My daughter suffers daily severe migraine headaches with optical involvement. The doctor she saw put her on Zomig. Zomig works but it is very expensive and she does not have insurance. Is there any other drug available in generic that mimics Zomig? She plans on going back to work in the next 3 months but these constant migraine are interfering with her life and her interaction with her 2 children. She is a single mom.
Person's Gender: Female
Person's Age: 39
HI. I'm a neurologist and can answer your question. Zomig is a good drug, but is in a class of medications for treating migraine abortively called tryptans. There are many brands of tryptans, and the drugs themselves are slightly different in there chemical configuration, so they may work based on individual characteristics of binding to the serotonin receptors on the blood vessel, this gets complicated fast, but genetic factors probably play a role as to which tryptan works better on which patient, but we don't know how to figure that out, so it is trial and error with all of the tryptans. That having been said, there is also differences in uptake after oral injestion and that plays a role in efficacy. Some tryptans have melt forms that give better uptake, some meds have alkaselzer like pop pop fizz fizz characteristics (I think they call it DSC technology) for better uptake. Also each tryptan has a different half-life in the body which effects its effficacy.
That having been said, it is a crap shoot sometimes and you have to try it to find out if it works. If Zomig works, she might do well with a drug call Imitrex, which is expensive, but they make a generic (sumitryptan) which is cheaper. Hope that helps, hit the accept unless you have more questions. thanks
She has tried imitrex and it caused a bad reaction. The zomig was a nasal prescription. But who wants to use zomig everyday. Long range I don't think that is good - I don't know. Any other ideas???
Absolutely correct. She cannot use tryptans everyday for several reasons, the most important is that it sensitizes your cardiac circulation and can cause long term effects, especially with a family history of stroke or heart disease. She can use tryptans no more than twice a week, or she can try Frova, which has the longest half life, and can be taken daily. Does she keep a headache calendar? does she have primarily menstrual migraine with headache preceeding her period? If she is having headaches daily, she needs a palliative approach, taking a medication to reduce the frequency and severity of headaches. Topiramate (topamax) or Lamotrigine (lamictal) are the more commonly used agents. I hope that helped, hit the accept or ask another question. thanks
General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics