When it Comes to Getting Your Meds, BE RELENTLESS

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.

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