cluster headache, pay for oxygen

Q. I take Frova for migraines. It works great and doesn’t cause a rebound migraine. My only complaint is that it takes a long time to work, sometimes as long as two hours. That’s an eternity with a migraine.

I wondered if it would work faster if I placed it under my tongue, so I tried it. It tasted terrible, but my migraine was gone in about 15 minutes!

Is there some reason I should not take Frova sublingually? I read the pamphlet that came with it, and didn’t see anything about taking it sublingually. What do you think?

A. We suspect the nasty taste you noted would be enough to discourage most people from repeating this experiment. The drug companies are usually happy if their migraine products relieve pain within two hours.

We looked to see if frovatriptan is available as a sublingual tablet. It is not, but researchers in India have had success with a related medication, sumatriptan (International Journal of Pharmaceutical Investigation, July 2012). They found that they could mask the bitter taste and speed drug dispersion with this approach. Ask your doctor and pharmacist if your under-the-tongue trick is OK.

You will find more information on alleviating migraine headaches in our Guide to Headaches & Migraines. Some people can get relief from a migraine by inducing an ice-cream headache as the pain is just getting started. Others have found it helpful to eat hot, spicy soup such as gumbo or Chinese hot-and-sour soup.

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  1. HB

    I had the same thought as Julie713 regarding migraine medication, since the digestive system seems to not function well during the severe headaches. My neurologist suggested Nasal Imitrex. Squeezed into a nostril, particularly if there is a pre-migraine “visual aura,” that comes before the really bad ones, 90% relief is just a few minutes away, some nausea remains but pain is stopped. It’s expensive, but a generic is available. HB

  2. Julie713

    The LW’s comment reminded me that when I was first diagnosed with migraine, my doctor prescribed a suppository version of Cafergot (ergotamine tartrate) that worked very fast when a headache had progressed too far to take oral medication. The secret was to bypass the digestive system and suppositories did just that. Seems like pharmaceutical companies could create a sub-lingual wafer for their migraine meds if the idea were on their radar. Perhaps we customers just need to ask…

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