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Suggest The Ideal Dosage For Maxalt Taken For Migraines
Question: Wife age 72 with recent onset of migraines. Occurring at night. Last night took a 5mg Maxalt and two hours later another one. Now midday 12 hours after last dose of Maxalt headache (bilateral forehead) back with a vengeance. Fiorinal has worked better in past so she just took one.
Can I give her another Maxalt right away also or wait 2 hours and repeat Fiorinal? Or wait 2 hours and restart
Maxalt's again?
Thanks for help
Can I give her another Maxalt right away also or wait 2 hours and repeat Fiorinal? Or wait 2 hours and restart
Maxalt's again?
Thanks for help
Brief Answer:
Maxalt is too early.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding the medication, since it has been only 12 hours after the last Maxalt I do not think it should be given for now. It is not recommended to take more than two doses of Maxalt in 24 hours. While at times in practice that rule is broken especially with 5mg formulations, in this case I wouldn't break it given the age factor, as medication like triptans may have increased chance of side effects in the elderly.
You may try another dose of Fiorinal in a few hours. If that doesn't work then medication with an antiemetic like 10 mg Metoclopramide has been shown to also reduce migraine headaches. It is more effective intravenously though so perhaps it may be administered in the ER. Other alternatives might be Ketorolac or in protracted cases (usually for headache lasting over 72 hours), intravenous valproate or rihydroergotamine is used - hope won't benecessary.
Also I wonder how the diagnosis was made if the headache has appeared only recently as you say. It is uncommon for migraine to appear so late in life, so a lot of caution must be made and when antimigrainous treatment doesn't work diagnosis must be reconsidered, brain imaging usually is advised.
I remain at your disposal for other questions.
Maxalt is too early.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding the medication, since it has been only 12 hours after the last Maxalt I do not think it should be given for now. It is not recommended to take more than two doses of Maxalt in 24 hours. While at times in practice that rule is broken especially with 5mg formulations, in this case I wouldn't break it given the age factor, as medication like triptans may have increased chance of side effects in the elderly.
You may try another dose of Fiorinal in a few hours. If that doesn't work then medication with an antiemetic like 10 mg Metoclopramide has been shown to also reduce migraine headaches. It is more effective intravenously though so perhaps it may be administered in the ER. Other alternatives might be Ketorolac or in protracted cases (usually for headache lasting over 72 hours), intravenous valproate or rihydroergotamine is used - hope won't benecessary.
Also I wonder how the diagnosis was made if the headache has appeared only recently as you say. It is uncommon for migraine to appear so late in life, so a lot of caution must be made and when antimigrainous treatment doesn't work diagnosis must be reconsidered, brain imaging usually is advised.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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