Abortive triptan

I can’t believe the side effects I get from #triptans are not common… in some degree.

Triptan side effects

 

Maxalt side effects

Heart Throbbing or Pounding Severe
Trouble Breathing Severe
Slow Heartbeat Severe
Abnormal Heart Rhythm Severe
Fast Heartbeat Severe
Chest Pain Severe
Chest Tightness Severe
Numbness and Tingling Severe
Serotonin Syndrome – Adverse Drug Interaction Severe
Heart Attack Severe
Angina Severe
Hemorrhage in the Brain Severe
Stroke Severe
Toxic Epidermal Necrolysis Severe
Wheezing Severe
Giant Hives Severe
Allergic Reaction caused by a Drug Severe

I made a post on the Migraine Misfits board about how hard it is to determine where the line between mild side effects and side effects that are of a concern is. Not the obviously concerning side effects of triptans, but the ones where you know it isn’t normal but the side effects in general that are mild are not great either… so hard to tell at times. But I realize it is because as my doctor said I am really reactive to triptans… I have a lot of the side effects you should not have… and I have ignored them for a very long time. I have linked the Maxalt one about, which by the way the list is quite long an interesting… don’t have many of the minor side effects. But have put in bolt the severe ones I get. I have not gotten angina that I remember ignoring on Maxalt… I have ignored it in the past, but don’t remember ignoring it on Maxalt… I suppose it is possible since I have been on it a while and there have been some occasions when my chest pains have been severe enough I ought to have done something about it but didn’t. But it doesn’t count unless I say it counts, or more specifically unless an ER does… and since I didn’t go, it doesn’t count.

Still it seems to me there are some mild ones that shouldn’t be a concern. People always mention some in one forum or another to which someone replies… that is just the normal side effect. Like that first flush when they kick in. You get that sort of mild chest constriction, you ‘feel’ you heart beat and you might feel dizzy. That sort of thing. And it seems to me that some heart rate increase and decrease would be in this category… how much and how long seems to be an issue for me. But the stuff always makes me heart race, so I assumed that had to me normal to some extent… but I really don’t know when it comes to that how much is too much anyway because I did consider it to be a normal sort of thing. And palpitations are so common for me I assumed they had to be a normal thing as well… just not the really pounding long lasting ones. I get chest pains are bad, but I always felt that the ‘milder’ ones were not really that bad… but the angina was bad. So if you got just a short bout of piercing pain… that was nothing. If it was longer, sharper with chest constriction… then lay down. If it was even worse… then stay laying down. If it is angina then it hurts quite a bit more obviously. I’ve never been sure about the uneven beats… like the fluttering and the skipping and a few times that really, really fast thing. Never really sure how important that is but doesn’t seem all that severe does it… but, yes at times, disturbing and other times not so much. And then there is the shortness of breath and wheezing. Well I know the shortness of breath is a side effect but trouble breathing more of an issue. The wheezing according to the list above is a rare severe reaction…. apparently one doctors are not aware of… so I was left to assume and debate it was asthma related and this was extremely freaking frustrating. And also, by the way, I would say one of the worst side effects… but what the hell do I know?

I have been taken off Axert, Amerge, Imitrex and Cafergot for adverse reactions. I think I have a pattern going on. Except I have a range of adverse reactions and it seems that while at least for triptans they all are the same some triptans are worse for some of the side effects than others. Amerge was particularly bad for breathing, Imitrex particularly bad for chest pains to the point of angina and Axert somewhere between the two. Cafergot was unique in that it Didn’t cause breathing problems and that my heart rate really liked to just drop on it consistently… so really, it was quite few in side effects compared to triptans, but still had to uneven heart beats… that it shared with the rest of them.

And maybe I assumed that to some extent this had to be normal because while I was taken off more than one no one say ‘Hey, you can never be on triptans again.’ They have expressed concern. One neuro was pretty concerned… said my breathing was more important than the migraines. I wasn’t too sure of that at the time given I did need to work. I think because of that nothing was quite done about it. One definitely took me off Imitrex and I know she put me on NSAIDs which completely buggered up my intestines and had severe adverse affects, but honestly I can’t recall if she completely took me off triptans as I seem to recall or merely switched me… she had been trying to treat the menstrual migraines so the NSAIDs might have been for that. She was the only one who did try to treat the menstrual migraines but I believe she took me off triptans for a bit. Because I was switched to Cafergot temporarily. And then to a different triptan, so they must have been trying to find something I would not react to.

