Counting Pills

Counting Pills

I know I can’t be the only one out there who’s doing it. Several times a month, I check my supply of rescue medications to be sure I have enough to make it to my next fill date. Between insurance-imposed limitations, medication-imposed limitations relating to allowed dosage, and the imposed limit my doctor writes for my prescription, I sometimes must ration my supplies to ensure I will have enough to last me to the end of the month.

IMPORTANT: All medication use and strategies should be set in consultation with your physician.

A hard choice

There are days, or times during the day, when I must choose whether or not to properly respond to escalating pain due to the fact that I’m running out of medication. I ask myself, “Do I really have to function right now or can I get by with severe pain? Can I get coverage for my responsibilities, such as transporting my children? Can I put off this or that deadline? Can I miss that appointment?” Choosing which days to medicate is an awful choice. Of course, given the option, we’d all like to be fully functional every day. But for migraineurs who are counting our precious medications, we don’t have that luxury.

Insurance-imposed limits

For many of us, the insurance company limits the amounts of our most effective medications. While our physician might determine it is safe and effective to write for a higher number, the insurer only covers a minimal amount. You may wish to talk to your doctor about appealing the insurer’s decision to attempt to gain approval for a higher allowance of that medication. And, if you have an organized doctor, a responsive insurer, and perhaps a little luck, that may work. Others are left with the option of paying out of pocket for more medication than the insurer allows. Unfortunately, many different types of migraine medication are extremely expensive.

Medication-imposed limits

One of the medications that work best for me when I’m in the most extreme migraine pain is ketorolac/toradol injectables. However, there is a limit as to how frequently I can take these. Some triptans also have intake limits. This can pose another hurdle in relation to pain management.

A question of tolerance

There exists a fairly major judgment among those in the migraine community (both medical and patients), who feel strongly that opioids are not suitable for migraine management. There is significant research that shows that this type of medication causes rebound headache and there is a high risk of developing an addiction to these types of drugs. That said, for better or for worse, many migraineurs do take opioids as part of their treatment protocol.

For those of us who take opioids for migraine, we must consider the risk of building a tolerance to these medications over time. There is really no way to avoid physical tolerance to opioids. However, tolerance is different than addiction. Many people who take these medications for migraine have been taking the same dose for years. They are not drug seekers who are seeking a high. They are merely seeking relief from severe pain and for many of us, opioids provide the best pain relief. With opioids and some other medications, the more you take the more you need. Therefore, it is critical to maintain the recommended dosage – never more – even when the pain is out of control and not responding. It bears repeating here that you should always consult closely with your physician about use of all medications, most especially opioids.

A harsh reality

No one wants to be spending time focusing on pills or making choices about whether or not this is a day they can get by without functioning. However, for chronic migraineurs, ensuring that our supply of rescue medications lasts throughout the month is an important, responsible and essential part of managing this disease. The harsh reality is that many of us go many days without effective treatment in order to pace ourselves and our medications throughout the month. I feel certain that, if given the choice, we would all love to be medication-free.

Is this an issue for you?  If so, how do you manage the challenge of ensuring you have enough medications to last you through each month? Please share in the comments section below so we can learn from each other.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (126)
  • 16ait3j
    3 days ago

    It’s very sad that most of us do not get the help we need.
    My pain level is a 8-9 everyday. Cervicogenic migraines, fibromyalgia, arthritis,…..
    We need help and no one is listening.

  • Holly Baddour moderator author
    1 day ago

    I’m so sorry to hear you are suffering. You are clearly managing a very heavy load. Unfortunately, you are certainly not alone. It really is a terrible time for those of us living with chronic pain. And in the last few months since this article was first written, things have only gotten more complicated. Rules and regulations are becoming more restricted, especially when it comes to opioids. This is wonderful when it comes to the goal of getting dangerous drugs off the streets and out of the hands of those who are using them recreationally. BUT it’s really punishing those of us who are living with legitimate and severe chronic pain for whom these medicines mean the difference between being bedridden and having some semblance of a quality of life.

    Please stay in touch and know that we are thinking of you and so glad you’re a part of this community. We are listening.

  • ChronicallyEverything
    4 months ago

    This month, August 2018, my insurance approved 12 Relpax, well the generic for it anyways, instead of the usual 9. Not sure if it was an error or what, but I’m so glad it happened! Also, I was able to get 15 sumatriptan today, Aug 28. Again, I don’t know what’s going on. Idk if the recommended amount has changed or what, but thank who or whatever! Because of this, and if it holds true for next month, I will have a rescue pill for every single day! I’ve never been so relieved!
    Side note: has anyone ever been told their neck was too straight and that’s what was possibly causing their migraines? My pain management Dr told me that yesterday. I was like, huh? Never heard that one before. Will ask on a new or another thread, but since this one is already so popular I thought maybe someone here would have heard of this.
    Thanks!

  • maryanne59
    5 hours ago

    Your neck is straight because the muscles are in spasm. Commonly referred to as “military neck” in radiology readings. Common causes are muscle strain or underlying cervical issues such as disc deterioration or herniation.
    All can result in cervicogenic headache. Look into it further.

  • Holly Baddour moderator author
    4 months ago

    Hi there- what a wonderful surprise! At a time when most meds are getting cut back, it’s lovely to hear of you being on the receiving end of an unexpected increase such that you actually have exactly what you need without having to fight for it. THAT’S what it should be like for all! Hope this continues for you and if you figure out why it happened, please let us know.

    As for the neck question, I have not heard about the straight neck being a driver for migraine, but there is something called cervical dystonia which can be a comorbid condition that goes along with migraine. https://migraine.com/blog/migraine-triggers-and-comorbidities-dystonia/. It shows itself in the neck, upper torso, and/or shoulders and generally is stiff and sometimes leads to twisted musculature. Definitely worth asking your doctor more about this (perhaps your general practitioner).

    Hope that help and so glad you chimed in. Please stay in touch!

  • TracieL
    4 months ago

    I have the same problem. I will wait hoping the pain will go away so by the time I do take my medicine sometimes it doesn’t even work. Forget talking to the doctor as they tell me to take it and don’t wait. Obviously they don’t have to count pills.
    Hang in there and keep counting….

  • Holly Baddour moderator author
    4 months ago

    Hi there- such a good point that our doctors are telling us to respond to the pain immediately as that is when we have the best chance of stomping out the migraine attack, but they likely have not lived the reality of having their backs against the wall with a shortage of medications. That said, some migraine specialists do understand the challenges of the limitations that insurance companies place on migraine meds, and they might be willing to work with you to call/write in for an override or write you for two different types of triptans, or two different dosages of the same drug, etc.

    There are some workarounds to the limitations (a number of great ideas came flooding in in the comment section below from our wonderful and resourceful community members– be sure to take a look when you have a moment!).

    Thanks for chiming in- so glad you’re a part of our community too!

  • headvice
    4 months ago

    I think that this is a way of life for anybody who suffers with chronic pain. You start asking yourself things like, “Can I make do with just 3/4 regular dose for the rest of the month?” Or maybe a regular dose today, a half-dose tomorrow. You do the math a thousand times, to be sure that your supply will be adequate, one way or another, to get you through the month. By limping along on a less-than-full dose, you just hope and pray that you are not setting yourself up for agony. It shouldn’t have to be that way. I understand why there has to be such a strict rationing of heavy-duty meds. But most of us try to make to with what we have. And hope that it will be enough. It is terrifying.

  • Holly Baddour moderator author
    4 months ago

    What a great articulation of this challenge. I’m grateful you took the time to write such an apt description of this uphill battle. Thank you for taking the time to chime in. So glad you’re a part of our community. It certainly helps to have each other to lean on in the midst of these struggles. Please stay in touch!

  • Mike
    4 months ago

    I’m wondering how many folks here use opioids because triptans don’t work for them vs triptans are too hard to get or too expensive. Do you use opioids as a rescue drug or at a maintenance level?

  • Holly Baddour moderator author
    4 months ago

    Hi Mike- My guess is that because there’s no one-size-fits-all migraine treatment, you would get a wide array of answers to these kinds of questions. Some people are prescribed opioids because triptans are ineffective for them. Perhaps others may be prescribed opioids because triptans are out of reach financially – however, I doubt a doctor would choose a treatment plan based on expense. In my experience, migraine specialists are driven by seeking an effective treatment. If the cost is too high, they seek an off-brand equivalent in the same family. Also, due to the STOP act, there are now so many restrictions on these drugs that they have become out of reach financially as well. Opioids are prescribed as rescue treatment for most, but certainly can be prescribed as a daily preventative as well. It all depends on the individual case and migraine specialist.

  • Martiw
    4 months ago

    I finally told my new doctor’s chief asst that I was counting pills to get thru the month and felt like a criminal. Perhaps being a female, she could empathize. Male doctors I’ve had seem to be super healthy. Sometimes I go all day in a lot of pain because I don’t ‘need’ to go anywhere and function. Then I have to take something in the evening anyway. I tried 4 doctors when my family doctor retired until I found one with an open attitude about opiods. Look for a more sympathetic doctor. I also discovered that weather changes trigger pain. Unlike some sufferers I know, I feel worse after the barometric pressure changes, not before. I have to watch the weather reports to get better prepared to prevent pain. Also flying is another trigger. Knowing I will feel worse for a day after and after weather changes, I feel less helpless and plan trips with that in mind and relieves a lot of stress I put on myself. Some generic meds are affordable at pharmacies that don’t use insurance.

