Is a generic injection prescription of Imitrex equivalent to the brand injection version of Alsuma. 14 year old girl with severe chronic migraine successfully took Alsuma injection yesterday with some migraine relief (mild nausea and other minor side effects) compared to rapid heart beat and more significant reactions to Imitrex nasal spray many years ago. Desperate for relief and can no longer take ibuprophen due to .9 creatinine levels. Topamax too dulling. Also patient is on 30 mgs of fluoxetine and 150 of welbutrin. Is this too high a risk for serotonin syndrome if injections are very limited and there are NO other relief options?