Yet when I posted on the Misfits board… no one really said much at all. Not like yeah… I get these sort of side effects which concern me but I’ve been told they are normal. Or my heart does this wonky thing. Or I was taken off this one for this or that. Just a few short replies. And for major things.

So clearly I have been putting up with side effects that I really should not have been putting up with on the Maxalt. Because they are the same ones I have been getting with all triptans. Maxalt is one that I have always said is bad on the breathing side of things. The shortness of breath. The chest constriction. Trouble breathing when I take more of it than the minimum or rarely. And wheezing when I take more of it than once a day. My last doctor when I mentioned that it seemed to make my asthma worse said triptans do not affect asthma, so he never took me off it… and never thought the other side effects were a concern. But previous doctors have literally told me to take more asthma medication or take my asthma medication with my triptan… so it is very confusing. I had assumed for a bit that it was the other side effects, like the shortness of breath, chest constriction, irregular heart rates… triggering asthma problems. But wheezing is bloody well listed as a side effect, so clearly I’m having some sort of freaking reaction to it. Needless to say that is precisely what happens… I take more asthma medication to keep up with my use of triptans. My asthma isn’t that bad, but I take twice as much of it to keep up with triptan use. And use my inhaler at times to manage symptoms. And… the reason I have personally minimized my use of triptans such that I can never treat even the most acute of migraines with two triptans is because if I do take two triptans… and don’t take enough asthma medication… go to bed… I can wake up just not breathing. I just wake up with no air in my lungs, having problems trying to draw air in. Or waking up gasping for air. Or wake up with something very much like an asthma attack. And my asthma is so mild, I’ve never had an asthma attack. I still can’t figure out if my asthma is managed… it should be, considering it was never bad to begin with and it seems to be if I take a boatload of asthma medication and keep the triptans spaced out and minimal. I learn otherwise when I forget my triptan ‘rules’.

I used to think it literally was the asthma that caused me to begin to have adverse reactions to triptans… especially of the breathing sort. It just seemed to aggravate the asthma. Made sense to me. From what I knew of asthma. But it seems it just mimics the symptoms a great deal. And keep in mind my asthma is pretty mild in the sense I don’t get full blown asthma attacks. And also keep in mind I actually developed asthma while on Imitrex the most adverse reactions I’ve ever had to a triptan… they sort of blended very well together such that at first, had no idea it was asthma until i was taken off it due to the angina and the laying down and wheezing stuff didn’t go away. And doctors who say ‘you don’t wheeze’ from triptans vastly confused me. Because although clearly it is a rare side effect it does happen… I’ve seen it listed on more than one site for different triptans. I have been told in the past the wheezing was the asthma, but not chest pain, that was the triptan side effect… so I was like what? They both keep happening together with a migraine when I take a triptan? That is a big coincidence. And it seemed it was around that time I seemed to begin to have All these adverse affects to every damn triptan I touched… when I had not before. But it is clearly two different issues. Or long term triptan use when you are allergic to them isn’t a good idea. But it is clearly two different issues because I actually was taken off Amerge because it really caused significant breathing issues, no wheezing, just troubles breathing and a heaviness in the chest and a lot of shortness of breath for extended periods of time… prior to being diagnosed with asthma. I had forgotten about that because I had also been getting some extreme nausea… so the pills when I had menstrual migraines where not staying in me long enough to actually work. So I had been switched to… Maxalt.

I have in fact in the past been on I believe Amerge (my first triptan), Axert and Maxalt… with relatively little side effects. Then it seems starting with Amerge that second time and most definitely with everyone after Imitrex have had adverse reactions. So I have had migraines for about fifteen years or so… and for about ten of those years I have been switched around from triptan to triptan because of adverse reactions of the severe sort. Not like any of the side effects I have had have changed… same ones. Just slight variations with different triptans, but same side effects. And in general while there is some concern no one really did much… so really it is not so surprising I have ignored them. Not so surprising I can’t determine how severe is severe. And when the Cafergot reaction started I ignored it too, but it was making me so drained, unable to walk around, dizzy… I couldn’t function on it… and that was obviously important. And I had a problem with shallow breathing at night and then that weird falling down thing without the actual passing out bit… that sort of was enough is enough of this abortive that sucks as an abortive anyway. I’ll go back to my triptan with its numerous side effects thank you. I think there is only one triptan I have not tried. Otherwise I’ve run out. So it is either rotate back to ones I’ve been taken off of for adverse reactions or use ones that never worked like zomig.