  • Holly Baddour moderator author
    4 months ago

    Thanks so much for sharing. Interesting that you react to the changes in pressure after the weather event. We all are so different. I do think that migraines thrive on change- regardless of whether or not it’s a barometric pressure drop or rise– or a hormonal shift down, or up. It’s great that you’ve learned to keep your eye on patterns to do your best to be prepared and lower your stress. I also really relate to your comment about choosing the days you don’t need to function. I absolutely hate that reality, but I think there are many out there like us who have to choose those down days in order to have enough meds on the days we need to function.
    Glad you’re a part of our community. It always helps to remember that we’re not alone. Please stay in touch!

  • Bskuhl
    4 months ago

    Good statement. My question is, what countries are free? where I can be an adult and make decisions about myself, for myself. I’m not a child.

  • bluesguy
    4 months ago

    Wow, look at that response. I do the same thing. I am sorry that you have to go through this each month. It is so hard to know what day to save our rescue meds for. I hope your doctor, and your insurance carrier will increase your needed medications. In our condition, it is difficult to live with out them.

  • bjs28cpht
    4 months ago

    Sorry I haven’t had a chance to actually read the full article because I’m at work, and with a migraine. I work in pharmacy and I will share with you that there are many discount programs available to drop the costs of these medications for you. Reps and others such as workers for United way, etc drop off cards for those in need to use. I can tell you first hand, they work. Don’t hesitate to ask your pharmacy staff. If they are professional and friendly, they will most certainly be willing to help.

  • Holly Baddour moderator author
    4 months ago

    Indeed! Thank you so much for bringing this up! In fact, I just spend a couple of hours on the phone last week with Botox about their reimbursement program. I understand they have a patient assistant program for people that either don’t have insurance or who are underinsured- which can help provide payment for the medication upfront. Because I have insurance I don’t qualify for that, but I evidently do qualify for the reimbursement program. I have never had to pay such a huge amount for this medication before, but they are now asking me to pay over $900 per treatment. The reimbursement program might cover up to $700 of that cost. The scary part is that this reimbursement amount is not guaranteed. I have to pay the total upfront and out of pocket, then submit all of my paperwork and wait and see what is covered. Still, it’s more than nothing to help cover a medication that is an essential part of my treatment plan.
    Thanks again for encouraging folks to look into these types of plans to assist them during this difficult time.

  • LindaBlackmon
    4 months ago

    I finally got a PA for Cambia, it took almost 6 months. It works and is non-adictive. It’s crazy you have to fight for something like this and opioids are approved
    My husband was prescribed these for years. They eventually stop working and to come off them, you have to go through withdrawal. NUTS

  • mztasha2u
    4 months ago

    What’s a PA!

  • mrst53
    4 months ago

    It’s not fair that the meds that work, either we can’t get enough of or we or stigmatized for taking the ones that work. The new things that are out, are so expensive that the majority of us will never be able to afford. We live in the wrong country.

  • PaJeane
    4 months ago

    In addition to rationing my meds as you’ve mentioned I do everything I can to avoid my triggers. My employer was even willing to install blinds on our very large street level windows to help with sun and glare from traffic.

  • Holly Baddour moderator author
    4 months ago

    What a uniquely kind employer you have! So nice to hear this kind of example is out there– hope it might inspire others! Thanks for sharing.

  • tlocker
    4 months ago

    Does anyone else ‘hide’ meds from themselves in fear that they’ll run out? Or turn over a certain number to a family member for “emergency backup”? Guilt really is one of the hardest parts of this disorder: guilt from society that doesn’t understand, at having to take pain-meds, at acting like a ‘junkie’ and stashing said meds; more guilt that family is ignored; and co-workers get stuck covering for unexpected and frequent absences. It’s just all so overwhelming sometimes, while I’m not at risk for suicide (too Catholic) it has crossed my mind when I’ve missed 3 personal events,half of two weeks of work, and am scrambling around my house looking for one last med to get me through before the refill day comes.It just feels so hopeless and never-ending at times.

  • Holly Baddour moderator author
    4 months ago

    You are not alone in hiding meds and trying to create an emergency stash. It is a terrible (and evidently all too common) reality. So many of us are missing events left and right, coming up short at work (if we are able to work at all), and the combination of all of these factors can lead to an awful sense of desperation that is so stressful and we all know that stress can trigger migraine. Such a vicious cycle that repeats every month.

    So glad you are a part of our community- as it helps to lean on one another and remind each other that we are not alone in navigating this disease and all of it’s complex challenges. Please stay in touch. Thinking of you.

  • vnf6em
    4 months ago

    I could have Written the same post as you just did here. Every month the anxiety starts about 10 days in —then… always thinking I had plenty and there is no reason to worry I don’t know why after so long I still think that possibility exists. By 20 days in a live my life mostly spent worrying and doing the same thing as you. Searching for hidden and or dropped medications, digging through my purse and/or luggage if I’ve been traveling. Sometimes I think I would rather live with the pain then go through the same anxiety every month. Even if I ration from the day I get a couple of medications I take somehow I never manage to comfortably make it till the end it’s a terrible feeling so I just wanted to let You know that you are not alone and being at a mature professional adult woman and having these issues can make you feel very inferior. I don’t know what the answer is I just wanted you to know and others to know that I totally understand and I hate having some thing like a little pill or the lack there of causing it to be what invades most of my days. you know that you are not alone and me being a mature, professional, adult woman and having these issues can make you feel very inferior. I don’t know what the answer is I just wanted you to know and others to know that I totally understand and I hate having something like a little pill or the lack there of causing so much anxiety it’s ridiculous even more anxiety trying to think of what another option might be. So thank you for being open and honest.

  • Holly Baddour moderator author
    4 months ago

    What a thing to take up our brain space every month! This rationing, counting, stressing leads to a terrible cycle that it sounds like so many of us are dealing with repeatedly.
    It does help to connect and remember that we’re not alone in this. Please stay in touch- so glad you’re a part of our community!

  • Bskuhl
    4 months ago

    Some here have stated that they withhold their triptan use, both for saving their pills as well as trying to tough it out, so to speak. Triptans are generally prescribed to be taken at onset of migraine. Of course you should follow your own doctors instructions. Triptans are also not considered to be pain medications whatsoever. They do not desensitize any nerve endings. They work generally in the brain and act upon centers that regulate vascular dilation. I have also read that this dilation is somewhat generalized in the areas of the heart and head but are system wide. My experience with opiates dictate that NOTHING is”fun” where a migraine is involved. Perhaps this may be the stigma I depicted I’m my earlier post.

  • Parismarcia
    4 months ago

    I too had this problem with limited supply from insurance. Fortunately I live part time in France and had a bad migraine attack and was sent to the American Hospital in Paris. I met a neurologist that immediately stopped all my medications explained I was getting rebound headaches from massive does it medicine. He gave me over the counter classical (aspirin and 500mg caffine) plus another medicine very mild.. I was very afraid and was sure the pain would not go away with just an aspirin type pill as I had been in emergency room for hours 3 days in a row with terrible pain. To make a !long story short. It worked like a miracle drug. Unfortunately it is not available in U S but the pharmacist can recommend a substitute.

  • Holly Baddour moderator author
    4 months ago

    Wonderful to hear you were able to break a bad cycle due to rebound. I must say I am envious of the way that some other countries prioritize the health of their citizens. I hope you are able to find the “miracle drug” substitute easily here in the US! Please stay in touch and so grateful you are a part of our community.

  • Mike
    4 months ago

    I think we need to change the perception, especially amongst family, friends and coworkers, that Triptans are “pain relievers”. It’s true that they break the cycle of vascular contractions within the tiny cluster of nerves that generate the migraine, thus ending the pain, but they’re not “fun” like an opioid might be. Sometimes we feel ashamed having to pop a pill, or judged. Give any one of them a migraine for an hour and see how judgmental they are.

    Triptans are highly selective and target a particular nerve cell that becomes overstimulated. That’s it. Insurance companies limit Triptans because they cost so much, not because they’re dangerous or habit forming. That’s why they’re not an FDA scheduled drug like pain killers all are.

    I’ll give an example of how generally ineffective opioids vs Triptans are. I had a pain in my chest I thought was unusual, so I went by an ER for an EKG. They misread the EKG and decided to do a bunch of tests (my heart was fine, it was a pulled muscle). One test required them to put a nitroglycerin patch on me. Nitroglycerin is a blood vessel dialator, so immediately an intense migraine ensued. I couldn’t take the Triptan since they were controlling the meds (as they should).

    Eventually the tests were clear but I was in agony. They admitted me and put me on a morphine drip. Didn’t touch it. They added oxy, nothing. Finally I asked the nurse if I could take my migraine meds. 300mg of Sumatriptan later, the headache was gone. Also the opioids were a lot of fun once the headache was gone.

    So, you’re not taking “pain meds,” you’re not weak, you don’t have a low pain tolerance and you’re not risking addiction and ruin. Have you ever seen the website “Faces Of Meth” with all the sad progressive mugshots? It’s terrible. Have you ever seen the website “Faces Of Immitrex”? Nope.

  • Holly Baddour moderator author
    4 months ago

    Hi again, Mike- You are right that there still remains an enormous stigma that surrounds migraine. On so many levels. Many people still believe that it is “just a headache” and not the complex neurological disease that it truly is. We are seen as weak- as choosing to avoid social situations, and work. The additional stigma that we can encounter regarding being drug-seekers is exhausting. All most of us are seeking is relief.

    It’s a good clarification you are making between triptans and opioids. They do work in entirely different ways. The only additional thing I might encourage you to think about is the awful judgment that you are so tired of receiving is the same judgment that those of us who are prescribed opioids by our migraine specialists feel when we’re told that taking pain meds means we are weak- when we are simply following through on our treatment protocols. Again, all everyone is seeking is relief from severe pain and complicated neurological symptoms of migraine. The way I look at it is that we face such judgement out in the real world that it can really help to try to be supportive and nonjudgmental here, even if we are pursuing different treatment strategies than fellow community members. I’ve met migraineurs who have tried every single treatment strategy out there, and the only thing that works for them is opioids. They have been taking the same dosage for 15 years with no increase. They are not weak, they are not drug seekers. It’s just what works for them. Opioids are not fun for them, either. They simply stop the pain, in the same way that triptans do for you. We are all different and there is no-one-size-fits-all when it comes to migraine management.

    I’m so glad you’ve found something that works for you, and additionally that you’ve found a way to access it in an affordable way. I look forward to looking into accessing triptans through your route as relpax is an enormous help to me. Those of us who take opioids responsibly are having to now navigate the very restrictive rules that have been placed on those meds due to the opioid crisis. The government is now restricting our access to the medications that our doctors prescribe for us- that work for us- because others are abusing them- which is incredibly frustrating.

    Again, so grateful for your insights and voice in our community.

  • vnf6em
    4 months ago

    Thank you. Opioids are not fun not by a long shot. The stigma is embarrassing and ridiculous. Running out of them after years of being on them is one of the worst feelings I never want to feel so I am very careful with dosages and making sure I have enough even if that includes skipping doses to have enough to get to the end. If I tell somebody that they look at me like a crazed addict, when in reality, physically I may be addicted mentally I feel a damn thing. FINANCIAL strain is also anxiety producing!! If I could take something else that did the same thing you know I sure in the heck would just to rid myself of societal judgment and the fear of running out etc. and don’t even ask your doctor for extra meds or to fill something a day early because they will label you the same in my experience. I said it before sometimes it’s ALMOST Not worth it.

  • Mike
    4 months ago

    Yes, whatever it takes for you to stop your particular attack, that’s what it takes. I’ve tried the preventatives..Botox, Lyrica, Elavil, the Cephaly device (pretty cool but not enough) hydrocodone, lorazepam, and of course the OTC stuff.

    I think the problem is those things I just mentioned are readily available and most aren’t expensive. Docs are accustomed to treating pain with pain meds, but because of the insurance restrictions and cost very few would tell you to take a triptan first PRN and keep the opioids on hand as a fail safe.

    My pill counting process used to go like this:

    “Uh oh”

    I’ll lay down with a cold compress and take Excedrin Migraine.

    “Yikes, getting worse. Also my wife and kids think I’m being a baby”

    Ok, if it’s not better in a half hour I’ll break the glass and take my emergency $20 migraine pill.

    “Now it’s unbearable”

    One migraine pill. Of course the process that drives the migraine has now had time to fully ramp up, and it’ll be three hours of slowly diminishing agony, after which I’m exhausted.

    I’m still on the lookout for a preventative. We’re going to try that new injection thing. Unfortunately for my doctor her teenage daughter had been struck down by debilitating migraines so now she’s super interested in tossing conventional wisdom aside and just finding anything that works.

  • rq79yq
    4 months ago

    I thought I was the only one to count my pills or cut them in half hoping that I’d have enough to see me through to my next refill! I’ve had migraines since I was about 8 years old. I suffer EVERY DAY. Some type of headache faces me every morning. Usually the pain wakes me from a sound sleep, 3:00 – 4:00 in the morning. I lay there for a while thinking…do I suffer through this…do I take ibuprofen or Tylenol hoping it helps (it never does), do a wait and see if it’ll pass? 9 times out of ten, it doesn’t. I have to make a decision between being pain free (thank God for Maxalt), or suffering through the day in pain. If I didn’t take daily maintenance drugs to keep some of the severe pain at bay, I don’t know how I would survive. Even with them, there are those days when all I can do is hug the toilet bowl throwing up, or lay in a ball in a dark room with my head in cold packs. Although I’m only 61, I am already starting to dread what my life will be like when I retire and may have to make the decision to eat and afford the pain meds that I need.

  • Mike
    4 months ago

    I feel for you. If I’m a reliable gunea pig, after 15 years of simply taking my triptan at the first hint of a migraine, sometimes several a day, and so far at 57 otherwise healthy, I can honestly tell you there’s no medical reason (and trust me, my primary has really tried to find one) not to simply take the pill and stop the attack. Every attack, not the ones you try riding out, or alleviating with OTC, ice packs, beta blockers, hydrocodone, meditation or voodoo.

    The key is to have an understanding doc (mine finally conceded there was no harm) and a ready supply of inexpensive triptans. Generic versions are available overseas from online pharmacies for very low per pill cost ( $1.50 or so).

    The government allows you to import a 90 day supply for personal use.

  • headvice
    4 months ago

    Over the decades, I have found that if I toss back two Excedrins with a can of Coke the instant that my head even THINKS about hurting, I can stop the headache in its tracks. This allows a feeling of control.

    But if, for whatever reason, I can’t get at my Excedrin-and-Coke cocktail immediately, I’m in for a rocky time. Weird, but true.

  • Holly Baddour moderator author
    4 months ago

    Even though this is not a reality anyone wants, I’m so glad that you’ve learned that you are not alone! I hope you’ve given a glance at the comment section below to see how many of us are out there! Truly there are millions navigating this reality. The community members offer some really great advice as to how to potentially get around the insurer’s limits- so take a look and see if any of those ideas might work for you.

    Tomorrow when you wake up at 3 or 4am, please picture hundreds of others doing the same– faced with the same hard choices of whether or not to medicate- and if so, what to take. Many of us ending up with the ice packs of which you speak.

    That choice you mention potentially having to make- between food or pain meds – is a terrifying one. Hopefully the mess that is currently our health care system will eventually get sorted out such that we won’t need to choose between being bankrupt and being able to function.

    We are here to provide information and support anytime and are so glad you are a part of our community! Stay in touch!

  • Holly Baddour moderator author
    4 months ago

    Hi there, @sharing_s_caring– thanks so much for your question. I wanted to suggest that you pose it on our Q&A page (https://migraine.com/q-and-a/) so that you might increase your chances of getting more responses there. Here is an article on beta blockers in case you’re interested: https://migraine.com/migraine-treatment/beta-blockers-for-migraine-headaches/. We have a few more articles you might be interested in seeing here: https://migraine.com/?s=beta+blockers.

    Please let us know if you have any other questions and thanks so much for being a part of our community!

  • Bskuhl
    4 months ago

    BTW, I’d kill for a rebound headache rather than have a full-fledged migraine I can tell you that.
    One last pet peeve, I am sick and tired of insurance companies overriding the proper treatment my doctor recommends and the federal government telling me what I can and cannot use to treat my diseases.

  • Holly Baddour moderator author
    4 months ago

    I couldn’t agree with you more on your statements both regarding fatigue regarding the government overriding our doctor’s recommendations and the stigmatization of opioids in their employment as migraine rescue medication. While research has proven this is not the best first choice in migraine treatment, for some patients, these medications work astoundingly well, and I believe we could all do well do lose the judgment on this front. After all, it’s all about seeking relief from the monster that is migraine. And if this approach works for you, then hallelujah! The opioid crisis is negatively impacting all chronic pain patients who are now having to fight to continue having access to medications they’ve been taking (at the same dosages for many years). It’s nothing short of maddening.

    Thanks for speaking up and for being a part of our community!

  • Bskuhl
    4 months ago

    It’s good to hear from people who understand!

  • Bskuhl
    4 months ago

    I am 55 years old and have had migraines since I was diagnosed at 23 years old. For 32 years I have successfully use the combination of either Midrin and hydrocodone or a triptan and hydrocodone for treating migraine headaches. I am truly mystified by the doctors and others with experience in the field who say that opiates can give you a rebound headache. Well this can be true, it is not always true. The rebound headache comes from overuse of not only opiate medications but all types of pain medications. This includes Tylenol, ibuprofen, Alieve…. I have gotten more rebound headaches from over the counter pain medications than I ever have from opiate medications. Why, because you have to over use over-the-counter medications to get them to a point where they can relieve enough pain that you’re not squirming on the floor. This doesn’t even address the fact that pretty much everyone who needs opiate pain medications is demonized and made to feel as if they are drug using criminals bent on destroying the world. it’s time to accept opiates place in the treatment of severe pain with migraine and also to stop the stigmatization.

  • ChronicallyEverything
    4 months ago

    Omg so true! And the fact that abusers of opiates usually get a hold of them illegally is always ignored by lawmakers bothers me so much! I wish I could get my medical records copied onto a disc or thumb drive so if or when I need to go to an urgent care or emergency room I’m not seen as a druggie looking for a fix!
    Also, I’ve experienced rebounds from otc meds many times. I didn’t know what was causing them until I realized I had used an entire bottle, the big one, of Excedrin migraine in less than 3 weeks. And my stomach didn’t feel great either. And they say opiates destroy lives? Well, so do migraines. There needs to be a balance and the ppl really suffering need to be given the benefit of any doubt.

  • tlocker
    4 months ago

    Baskul — Sounds like my life,except I don’t tolerate triptans *ugh* and no longer bother with OTC pain meds. I seem to run 3-5 days short every month, and am SO fortunate to have a PCP who understands and is willing to script the meds I need (stigma and all). If she ever retires…well, I live in fear. Ironically, my career has been spent in work with individuals with severe mental illness — NO ONE would ever limit their medications for these neuro-biological chronic illnesses. Unfortunately many also misuse substances, AND about 30% suffer migraine (often totally overlooked in individuals with Schizophrenia or Bipolar Disorder). I do my best to bust the stigma,but it’s a downhill battle with the “Opioid” aka ‘Heroin Crisis” in full force. Just took first sub-Q CGRP last week. Hoping hoping hoping praying praying praying it works. I’m so tired of never knowing when I wake up if I will be able to work or have to call in yet again…I lost over $20,000 in unpaid (thankfully FMLA) leave last year. Here’s hope for both of us surviving 30 years of ill-treatment and still standing, well when we aren’t cowering under ice packs in dark rooms. We deserve better.

  • Bskuhl
    4 months ago

    Tlocker: Oh no! I feel so sorry for you. I am going to have to stop using triptans soon as well. I have a family history of heart disease and now every time I use the triptans, my blood pressure go way high. That in turn makes me feel like I am going to explode with anxiety. A seething feeling.
    I’ve already had one doctor abandon me because of the DEA harassing him so I too live in constant fear of no more medicine.

  • SunupShutterbug
    4 months ago

    Oh, this is so me. I often try to ease my migraines with ibuprofen because my insurance only allows me 9 sumatriptan per month. Once I thought I was being clever and suffered through one month then refilled my Rx even though I still had some left in a desperate attempt to have some extra ‘just in case’. The insurance company balked even at that and questioned the refill, but the pharmacist bullied them into approving it, as it was a legitimate time frame for a refill. I went home feeling like a criminal.

  • Holly Baddour moderator author
    4 months ago

    Ugh! So sorry to hear! Please take a look at some of the suggestions our community members are offering in the comment section below. Some include asking your migraine specialist to give scripts for different triptans (often we have favorites, but others work alright) – and/or to ask for a script for various dosages of the same triptan (20mg and 40mg). These have proven to be ways to get around certain insurance limits- might be worth a try.

    Terrible that so many of us are juggling this kind of stress atop the stress of dealing with the severe pain and related symptoms that come with migraine.

    Thinking of you and so glad you’re a part of our community! Stay in touch!

  • mrst53
    4 months ago

    I am truly blessed,that I have great doctors that give me prescriptions for as many as I need. I am also that my insurance will give me as much as I need.

  • Holly Baddour moderator author
    4 months ago

    Hi @Mrst53– You are indeed very blessed to have an amazing combination of an understanding doctor and strong insurance plan! I must say I’m curious what insurer you have. If we were all so lucky! So happy for you. Stay in touch!

  • Mike
    4 months ago

    Hi Holly, I hope I didn’t give the wrong impression. There have been zero issues for me with the effectiveness of the international sourced Sumatriptan. My understanding is that the prices we pay for it in the US aren’t close to what the rest of the world pays, which is why you can order a hundred 100mg pills for $150 but the same, and I mean the exact same pill locally is $130 for 9.

  • Holly Baddour moderator author
    4 months ago

    That’s amazing! I’m just curious how to access the internationally sourced triptans? Do you travel there or order them? What an incredible deal. Thanks for sharing this information.

  • Patticatlover
    4 months ago

    I just took my last pill of Imitrex, and I can’t get any more until after September first.

    When I see my PCP, I’m going to ask her if she can get me approved for more. I have had this migraine that has been coming and going since last Sunday and now it’s Wednesday.

    It’s so unfair.

  • Holly Baddour moderator author
    4 months ago

    That is unfair and it is terrifying not to have the treatment we need when we are navigating severe pain and related complex neurological symptoms. Please take a look at the suggestions of other community members in the comment section here. Some mention having success asking their doctors for scripts for other triptans (like, if you have one for imitrex, you might ask your doctor for an additional script for maxalt) and then in addition to that, perhaps ask your doctor for two different dosages of the triptan that works best for you (a 50mg and a 100mg) – doing so might be a way that you can get around your insurers limits.

    Thinking of you and hoping that intractable migraine attack lifts soon.

  • judyelaine
    4 months ago

    I have been where you are and I mean all the time. Currently I pay about $714.00 for my migraine medication. I am using the Imitrex injection and I get 12 tablets a month. Lately, the Imitrex injections are constantly back ordered. I am afraid to use what I have, for fear that I won’t have any when I need it. It is a constant circle. I have spent so much family money on medication, that we don’t go on vacations. Both lack of money and the migraines…limit my life and my families. I feel guilty and horrible at the same time. I have tried everything. That means from meditation, biofeedback to beta blockers, anti-seizure meds, etc. Imitrex is still my go to med. It’s just super restricted by my insurance. I am only able to take the imitrex because I take high blood pressure medication. Take care, there are so many in your same position, not that it helps but it’s true.

  • Holly Baddour moderator author
    4 months ago

    Thank you so much for sharing your story. The theme of guilt runs strong for us migraineurs. Guilt for not being able to show up, or follow through, for being sidelined from work such that we can’t contribute financially, and, yes, for draining our family’s bank accounts to see doctors and buy medication so we can simply try to function. And with the guilt comes stress, and with the stress comes another migraine. Quite an awful cycle. You are right- there are so many in this position.

    Please check out the suggestions made by fellow community members in this comment section regarding how to potentially bypass insurer’s restrictions. Some mention having success asking their doctors for scripts for other triptans (like, if you have one for imitrex, you might ask your doctor for an additional script for maxalt) and then in addition to that, perhaps ask your doctor for two different dosages of the triptan that works best for you (a 50mg and a 100mg).

    Please stay in touch and so glad you’re a part of our community!

  • Mike
    4 months ago

    Sorry you’re going through that. I just posted info about my struggle and how I now have access to as much low cost Sumatriptans I need. It’s life changing to be free of the worry, cost, rationing, begging your doctor etc.

  • katetyndall
    4 months ago

    Holly, I’d be happy to try and work something up for the website. I’ve spent so much of my brain’s bandwidth over the decades dealing with migraine, it would give me pleasure to share what I’ve learned.

  • Holly Baddour moderator author
    4 months ago

    Thank you, Kate! Would be grateful to you for doing so! Please let me know if you have any questions as to the process.

  • sharing_s_caring
    4 months ago

    I know that this topic is stretching your pain meds to last from prescription to prescription, however I’d like to ask fellow sufferers if they are on beta blockers and blood pressure meds in addition to current rescue meds? The addition of both to my life reduced the number of rescue meds that I need to take for migraines. Diet (food additives) restriction, adequate water, enough rest, boring routine help also. Ice packs work better than heat(sometimes I alternate), taking pain/anti-inflammatory meds with hot coffee or hot tea helps kick meds in more quickly also. A Benadryl with an Aleve (generics will work too) and cup of coffee will often work if taken early, if possible add ice pack on trigger point and take a 45 min nap. My DR said I was waiting too long before taking migraine meds, that being said coffee avoidance will cause my migraines to kick in. Down to one or two cups per day. Most days only one. Working on seeing if magnesium supplement will help stop barometric change triggered migraines. Migraines since I was 9, am now 66.

  • shefnmary
    4 months ago

    I, like you and many of us find that we are hypersensitive to “life;” be it barometric changes, tight isobars, rapid fluctuating temperatures or weather changes, extremely high tides… the list goes on. Having severe MCS (Multiple Chemical Sensitivities) drives me “nuts.” Anything from odorants of virtually any kind, i.e., paints, deodorants, soaps to different trees (especially eucalyptus) takes me over the top in a matter of seconds. The Pain Center has signage stating that odorants are not permitted in this area (including the Waiting Room.) Our house is as odorant free as possible. 

       Concerning Magnesium, it, in combination with other medications, mostly OTCs, seems to provide some benefit most of the time for me.I’ve learned that nothing I have works all the time and sometimes nothing works any time. In my comment posting below, I listed what and the dosage I take. It was a trial by trial effort to find what provided a benefit for me. You will be different, but it might be a starting point for you.

       I’m fortunate that I am able to be the “head coach” of my medical team. I trust them and they me. But the bottom line is I get to make final decisions on treatment, medication, referral and testing. It took years to get here and I’m lucky that I’ve had some of the specialists for over twenty years. Because of this. they have found some “work arounds” including a lidocaine push (not infusion) and taking an Alzheimer’s medication, Namenda. My Migraine Specialist discovered that this, as well as vitamin D3 helps many sufferers. Don’t be shy about being your team leader. My belief is if a doctor has a problem with this approach I find another doctor.

       Next  read everything you can find (being suspicious) and be willing to look outside the box. I have friends that found some benefit in Biofeedback or Acupuncture. It didn’t seem to help me.

       Finally, remember that many medications or forms CANNOT be cut or opened (if a patch.) Cutting many extended release medications, such as Ultram (Tramadol) ER can result in an uncontrolled release of the medication, resulting in an overdose or possible death.

       Don’t give up trying to find what works at least some of the time for you. And don’t give up working with your doctors to fight and appeal decisions made by a healthcare providers. Occasionally, I’ve had success overturning a decision.

       And yes, your doctor is correct if you’re waiting until you have “pain” to take a medication. By then, it is usually too late to get maximum (or any) benefit, especially since most pain medications won’t kick in for 30-60 minutes, unless an injection or ODT. Even then relief will be longer than taking it at the onset of exposure to a MCS or other trigger. Good luck.

  • mrst53
    4 months ago

    I am also on preventives and blood pressure.
    I have been having migraines since I was 12 and I am 64.

  • Patticatlover
    4 months ago

    I too have had migraines all my life I’m 60 now.

  • Linda
    4 months ago

    This is a constant worry for me, too. My insurance pay practically nothing. One on the meds in my rescue is Ketorlac which is expensive for me. The rescue can only be used 3 times a week. Since I have 12 to 15 a week there are usually 2 to 3 without relief.
    I know I should be grateful for the relief I do get but it worries me that what I use may quit working.

  • shefnmary
    4 months ago

    Let me share two things. I am a severe chronic pain suffer, the result of neurological disorders. Second, I am a chronic migraine sufferer (35+ years). Like many of you, if it’s out there, I’ve tried it, seriously! Then I heard about a world renowned migraine specialist from Belgium that had been recruited by a research hospital in northern CA. After 18+ months, I finally got my first appointment. Between the questionnaire and notes made, he agreed I had them bad. And, most medications were at best barely effective. So, what helps you ask? Keep in mind that these are not some kind of magic cure all. What they have done is take 15-20 days of being down, frequently hiding in a dark, quiet room to a few days down, most days functional, and even a few migraine free. Here is my combination: Botox every two months Daily: CoQ10, 200mg in the morning (m) and 100mg at night (n); B2,100mg, m&n; D3, 25 mcg (1000 IU); B12, 5000mcg; Magnesium, 400mg (every other day); Iron, 65mg, every three days (lab work showed this kept me in the middle range); and Namenda (generic), 10mg, m&n, (It was discovered that many migraine sufferers have a protein found in Alzheimer’s patients). If I’m lucky, medications like Cyrophptadine or Midrin “might help, though rarely. There’s really no OTC pain reliever that helps, and most prescribed medications do little, including Fioricet. Opiods don’t help, because they are already part of my chronic pain management package. I don’t ever expect to be free of any type of pain. It is nice to know, that for me, the above migraine package has made life manageable (most of the time) and at times pretty good. You just have to be persistent, find a Neurologist that really listens, and not be afraid to look outside the box to try and find what helps or works for you. Good luck.

  • BrianQ
    4 months ago

    My local chain grocery store, which is also my pharmacy, has a discount program that anyone may participate in. Insurance only pays for 9 sumatriptan tabs per month but I can get it for just $13 through the discount program. Ask your pharmacy about discounts.

  • Ruth
    4 months ago

    I count pills every month. I’m always hoping I’ll have a few days when I can just take zero to half as much, and I’ve tried to average how many I need, but I never seem to come out ahead and usually run out too soon.

    I began having daily migraines about 19 years ago. I was in my mid-40’s and could take multiple triptans each day. But after my mid-50’s they started affecting my my heart so now I can only take 6 each month, and I have to be very still and not get excited. For about 15 years, the triptans alone only got me partial relief. My neuro gave me fentanyl citrate lozenges to take with them and that combo gave me back my life to a great extent. I was even able to take graduate courses and enjoy my life a bit. But the migraines still came every day so I had to stay on top of it. Back then I was counting fentanyl lozenges! Then of course the government began cracking down on that drug and apparently you have to have cancer to get that kind of relief. Most pharmacies treated me like a junkie and no one ever asked what kind of life I had before. If only they knew, they’d realized that no one would walk away from the kind of life just to use opioids. I mostly manage pain with Opana now, but I can’t do much of anything. The level of relief doesn’t compare to when I was able to use fentanyl.

  • aprilarlady
    4 months ago

    Eletriptan is generic for Relpax Holly. Thanks!

  • Holly Baddour moderator author
    4 months ago

    Perfect- Thank you!

  • Mike
    4 months ago

    I used to count pills. Honestly the anxiety about the availability and cost of my nine pill a month limit was itself a migraine trigger. Two things happened. First, my rx plan changed and allowed a 90 day supply. My doc wrote a script with a one a day dose, so 90 tablets of Maxxalt arrived. That alleviated the stress about cost and supply, but my usage increased, mainly because I could easily abort a migraine before it really got going.

    Then my concern was for how much of the Maxxalt I was taking. My primary got me a consult with the head of neurology at the University of Florida (UF). This is how the visit went: “Does the medication work? Take as much as of it as you need.”

    I got a new primary (mine retired) and she was aghast at how much migraine meds I was taking (roughly the equivalent of 100mg of Immitrex, sometimes 3x a day) but I felt fine and the migraines were totally under control. At that point I had been on that dosage for ten years.

    She ran every test imaginable and every lab came back normal. I’ve been at that dose for fifteen years and zero issues.

    As for cost, I left the employer with the great rx plan, so five years ago or so I took a shot at buying generic Sumatriptan from an offshore vendor. Cost is around $1.50 for 100mg. The stuff sure looks and works like the real thing though. I’ll usually buy a bunch all at once for the discount and stock up every six months or so.

  • Holly Baddour moderator author
    4 months ago

    Hi @Mike5215– Thanks so much for sharing what has worked for you and a little of your story. It’s fascinating how different amounts and types of meds work for different people. So wonderful that you’ve found something that works for you.

    Would you be comfortable sharing information on the offshore vendor you mentioned if it’s something that others can utilize? This is such a challenging time with insurance companies limiting quantities and with medications being so expensive, we are all looking for accessible affordable relief!

    Thanks again for chiming in. So glad you’re a part of our community. Please stay in touch!

  • Mike
    4 months ago

    Absolutely. Didn’t want to run afoul of the rules. The site is Inhouse Pharmacy https://www.inhousepharmacy.vu

    Now I’ll admit it took a leap of faith to pay for that first order, but a couple of weeks later a very sketchy looking hand addressed package came airmail from India.

    But what was inside were perfectly normal commercial packs of Sumatriptan, made by Arrow Pharmaceutical. Currently I get APO Sumatriptan in blister packs of 10 tabs, which are handy for keeping in your wallet, pocket, car etc.

    For the first buy you need an RX of course, and payment is by e-check and it has to be verified, but after that you can just continue ordering and using the same bank account.

    Customer service is good. I’ve had one shipment delayed in customs and they sent a replacement. No monkey business with mystery charges or anything like that.

    I firmly believe there is no medical reason to limit Triptans. They’re just so expensive in the US that insurance companies won’t pay for them.

    In fact, it’s probably more detrimental to you to suffer repeated debilitating attacks than whatever the side effects of using the meds whenever you need them are.

    I’ve also been put on all kinds of stuff to avoid Triptans (Lyrica, Elavil, Lorazepam etc.) They all have way worse side effects, plus for me they made little difference.

  • rebeccau
    4 months ago

    I have read theories of both sides of rebound possibility with “overuse” of triptans but know people that use daily and from my personal experience don’t feel a connection. I think there is more risk to my health of being in terrible pain than from the medication.

    As far as generic Sumatriptan, I also just purchased some in Mexico. I don’t feel as much efficacy, so use it at bedtime if I still have migraine pain which does help.

  • Mike
    4 months ago

    Absolutely right. Whether it’s a rebound headache at this point is irrelevant…it hurts just as much as a regular old curl up in a ball with the lights out for eight hours migraine. For me, having a ready supply of inexpensive generic Sumatriptan and popping one at the very first hint of an attack has given me almost total control over migraines. Maybe once every six months or so one will develop as I sleep and by the time it wakes me up it’s a monster, but it’s rare.

    Really, not living in fear of the next attack is the real goal, so however you get there, just get there.

  • Holly Baddour moderator author
    4 months ago

    You are so right that there are contradicting theories on medication overuse headache (MOH). We have many articles on our site that argue various sides: https://migraine.com/?s=moh. I tend to agree that fending off the severe pain and related symptoms that accompany the complex neurological disease that is migraine is incredibly trying and can take its own kind of toll. We all must choose our battles.

    Interesting about purchasing meds internationally and finding that they may not be as effective.

    Thanks so much for sharing and for being a part of our community! Stay in touch.

  • TXdittybop
    4 months ago

    My Neurologist prescribes a muscle relaxer to take at night and together with sleeping at an angle (head up) I don’t wake with headaches or migraines most days. However, I still get migraines enough during the month to also watch my Sumatriptan pills. Sometimes, if the migraine is just starting, I can manage with taking 2 Excedrine with 2 Aspirin, place an ice pack on my head and lay down for about an hour. I haven’t tried to pay for extra pills before but will keep that in mind. My migraines come regular just before a new and full moon and last for several days each. Plus I get more in the heat & sun of summer when I leave the house or stay outside for too long (but I hate cold weather more). I don’t know what I would do without those Sumatriptan pills! Oh, and I take an Advil liquid pill with each Sumatriptan. Maybe this will help other people. Never loose hope…

  • Holly Baddour moderator author
    4 months ago

    Hi TXdittybop- Thank you so much for sharing what works for you. It really can make all the difference to mix a combination of prescribed and OTC medication with home remedies to stretch out the supplies and make them last for the month.

    I’m with you on riding the waves of the full moon cycle and the weather too. https://migraine.com/living-migraine/full-moons/

    Thanks again for chiming in! So glad you’re with us.

  • ChronicallyEverything
    4 months ago

    I also only get 9 triptan pills a month. My headaches are chronic and severe so when I fill my prescription I’m usually out in 2 weeks. My July prescription lasted me 15 days and I’ve felt like dying ever since. I used to get Xanax from my regular Dr and it helped with my stress levels a lot which helped keep my headaches at low levels (2-3) every day instead of the horror show I’m dealing with now that the drug rules have changed. My insurance also changed so specialists are subject to my deductible so I have to pay $6,000 out of pocket before insurance pays anything and I jist hit that amount. That financial stress makes everything so much worse. I’m drowning in debt, drowning in pain, drowning in stress and I’m not sure how I’m going to make it. My insurance won’t pay for anything that isn’t mandated by law and of course our healthcare is under attack daily now. Our rights are being stripped in favor of their profits and I’m so upset by it. I don’t have a Neuro or headache specialist anywhere close to me. I’m in a rural area and it’s a terrible additional burden when one is already sick. Having to travel an hour each way to the Dr is bad enough, but to see a specialist it would be 2 to 3 hours each way and I can’t even drive. I have to get someone to take me and that is its own set of issues, problems and nightmares.

  • Holly Baddour moderator author
    4 months ago

    Oh dear, Chronically Everything.
    I REALLY feel for you and am so glad you are here with us. I feel your outrage and your exhaustion. I’m right there with you, honestly- and I deeply relate. I have hit the same walls you describe with my insurance company denying coverage of nearly all the medications that are key to my treatment plan – and those that they are continuing, they have spiked the cost (or hiked the deductible) to levels that are out of my reach. I have never felt this level of fear, desperation, and anger in relation to my health care, which I thought was my right! My head is spinning, both figuratively and literally.

    I share all of this with you not to grab the mic, but to ensure that you know you are not alone in this. It really is a desperate time. I have been navigating life with migraine for 40 years and have never encountered anything like I have for the past year.
    You have the additional nightmare of having care be literally out of your logistical reach which touches on another injustice related to the migraine field – that it needs so much more attention than it has by researchers and funders. We need so many more doctors to pursue training as specialists- but it’s not an enticing field because there are no solutions. No fixes. And doctors, generally, love to mend people.

    There are some new and truly exciting treatments that have been FDA approved for migraine- but they, too, are currently either being denied by insurers (Gammacore), or are looking like they might be potentially wildly expensive (Aimovig/CGRP).

    Must we choose between being functional and being bankrupt? That can’t be where we land but it sure feels like where we are at the moment.

    In the meantime, again, please know you are not alone- we are all navigating this together- millions of us. This stuff makes for a tough chapter in the book on migraine- but the page will turn. I hope you’ll stay in touch- we are here to provide support anytime. I’m thinking of you.

  • Ellensr
    4 months ago

    Perfect timing Holly! I recently came back from ordering my Amerge locally (the only Tryptan that works for me). I paid $258.79 for 9 pills. That is because I nearly ran out of my other script that I order out of USA. I tried only using one pill per headache and that led to a pretty much 24/ 7 migraine.

    I get 2-3 headaches per week and they are (7-9) on pain scale; but predrome and post drome add another 2 days of suffering for me.
    I just came back from a Doctors appointment to see if my severe digestive issues are a result from this medication. (Lets see if this gets published?) It says it is on the ‘Patient Information insert’.
    I am only tying to find out the source of this; more interested in healing one part of me while treating my (M).
    Because I am on Medicare, I am having difficulty even trying CGRP meds. I have been following them for 5 years. I am too old and my migraines too severe to drive required 25-45 miles for past trials.
    Yes I have submitted the proper forms to my Doctor and I should know this Friday if I can even try it.
    The stress and anxiety for Migraineures is awful. When will society know? How can the government not help us? We all know about profit, but what about suffering?

  • Holly Baddour moderator author
    4 months ago

    @itsmyhead– I’m so sorry to hear how relevant this article is to your life! It is ridiculous how expensive these treatment options are. Migraines are the 7th leading cause of disability- therefore many of us have been sidelined from the workforce and are living on fixed incomes. And yet somehow, the medications they are offering us are skyrocketingly expensive. How does anyone think the majority of migraineurs could be capable of paying thousands of dollars out of pocket a month for medications? It does feel like we have to choose between being functional and being bankrupt.

    The very new treatments (Aimovig/CGRP and Gammacore) are so new that the insurers and doctors are still struggling to figure out how to handle them. With Aimovig, I believe the company was overwhelmed with requests. Various insurers are in the midst of trying to decide in what way they will cover the treatment. This is a bit terrifying as some patients might try it and learn it is life-changing just to later learn it is out of their reach financially. Is it better not to know?!?

    Gammacore, another new treatment, had a similar situation- with many patients responding very positively to it, just to have their insurers deny coverage on the grounds that it didn’t have enough research to prove it’s efficacy for migraine (this, after it had been FDA-approved for migraine!). Can you imagine the insanity?

    I can only hope (and ultimately I do believe) that this sort of thing will be ironed and sorted out with time. We are in a particularly challenging time with insurers, government and drug companies, that’s the hard part. The wonderful part is that there are new therapies being researched and made available after many years of nothing on that front. Getting the kinks worked out such that these therapies get into the hands of the deserving has to happen eventually, right? I have to believe this to be true, but it sure is a very bumpy and nightmarish ride getting there.

    So glad you are a part of our community, Ellensr. Please remember that you are not alone- we are here anytime to provide support and we are navigating all of this right alongside you. Please stay in touch.

  • gingercat
    4 months ago

    ps Forgot to say that these neck exercises are combating a life of poor posture, sitting for too-long stretches at the computer while writing, and being in a state of “high-alert” anxiety for much of my life (but, denial, denial, denial about that right?) – and scrunching my shoulders up as a response to any tension. But – at 68 – I know it’s never too late….

  • tlocker
    4 months ago

    gingercat — “Shoulders-in Ear-Level” is a sure sign of tension for me..happens when I am computer a lot. It took me years to realize that, but if I notice it I try to re-adjust chairs or pillows. Doesn’t stop migraine, but reduces risk of them. My Neuro gave me tizanadine to take at night. It does help, but leaves my mouth SO DRY I only take when I feel like I might have a migraine coming.

  • TXdittybop
    4 months ago

    My Neurologist prescribes a muscle relaxer to take at night and I don’t wake with headaches or migraines. However, I still get migraines enough during the month to also watch my Triptans. Sometimes, if it’s just starting, I can take 2 Excedrine with 2 Aspr

  • katetyndall
    4 months ago

    I’ve had migraines for 45 years, and for the last 10 years I’ve had them daily. I could probably write an instruction manual on strategies for getting the medication you need to manage your migraines. But if I had to sum it up in two words, it is these—Be Relentless.

    Don’t let your insurance provider off the hook. Their limits are a number suggested by the FDA based on averages. I take triptans every day of my life. Nine pills a month would leave me in migraine hell and unable to function. Work with your neurologist, and if you don’t have one, get one. If you have a lousy one, get another. They are your best partners in managing your migraines. Remember, though, you are your best and most eloquent advocate. Use your voice.

    Get a letter of medical necessity from your doctor. If it’s denied, keep going. Find out why. Keep going up the chain of command. Relentlessness is your friend.

    If you take triptans, you can get prescriptions for several different ones in the same month. Although most migraineurs will have an optimal triptan out of the seven on the market, there might be a couple that can function as rescue meds when your primary runs out. Work with your neurologist to find out the best ones for you. It’s a stupid run-around necessitated by drug limits, but it’s better than nothing.

    I found the same thing applies for different formulations of the same triptan. For instance you can often get multiple prescriptions per month for the same triptan in different strengths, for example Relpax in the 40 & 80 mg. versions. Or different formulations of a particular triptan, say a pill version, a rapid-melt pill version, and a nasal spray. Or injectable, pill and nasal spray. Here’s where working with a good neurologist is key. Sometimes you have to kiss a lot of frogs to find one.

    A good neurologist, especially one who specializes in migraine—scarcer than hen’s teeth, I know, but if you have one within driving distance do whatever you can to get in with that person—can come up with combinations that you may not have considered, and has access to money-saving programs that he or she can put you in.

    Another suggestion I have for migraineurs is if you find your medication of choice is not working, see if your pharmacy has switched manufacturers. Generics are not all the same, and one manufacturers product may work while a different one may not.

    I had three months of unrelenting misery a year ago when my triptan unaccountably stopped working. Once I realized the problem, I was back on track. Migraines take a LOT of managing.

  • Holly Baddour moderator author
    4 months ago

    @katetyndall – This is an incredibly helpful, informative and enlightening comment. Thank you so much for taking the time to write it and share it. It is a real gift written in an uplifting tone with real world advice to many who are in need.
    If I may ask you to consider posting this comment (and adding/editing it however you see fit) as a story in our Story section so that more of our community will see it? https://migraine.com/stories/

    It really is a great piece worthy of more eyes reading it. No pressure- just a thought. Thanks again, so very much, for taking the time to share these resources.

    Stay in touch!

  • gingercat
    4 months ago

    Dear Holly,
    Your quandry about when and how much and all the considerations about insurance, timing for prescriptions running out etc. etc. definitely resonated. I always hesitated before taking the generic form of one of the triptan drugs, mainly because of their high cost. And – I would break each pill into thirds, hoping that that small amount would do the trick – similar to the comment posted below by “nottoday”.
    However – I’m happy to say that I’ve had a breakthrough with headaches – the ones I was never quite sure if they’d develop into real migraines. It has to do with muscles in my neck which connect to trigger points and which go all the way up to my head. I’ve been doing “simple” neck exercises recommended by a physio. who suspected that some of my headaches might be “cervicogenic” (sp?) rather than true migraines. And six weeks into doing these exercises faithfully every day, I’ve had a HUGE reduction in head pain – and only one true migraine in as many weeks. I’m still completely amazed.

  • Holly Baddour moderator author
    4 months ago

    Hi @gingercat– So grateful for all of your insights- and that this article resonated with you. Wonderful to hear of the breakthrough you discovered with the neck exercises. I, like @nottoday, would love to see a link to the exercises you mention- if you’d be open to sharing them with our community.

    I have cervical dystonia (CD) for which I receive botox injections (in addition to getting injections for chronic migraine)- so my neck is all out of whack. I’ve been to a physical therapist to address the CD and got some guidance about how to be more conscious regarding how to keep the back of my neck long, tucking my chin- using a piece of material wrapped around the back of my head/base of my skull (I use a leash made of fabric) gently pulling forward on both sides- pulling my chin in, and the leash down and forward for a nice tension/stretch. In that position, I’ll gently put my ear to my shoulder and/or look from side to side- the leash serving to provide traction.

    Would love to hear any tips you (or others) can provide along these lines. Thanks!

  • nottoday
    4 months ago

    can you provide a link to the exercises?

  • lucylou
    4 months ago

    Yes this is an issue for me also, and yes we DO need to treat early so the pain doesn’t escalate…..sooo just what are we supposed to do if we are always worried about running out of meds?? I struggle with worry and anxiety when I only have a few meds. left…this is so very wrong! It’s bad enough to suffer with headaches and migraines after trying all preventatives and then we worry ….which also causes more guilt and shame for us. I have always bought my triptans if insurance won’t pay because my migraines keep escalating without until I feel the need to go to ER while vomiting!! I feel angry just thinking about it! Some Drs. have appealed the # which usually works…Bless us all for having to live like we are GUILTY for dealing with migraines!!!

  • nottoday
    4 months ago

    I use sumatriptan (generic 50’s). 9/mo. I figured out a trick to make them last about 2-4x as long.

    The earlier in a headache cycle that I take the meds the more likely I am to stop it. But I don’t want to waste a whole tab on what might NOT turn into a mind-blinding whopper. That could cost me dearly around day 20. So when to take it? In desperation, I tried something novel that has worked for me.

    I cut my tabs into quarters with a pill cutter ($3 at walmart.) If I feel a suspicious headache coming on, I take 1/4 tab. No food! I wait one hour.

    Gone or nearly so? Sometimes yes, but often no. If no, I take another quarter tab (still no food!) and wait another full hour. About 75-90% are gone by now.

    If not gone or much better? I take 2 more quarters AND an Aleve gel cap. (plus a light snack to buffer the Aleve. I’ve now taken one 50 mg dose of sumatriptan over 3 hours.) 95% of the time this does it, and I’ve got my day back.

    If after another hour I’m not functional I MAY take another whole 50 and another aleve if I’m not already barfing. (I reach this point only about 2x year now.)

    Using this technique I have gone from one or more killer headaches a week, (many at the end of the month when the script had run out) to one or two killers a year.

    A side benefit is I now need to take less, so I generally have a small surplus at month end!

    PS: I ALWAYS have a background headache (1-2 out of 10). I don’t even try to medicate for that. I’m talking about “I’m going down!” headaches.

    I hope this trick helps someone else cope.

  • rebeccau
    4 months ago

    This is so very similar to what I am doing! The pill cutting of my triptan, taking as soon as I can, taking quarters- it really has helped! And it has helped cut down on the side affects I would feel of jaw tightness, sleepiness and moodiness.

    I still hate the anxiety of looking st how many I have left each time I take one. Thank God my 21 year uses the same triptan and she doesn’t suffer as frequently as I do so I can use more of hers.

    I will borrow from the idea I read earlier of asking my Neuro to prescribe a scrip in another strength!

  • Ang
    4 months ago

    I too count pills. I hate it, as it makes me feel like I am addicted when I know that I am well below that threshold. Before the opioid crisis became one I didn’t have the added stress of worrying that the only medicine that gives me any relief (and I have tried pretty much everything) might not be there the next time I need it.
    I use ice and heat, am as pale as can be from lack of sunlight, and just power through a certain amount of pain while trying to guess how today’s headache will progress. I am eagerly awaiting approval of Aimovig in hopes that it helps me regain my life. It is nice to know that I am not the only one counting pills.

  • Stevie
    4 months ago

    I face the “pill counting” panic every month!! This only adds to the possibility of getting a Migraine, from this worry!!! I have nerve blocks injections every other month, implanted all over my scalp. At times there are break through Migraines, and every month I am so afraid if running out of Sumatriptan. I am forced to hoard them and rely on over the counter headache aid, if which very often is unreliable!! Very unfair to Migraine sufferers, what these insurance companys inflict on us. Not to mention life altering, depressing and painful. S.R.

  • Holly Baddour moderator author
    4 months ago

    So glad this article resonated- but then again, so sorry you can relate on such a stressful issue. The stress of this cycle, of panic and worry is just a recipe for more migraine attacks. You are so right that the insurers are making life very challenging for us right now: https://migraine.com/living-migraine/when-health-insurance-makes-you-sick/

    Thanks for chiming in. Please stay in touch!

  • cotts
    4 months ago

    Yes, I’m constantly counting and running out. Not just my migraine medicines. There is/are some controlled substance list(s) that is/are interpreted by the insurance companies. I’ve had numerous fights with multiple insurance carriers over this. Tell me, how is synthroid needing to be limited? Opiods, yeah, I could understand but non-addictive doctor prescribed medicines? Latest insurance scam issue, they refuse to send out a 90-day supply of my meds. Why? Why? Why?

    Great article by the author. I could not agree more.

  • Angiestl
    4 months ago

    Over a year and a half ago, I suffered 3 cardiac arrests, caused by sepsis. This has left me with some pretty nasty heart and overall health issues, but because of the heart problems, I can’t take any triptans. I already take opioids for back pain, though somehow I always sleep through a few doses, so if my head is out of control, I’ll take an extra one, which I used to be on that strength. Up until about March, I was taking fioicet, but apparently the FDA or CDC changed guidelines so that you’re not supposed to take a benzodiazepine or a barbiturate. So I lost the one medicine that helped with migraines and my daily headaches when they got out of control. And my anxiety medicine. I refuse to take topamax anymore, since I’m half bald and stupid from that crap. I convinced my dr to give me diamox because it helps with my underlying neurological condition and supposed to help prevent migraines. The only other things I can use are Excedrin and Aleve. If my cardiologist knew how much Excedrin I take, I’d most likely be in alotta trouble!!

    A friend is supposed to start taking Aimovig here pretty soon, and since she made me go first on Botox (didn’t work the second round) first, it’s only proper she takes this stuff with a needle!! Lol!! I might try Botox again, I liked how most of my face wrinkles go away when I get it!!!

  • pwrnapper
    4 months ago

    I’m sure most of us have been through this pill vs insurance/doctor/functioning merry go round before, not fun. While what I do is certainly not a solution it does make my migraine life a little easier. I am also Chronic but as we know some days are worse than others, requiring either less or no medications. This is where I prefer vials or ampules of liquid meds to the pill or nasal form. I am able to adjust my dosage from the recommended 1 mg injection down to 0.5 mg and in some cases 0.35 to conserve and stock up for when I really need it. I too use ketorolac/toradol injectables and am usually able to get by with a 0.5mg dose rather than the full 1 mg. As my abortive I take DHE (dihydroergotamine mesylate) and get it in 1mg ampule form and usually cut back to 0.5mg, which still provides great relief. I just started a new Bio-med names Aimovig and am on my second monthly injection now. My migraines have been reduced by over 50% in quantity per month so I definitely recommend people talk to their doctors and give it a try, keep in mind that most doctors do NOT know of this drug so you may need to education them first. Amgen, the manufacturer, provides the first two (2) months of injections for FREE while your doctor, pharmacy and Amgen are trying to get your insurance to cover it. There are also Patient Assistance programs available with as little as $5 co-pay. This is an expensive med, $575 per month, so unless you have great resources getting insurance approval or on the PAP is important. Other than these ideas it seems like having your doctor switch to liquid injectable form allows for conservation so I would suggest talking to your doc and getting as much med as you need, even when you don’t need it, as long as your insurance will pay for it and save up for those times when your situation is critical and you need it desperately. And please try to get Aimovig, give it a try.

  • ezlivin1
    4 months ago

    Isn’t it very costly to pay over the counter price?

  • ChronicallyEverything
    4 months ago

    Yes. Sumateiptan cost a me around $30 to $50 a pill depending on where I get it.

  • 18y5nk5
    4 months ago

    If you use the goodrx site, their free coupon can save you a lot of money!!!!

  • pwrnapper
    4 months ago

    Very true, ketorolac/toradol injectables for a pack of 10 vials of 1ml/30mg only cost $18 at CVS

  • 63ug
    4 months ago

    Hi Friends: We all have had to make the difficult choice of counting pills. It’s a tough choice to not use an abortive. I got my neurologist to write an extra script for sumatriptan and I pay cash using goodrx as a discount. It ends up giving me an extra 18 pills a month for $30. Work with your Doc as a partner, and use your Triptans wisely. Save them for a rainy day. By the way, I just submitted the paperwork for Aimovig, so fingers crossed. Be well!

  • reliefnow
    4 months ago

    63ug. I have a prescription for 18 naratriptan every month. Since I have MOH, I wake up with a headache almost every day. So I take the 18 and split and that will cover the month. Occasionally I’ll take a full pill if the headache is especially bad. 3 weeks ago I had my first Amovig injection. Then I was reading some amovig info and it said the clinical trial did not include people with medication overuse headaches – I was terribly disappointed to read that as I hadn’t heard that anywhere else. So now my neurologist says I need to withdrawn from the triptan in any hopes that a next imjection of amovig will help. Anyone else experiencing this dilemma?

  • gg23g7
    4 months ago

    I’m sad to admit- and I get the danger in doing this but I have actually bought imitrex in another country so I could have more on hand of I run out. I’m at about 10-15 migraines a month and like a lot of you, I try to pick and choose which ones are bad enough to need medication. I start with Excedrin, praying it works then usually end up taking imitrex anyway. Yes I count my pills every month and if the pharmacy can’t refill them due to insurance it makes me a bit anxious. It’s too bad we all live like this.

  • ezlivin1
    4 months ago

    I have had chronic daily migraine up to twenty times per month for eighteen years. My Triptan intake is off the charts. Then my stomach began to hurt so bad I went cold turkey off triptans. It was very tough to get though this but after a few weeks of no migraine meds my stomach started to feel better and I could begin eating more regularly. Plus my doc switched me to an orally under the tongue melting absorbing triptan. Only now after a few months of the new med I back with stomach problems again. My doc says nothing in the Rx literature says anything about stomach problems being a side effect from triptans yet I’m proof there is this stomach side effect. I’d like to know if any of you reading this has had the same problem and if so what have you done about it. I’ve tried every migraine med and treatment that there is and only triptans work for me and give me some sort of life. Now I’m back in bed or in a recliner chair 90% of the time just as I was before triptans came available years ago.

  • marilynb1029
    4 months ago

    I have been splitting my Zomig tablets for the last year or so. The insurance limits me to 9 per month, so I’ve had to resort to tablet splitting. I have also done the same with Fioricet. Unfortunately, my pharmacy has been giving me capsules rather than tablets, so that’s been a problem off and on

  • 30yrsofpain
    4 months ago

    I use sumatriptan, have used it for over 15 years now. I think in the past I’ve actually made migraines worse worrying about whether not I was going to have enough to get through the month .
    My doctor is fantastic about refilling my prescription however my insurance has never been good about allowing me more than nine pills a month so here are two things that I’ve learned .
    In most cases( but not always there are migraines that require a full 100mg ) if I catch my migraine right at the very beginning 25- 33 mg of sumatriptan will work for me . My doctor writes a prescription for 100 milligram tablets therefore I am able to cut them into fours or threes. Because my doctor is willing to refill whenever I need I’m also able to refill if I’m willing to pay out-of-pocket . I use blink health .. you simply pay for the prescription with a credit card go in with the texted coupon code they send you and pick up your prescription I get 9 – 100mg pills for approx $16 …
    It’s not a perfect solution but it works for me !

  • Ali A.
    4 months ago

    I relate to this so much. I take Relpax and I’m only allotted 12 pills a month by my insurance. MOST times that’s fine, but as all migraineurs know–sometimes you have an exceptionally bad month. When this happens, every day is this internal bargaining where I ponder if the pain I’m feeling is really & truly “pill-worthy.” Thankfully my migraines have been under control lately and I also have two different kinds of meds I take which helps, but yeah…this is very real.

  • Holly Baddour moderator author
    4 months ago

    Hi @aarnone15 – The quantity limit on triptans is common and so unreasonable. I’ve heard some mention numbers as low as 6/month. An infuriating reality – except that getting angry and worked up can trigger an attack! Ugh.

    “Pill-worthy” is the perfect term to describe this challenge.

    So glad to hear you’ve been feeling alright lately and very glad you’re a part of our community! Please stay in touch!

  • aprilarlady
    4 months ago

    Relpax now has a generic I get for $4.00 with insurance, and even before that I had a manufacturer coupon card I could get it with my insurance for $40 a month or less instead of hundreds. Please check into this. God Bless.

  • Holly Baddour moderator author
    4 months ago

    Hi @aprilarlady– Thank you so much for sharing this! Do you mind providing the name of the generic? Grateful for the tip! Please stay in touch and glad you’re a part of our community.

  • lmlahlum
    4 months ago

    I too am on Relpax. It’s the best triptan I’ve tried, it works at least 80% of the time, as long as I take it early enough. Limited to 6 a month. That’s a joke. I call it my “hundred dollar pill”. (It’s actually like $ 550 for 6 tablets, but hundred dollar pill resonates better. That is WITH insurance. I have to meet my deductible before the insurance actually pays anything for a prescription) Just like the rest of you, I have to decide if a headache is worth close to $100.

    I do have to take opiates. Relpax takes at least 3 hours to work. If the headache is bad enough to need Relpax, its bad enough that I feel I can’t wait. I need the codeine to take the edge off it. I take the smallest bite of a tablet that will work. I am limited to 30 tablets a year. I am not worried about rebound, because at 30 tablets a year, I will certainly not become dependent. I see my neurologist once a year, and that is all I can get.

    I have new insurance now, and will have to choose a new neurologist. I am dreading it. Any suggestions for what to say so I’m not just treated like a drug seeker?

  • rebeccau
    4 months ago

    A good Neurologist will know you’re not a drug seeker. Just try to answer the health history as completely as you can- that’s all it takes.

    The generic Relpax is Eletriptan.

  • aprilarlady
    4 months ago

    Relpax now has a generic I get for $4.00 with insurance, and even before that I had a manufacturer coupon card I could get it with my insurance for $40 a month or less instead of hundreds. Please check into this. God Bless.

  • ddnben
    4 months ago

    I have never thought about cutting or asking for various triptans. I only have one that has worked for me and continues to but it does take an hour to work. I take 3 preventatives but once it starts, you have to use those rescues. I constantly count pills to make sure I have enough and try to keep a stash. My doc is not bad about refilling and I don’t deal with the insurance as others do (I am retired military) but there are still times where it comes close. Thank you for the discussion.

  • Holly Baddour moderator author
    4 months ago

    Thanks for chiming in with your experience. It sounds like we are all in the same boat (and it’s not a fun cruise, either!). I’m glad your doctor is responsive with refills. Not all doctors are- and this problem can really cause stress for migraineurs (the last thing we need).

    So glad you’re a part of our community! Please stay in touch.

  • 18y5nk5
    4 months ago

    My insurance will only allow nine Rizatriptan pills per month. I recently discovered goodrx.com. They will tell you the lowest prices of the drug in your area. Then just print the free coupon and take it to the store. It will save a lot of money for me. I hope it will help others too.

  • Holly Baddour moderator author
    4 months ago

    Thank you so much for this tip! I’ve heard of this as well and talked to my pharmacy who said he could match their prices, but then again I use a small business, locally-run pharmacy- I doubt that would be the case with a bigger pharmacy. I do know several people who use goodrx who’ve saved a lot- especially when they’ve been forced to buy their meds out of pocket because, infuriatingly, their insurers won’t cover the scripts their doctors are writing.

    Let us know if it works for you! Thanks again for sharing!

  • GigiBiz
    4 months ago

    I suffer for MOH headaches due to my addiction to maxalt. However, I can’t function well with a certain kind of headache so always take it. I have started using health warehouse online pharmacy which gives you 30 pills at a time. I stopped using opiates 4 years ago due to dependence on them. Now I’m dependent on maxalt, which is totally the lesser evil. But still. I can’t wait to get off I.

  • Holly Baddour moderator author
    4 months ago

    Hi @GigiBiz– Oh- you are so not alone in this! It is incredible complicated and hard to avoid MOH when we are navigating frequent and severe migraine.

    One thing I’d encourage you to think about is the terminology you’re using. There’s a difference between addiction, tolerance, dependence and a change in pain pathways which can result in MOH: https://migraine.com/blog/the-confusion-about-codeineopioids-and-migraine/ .

    Also, this article speaks to the challenge you describe: https://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/. It’s such a hard journey and again, you are not alone in this.

    It is so human to desperately seek ways to escape severe pain. The extreme pain that comes with migraine makes it hard for us to see straight so and when we find something that works, it’s tempting to take it even if we know it might cause repercussions later. I hope you can find an alternate treatment soon.

    Have you looked into the newly FDA-approved treatments Gammacore:https://migraine.com/video/gammacore-approved/ and Aimovig: https://migraine.com/living-migraine/aimovig-cost/? Might be worth checking into and asking your migraine specialist about at your next appointment.

    Please stay in touch and we’re so glad you’re a part of our community!

  • CaliAriesGirl
    4 months ago

    I am cutting my Sumatriptan in half. Sometimes it helps, sometimes doesn’t.
    That’s the only medication that helps.

  • Holly Baddour moderator author
    4 months ago

    @pwrnapper– Thanks so much for chiming in- and I AM picturing your reality. It sounds so rough. I live with chronic daily migraine so am in constant pain but the severity ebbs and flows. I’ve heard of the extreme severity that comes with cluster and I can only imagine that level of pain coming with such frequency. I also take injectables (toradol). I took my first injection of Aimovig last week and my fingers are crossed so hard with hope that I’ve lost circulation.

    Have you researched Gammacore? That’s the other newly FDA approved migraine treatment. It was specifically approved initially for cluster so I’m assuming you’ve already heard all about it. If not, here’s some information: https://migraine.com/video/gammacore-approved/. We have a number of other articles on our site on the topic, if you’re interested here: https://migraine.com/?s=Gammacore+.

    Again, thank you for sharing. Glad you’re a part of our community. Thinking of you.

  • Holly Baddour moderator author
    4 months ago

    Thanks for sharing this idea. I guess the only challenge with cutting a med in half to make it last longer is risking decreasing its efficacy by half or completely! The upside would be that you’re extending the life of your meds by double if it works for you. Something worth discussing with your doctor, for sure. I talked to a fellow migraineur who said she got around the triptan limits with her doctor by asking him to prescribe two different triptans. Not sure that would work with every doctor or every insurance company (or every patient!) but might be worth exploring at your next appointment. Thanks for chiming in!

  • pwrnapper
    4 months ago

    Picture me Holly, I am a Chronic Cluster Headache sufferer for the past 16 years now and get 5-6 attacks per DAY when in full cycle. Imagine what I have to go through with these monsters. Injectables abortives is the only way for me, I need them to act quick and pills just don’t cut it for my condition. Hopefully Aimovig will be approved for Cluster Headaches soon, I hear wonderful stories about it.

  • deadeyes
    4 months ago

    I share this issue. My advice would be to give your doctor an accurate count of your pain days, so the number of pills reflect it. I’m still short 4-6 days during the month due to limits. My daily medication may need to change, the Topamax isn’t working anymore. Until then, I use heating pads, aleve, tea, cough drops and a handheld massager. Also, I usually stash 1 Sumatriptan in another location when I’ve finished half the pack, (for the days I have to work perform). If anyone has a way to stretch the prescription, please share

  • Holly Baddour moderator author
    4 months ago

    Thank you for sharing the more natural ways to handle pain when we are out of medication. I turn to ice packs and will sometimes turn to meds I have that help me sleep if I’m out of pain meds to help tamp down the pain as at times it can help to sleep off a migraine. I hate that any of us have to find these types of workarounds in the first place! Thanks again for sharing.

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