Zomig spray and pill.

Richard

You can use a second spray after 2 hours if the attack is still present. But no more than 2 in 24 hours.

I use the sprays,  but I don't mix them with the melts as the melts are slower to work.

Some people would say go for the injections as the medication works faster but it's whatever works for you.

Are you also using oxygen?......It's the way to go!

John

Hello Richard,

My husband uses the Zomig nasal spray, but as we understand it you have to wait 2 hours before you can have a second dose, and definitely only 2 in any 24hrs. 

The NICE guidelines tell the GPs that people with CH should be prescribed nasal or injectable Triptans, and also state that oral Triptans should not be given to treat Cluster Attacks. I think that is because they are absorbed slower and take too long to get into the system to be much help. Whereas the nasal and injection forms are absorbed much faster and therefore have a hope of aborting the attack. I may be wrong, but if don't think Zomig is available in injection form.

Regarding the idea of having the oral and nasal forms, I just wonder what your GPs thinking actually is?

From a safety point of view there would be an issue if the combined amount of the melt and the spray equalled an overdose. As far as I can see the maximum single dose is 5mg not to be repeated within 2hours and the maximum in any 24hour period is 10mg. 

Personally I would follow the directions from the manufacturer, unless an expert in CH was able to give a very clear explanation of the reasons why they know it is ok to do something different. GPs do seem to have some unusual ideas where CH is concerned!

It would be interesting to hear if anyone else has been prescribed the melt and the spray concurrently, or been directed away from the manufacturers guidelines.....

Harriet

2 triptans in a 24 hour period maximum.

"Regarding the idea of having the oral and nasal forms, I just wonder what your GPs thinking actually is?"

Cost. Plain and simple.