Nevertheless I do have to wonder what made me so ‘reactive’ to them. I suppose it simply could be when I started using them regularly. Since that would be around the time my migraines became chronic… so using them more regularly. Instead of episodic. Makes sense I guess. Not much sense because when I was episodic I really don’t recall much side effects at all. I would not have had this issue of how severe is severe. Because I only had typical side effects. Maybe a bit with the skipped beats… that really seems to just happen. And I think some palpitations… they do seem to cause that when the triptan ‘kicks’ in… but if so it would have been short lasting and nothing too extreme.

But whatever. Seems like once a person has all these stupid side effects from every damn triptan they touch someone would look into it a bit further. Not like I have died or anything. But still. The fact my doctor got progressively more alarmed when i told her that she didn’t even want me to take the Maxalt at All suggests to me some of these side effects are alarming. At first she said use them less and get an EKG when you feel your heart rate change in any way. Then she really didn’t like the idea of me using it at all, but obviously I like the idea a Little since otherwise I just have T3s… so she said, okay, you can rarely but again the EKG. Normally they just switch me to another. So I’m not sure why she wants to have the EKG except to see what sorts of things are occurring. And I guess after seeing on the board how few people mentioned anything… maybe I should do that soon. I kept waffling. I took a Maxalt recently and of course right away I really felt the beat of my heart for the first few hours, with some frequent skipping beats and shortness of breath but my heart rate stayed stable so I was like that doesn’t seem that bad at all, but then later on as usually my heart really began pounding and pounding and I got those ‘mild’ chest pains and shortness of breath… but even that is a very typical thing to happen later in the day. That is in fact the pattern for one triptan. Sometimes there is a heart rate change in there too, sometimes not. It didn’t seem Extreme enough to warrant what she was looking for. Maybe if she could have caught it all from start to finish… but the side effects spread themselves out. So I wanted to wait for a batch that was pretty good. But… if no one gets any of these things, then I should just take it, wait for the whatever to start and get it done. She will likely get the uneven beats anyway, since that is always earlier.

I find it so hard to believe no one else gets this crap. Aside from the wheezing, which apparently no one gets. Aside from the angina, which is very rare for me. All the rest of it, can’t believe some of it or ranges of it… doesn’t occur in others. It astonishes me. Because I still don’t believe they are all that severe… I still think it is a matter of degrees. I get these side effects… but I don’t know if some of them are that important. Some might be. I just don’t know. Would have been nice to have others to compare notes with. Without that… I’m like is it a bad thing? https://w.atcontent.com/-/24mbdaAcP7g/nikki.albert/0oNV633wA6t.text/Panel/Autocheck

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2 comments

  1. I don’t think I get side effects from triptans, they just don’t relieve migraine pain for me at all in 75-80% of the times I have taken them, maxalt, imitrex, the ones you inhale, cafergot, none of them have been effective if I didn’t take them at the exact perfect time which was in the aura stage but before the head pain started. If the pain had started, I might has well have taken an m&m for all the good it was going to do me, and then I could at least have a better flavor to throw back up.
    Unfortunately, as far as pain management goes for me, I have to say the same thing about all of the medications I’ve tried as well. Especially the opiates. No relief and lots of vomiting. I will pass, thanks. NSAIDS, m&ms are seemingly as effective with fewer side effects. I miss vioxx, at least it helped with my joint pain, even if it did nothing for my migraines.

    Liked by 1 person

    1. I remember that triptans for me were far more effective before I became crhonic, but you are right, the success rate isn’t that awesome. And often even if it kills it, it comes back. Many a time it just dulls it, so half works and when that happens within hours it is back on full force. Unless you catch it right within the aura, but sometimes I want to ‘wait and see’ so I don’t waste the triptan… and then I lower the success rate substantially by doing so.

      Like

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