Rimegepant and Sumatriptan injections together?

[SkippyPlatt]

Hi there, I have had chronic migraine for the last 13 years but have had them every single day for the last 2 years. I have a monthly Galcenezumab preventative injection and treat them acutely with a sumatriptan injection and soluable aspirin which I was recommended to take in a sugary fizzy drink (I use Lucozade). The effectiveness of this has diminished in that it sometimes works and sometimes doesn’t.

I’ve finally been prescribed Rimegepant as an acute treatment and my question is can I take it alongside my sumatriptan injections? I wouldn’t use them both to treat the same migraine but perhaps use different ones on different days depending on need.

I have so many migraines I’m always at risk of overuse so it would be amazing to be able to treat more of them by using both medications within their individual guidelines. This would give me so much of my life back. My neurologist is pretty useless so can’t get the answer I need from him.

I’d really appreciate any advice from people who have been prescribed Rimegepant either as a preventative or for acute use and whether they continued with their other acute treatments. Thanks so much.

[Mary1959]

Hi so sorry to hear about your pain for so long. I've had similar for the last year. I was prescribed Aimovig injections but still take sumatriptan when I have a bad episode. The aimovig does help and makes the migrane S less severe but I sometimes need both. I also have cocodamol for not so bad migranes. I had to come off the triptans when I first started the Aimovig, to see what effect it had against my migrane on its own but I'm on my 5th injects now so can take other medication too. Really hope you soon feel better, it's so miserable isn't it. I've started using voltorol gel on my neck at nights, as I get pain in my neck as well as head, and it does seem to help. Take care

[SkippyPlatt in reply to Mary1959]

Thanks so much for replying, yes you’re right migraine is so miserable isn’t it? Glad you’re getting a bit of relief from the Volterol. I tend to sleep with the Lloyds pharmacy migraine tens machine on my forehead which can sometimes help a bit but sometimes just be a welcome distraction. Other times I sleep in a migraine relief cap, one of the ones that’s covered in ice packs and makes you look like you’ve been kidnapped when you wear it😂I’ve been waiting for so long to get Rimegepant on the NHS but so far it hasn’t really worked for me. I will try again and maybe it’ll work better in conjunction with my injectable sumatriptan. Wishing you all the best.😊

[Xandi2]

If my rimegepant doesn't work I take a rizatriptan, my lady at the national migraine centre said that was ok to me.

[SkippyPlatt in reply to Xandi2]

Thanks so much for this. That gives me confidence. I was a patient at the National Migraine Centre myself about 10 years ago under the care of Dr Katy Monroe who was brilliant. Unfortunately as I live a long way from London it just became too much travelling and I now see a neurologist at my local hospital. He’s pretty rubbish tbh and doesn’t seem very informed or even that interested in migraine. He told me to stop taking my injectable sumatriptan if I wanted to try Rimegepant and that I wouldn’t be able to go back to taking the injectable sumatriptan if the Rimegepant didn’t work. This didn’t make sense to me as people who take Rimegepant as a preventative presumably still treat their migraines with a Triptan so presumably they can both be used together. And not being able to go back to it if the Rimegepant didn’t work I thought was just nonsense. It’s so frustrating to have a neurologist who can’t answer your questions and is unwilling to look into anything. Thanks again for your reply and hope your migraines are under control ☺️

[Pingez]

Good morning. My short answer to this would be take what you like when you like provided you stick to the dosage on each mediation. I speak as someone who has trodden this path last year.To clarify.

I have been desperately trying to ameliorate the effects of chronic migraine for quite a while and have been willing to throw quite a bit of money about in order to do it.

At one time I was taking a CGRP drug ( all 3 injectables at different times), alongside Botox and Remegepant. I was first given a prescription for this to take as an acute mediation to prevent the need for triptans. It didn't work, so I carried on taking them as a preventative for 6 months. Again it didn't really work, especially as they were hideously expensive at the time ( over £500 a month). Not sure what the cost is now. Obviously, as they didn't work too well, I needed to take triptans as well. Now, some chemists warn about not taking a triptan within 24 hours of taking Remegepant, which for me was almost useless as I was regularly taking R, but still getting migraine. I asked my neurologist about this and he did a bit of research for me and told me there was nowhere in any of the literature about this drug that it couldn't safely be taken with triptans, despite the guidance from Lloyd's pharmacy. So, I just carried on taking triptans as I needed them without any difficulties at all.

Incidentally, I am now on the Vyepti infusion and things are quite a bit better. Finally I've stopped being sick, after losing 4 stones in weight over the last 3 years without trying. My weight reached a worrying level at one point, so this life saver has come just in the nick of time for me.

Finally putting weight back on, not losing it.

Hope this has been of some help.

[SkippyPlatt in reply to Pingez]

Thank you so much for your reply, and sorry to hear you’ve been suffering so much. It’s just the pits isn’t it? I’d been waiting for Rimegepant to be prescribed for acute treatment on the NHS and FINALLY got it after years of waiting!!! It was initially only available as a preventative for people with episodic migraine so I didn’t qualify as my migraines are chronic (daily for the last 2 years) It’s rubbish you’ve had to spend so much money. I’d also be interested in the Vyepti infusion but at present my hospital doesn’t provide this even though NICE says everyone who needs it should be able to access it. Seems to be a bit of a postcode lottery. Glad to hear this is helping you and gives me hope that it might be something that works for me too as we seem to have tried most of the same things. I’ve taken my first Rimegepant to treat a migraine and unfortunately it did precisely nothing so I went ahead and used a Triptan which helped. As I mentioned in response to another reply my neurologist is useless and I’m usually left to research everything myself then try to persuade him to prescribe things for me. He seems weirdly terrified of prescribing anything and is more interested in running his clinic on time. I’ll keep looking for ways to access Vyepti but in the meantime have a bit of confidence that I can take Rimegepant and sumatriptan injections together should I need too so thanks again for you advice. Hope you continue to feel better☺️

[Pingez in reply to SkippyPlatt]

Thank you for your reply. Sorry to hear about Remegepant not working on your migraine. That is what I found, but lived in hope it would work as a preventative. You could try this if your doctor will let you.I'm glad NICE have changed the rules about Remegepant for chronic migraine because I'm sure it must help some of us.

The Vyepti I'm taking I'm paying for. To be honest I didn't even bother going to my gp. There's no point. They haven't even the confidence to alter my triptans without a notification from my neurologist.

Actually, I've had to travel down to Kent for this ( I'm based in Sheffield, so it's a bit of faffing about and requires an overnight stop because at my age, I can't spend too long sat down travelling).

My usual neurologist in Leeds couldn't arrange Vyepti for me, so I had to do it via the National Migraine Centre. They have 3 places to do this: London, Rochester and Glasgow. Rochester seemed like the easiest option, but I wish it had been Manchester or somewhere like that. Goodness knows how you'd cope living in Cornwall.

Fingers crossed for some success for you. X