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Suggest Treatment For Migraine And Nausea
Question: Dear Dr.
I am a working woman of 42 years of age. having severe head ache (Migraine). Head ache started from Dec 2007 onwards. Also diabetic since 2006. head ache was severe 4-6 times monthly and lasts for 1-3 days. vomiting sensation, heavy eyes. are the symptoms. tried Homeopathy did not find any use. in Dec 2013 wend to dr. who is physician and Cardiologist. that time (Dec 2013) BP was 170/90. He presecribed Grenil F10 (0-0-1), Newtel H 40 (1-0-0), Bigomet 850mg (1-0-1). Vasograin/dispirin/Grenil plain in case of SoS. Pluse iron tablets. Used this medication for 6 months head ache came down drastically. