Generic Injectable Imitrex (Sumatriptan) Now Available

The generic version of Imitrex Injection (called sumatriptan) is now shipping in the US. I don’t know if it is available in other countries, nor do I know when/if the tablets will be available. I doubt all pharmacies have it in stock yet. I recommend calling your pharmacy before taking your prescription in.

From Par Phamaceutical’s press release:

Par Pharmaceutical Begins Shipment of Sumatriptan Injection
November 6, 2008 – Par Pharmaceutical Companies, Inc. today announced that it will begin shipping generic versions of Imitrex® Injection (sumatriptan succinate injection) 4mg and 6mg starter kits and 4mg and 6mg prefilled syringe cartridges to the trade immediately.  In addition, Par anticipates launching the 6mg vials early next year.

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Maybe Birth Control Pills Would Be OK

Talking to Hart about hormonal birth control, migraine and stroke risk got me wondering what my risk really is. If it is low, multiplying the number by eight isn’t that big of a deal. Kersti explains this well in her comment on the post:

[T]he problem with statistics is that they’re misleading. 8 times more likely… 8 times what? You need to find out what the baseline actually is, and you need to find it out for your own ethnicity, gender, circumstances before you know if this is a problem. If for example the baseline is 10% then 8 times is pretty ghastly, however, if the baseline is 0.01% then you’re still at 8 times 99.92% likely to NOT get one.

I’m kind of embarrassed I didn’t think this through before I wrote the post. I’m always urging readers to think critically. No matter how much I recommend caution, I too fall into the trap of fear. “Stroke? Eight times more likely? No way!” is how I reacted yesterday.

According to the American Heart Association’s stroke risk factors, I’m at very little risk. That’s reassuring. I’ll talk with the doctor on Monday and see what she recommends.

Check out the this BBC article on understanding — and critically evaluating — statistics, which Kersti suggested.

Sorting Out My Hormonal/Menstrually Associated Migraines

As the frequency of my migraine episodes has reduced this year, I was finally able to tell that I always get a migraine the first and second or third day of my period. Today once again provided confirmation.

My plan was to try hormonal birth control, like the pill, as a preventive. Researching this post has me reconsidering. Turns out women with migraine who use birth control pills are eight times more likely to have a stroke than women who don’t. This applies to everyone with migraine, not just those with aura (who are twice as likely to have a stroke than migraineurs who don’t have visual auras).

Other treatment options exist. Most of them I’ve already taken without success. Magnesium, which I think is responsible for decreasing the frequency of my migraines, is a common treatment. Unfortunately I’m already at the highest dose of magnesium I appear to be able to tolerate without extreme nausea.

I found on headache specialist Christina Peterson’s website that a small study of black cohosh shows it may be effective in treating menstrually associated migraine. Because there has only been one study, there is no confirmation that it works. Nonetheless, I’ll be researching black cohosh extensively. It is in the same family as rununculus, one of my favorite flowers — maybe that’s a sign it will help my head!

I thought hormonal birth control would be the ticket. A stroke would certainly be worse than having two more migraines a month.

If your migraines are associated with your menstrual cycle, please let me know if you’ve found an effective treatment. Leave a comment below or respond to the forum post with your suggestions.

Lower Risk of Breast Cancer for Women With Migraine

Finally, some good news for migraineurs. Women with migraine had a 30 percent lower risk of breast cancer than those without, according to a recently released study. Hormonal changes, which commonly trigger migraine, are a potential link.

In particular, migraine history appeared to reduce the risk of the most common subtypes of breast cancer: those that are estrogen-receptor and/or progesterone-receptor positive. Such tumors have estrogen and/or progesterone receptors, or docking sites, on the surface of their cells, which makes them more responsive to hormone-blocking drugs than tumors that lack such receptors.

The biological mechanism behind the association between migraines and breast cancer is not fully known, but Li and colleagues suspect that it has to do with fluctuations in levels of circulating hormones.

About My Dad

I’m finally ready to tell you about my dad, Lee Smyres. He was 65 when he died, but everyone said he looked 10 years younger. He grew up on a farm in Kansas. Even though he was a practicing CPA, he was on the farm at heart.

He was loving and kind. He always saw the good in people, often to the point of not seeing anyone’s faults. He was always ready to help anyone. He’d give the shirt off his back, and then some, to anyone. I know people tend to exaggerate this sort of thing when someone dies. In his case it’s true.

He wore glasses like the ones in this picture my entire life; up until a few years ago when his optician couldn’t replace the frames.

He loved sweets. Candy, cookies, cake — it didn’t matter. He often had chocolate in the corners of his mouth. One year he ate a five pound box of candy between Christmas and New Year’s. Really.

When I cooked or baked, he cleaned up the kitchen. If I burned the cookies (which was often), he’d patiently stand at the sink, scraping the black off the bottom of every cookie. I’m sure it was as much about making me feel better as it was about eating the cookie.

He worked hard. Hart’s and my first house in Phoenix was built on the road of old farmland. My dad came over with a pick axe and broke up the hard soil. He was 57 at the time. That’s just one example of many, though. He was always at work on many projects simultaneously.

He was devoted to his church, serving on countless committees, volunteering for whatever needed to be done, cooking huge meals along with my mom, singing in the choir. If he wasn’t at home or work, he was doing at the church.

He loved to watch sports. He’d sit in the corner of the L-shaped sofa. His legs stretched out on one end and a pile of newspapers on the other side. He was so laid back that my sister’s friends thought he was on drugs.

He was always forgetting things, often driving away with his coffee cup or cell phone on his truck’s bumper.

My parents taught the three-year-old Sunday School class for almost 20 years. He spent many Saturday nights in front of the TV, cutting out parts of craft projects.

He loved to exercise. When I was young, his obsession was the NordicTrack. The Bowflex was the miracle exercise machine for about the last 10 years. He thought the Bowflex could do anything. All spring, he talked about getting back on the Bowflex, knowing he would feel better if he could just build up his muscles again.

He was proud of me and thought I could do anything. He got it in his head that I was going to write a book. When I was with him at the hospital in July, he asked several times how my book was coming. (I’m now starting to work on a novel.)

I miss him. It hurts more than I can possibly describe. But as far as grief goes, I have it pretty good. After he started getting sick two years ago, I’d sit next to him on the couch when I’d visit. He’d put his arm around me and tell me how much he loved me.

I’m the only person who could out-stubborn him and we butted heads a lot. But I know he forgave me for anything I’ve done to hurt him. I got to spend a lot of time with him in the last couple years and we laughed much of that time. I don’t have to wrestle with regret or what ifs. I just have to learn to live without him.

When he got out of the hospital he wanted three things. To volunteer at the church, sing in the choir again, and get a new truck. He only wanted more of what he already had. What a beautiful testament to how he lived his life.