typically alcohol or tyramine containing foods. These tyramine type foods sometimes trigger classic migraines and are worth knowing about. Chicken liver,Pickled herring, aged cheese(cream cheese and cottage cheese are not a problem), yogurt, sour cream, bananas, advocados, raisins, chocolate, soy sauce, active yeast in any preparation(bread is not) red wine is especially high. There is a long list of medications used to minimize or prevent migraines. As to the side effects, wouldn't think these would be considered serious enough to avoid the benefit of Imitrex.

Imitrex Nasal Spray vs. Injection [posted 8/13/98]
Question: I recently found out that Imitrex now has a nasal spray. I have been using the injections for quite a few years, with very good results. However, I would like to know if I should consider trying the spray? I have results with the injection anywhere from 10 to 20 minutes. Would the spray compare these results?

Answer: Compares very favorably. Onset in 15 minutes or so with the nasal spray versus 10 or so with the injection. The nasal spray comes in two dosages 20 and 40 mg. Start with the 20 mg. Most patients like the nasal spray better.

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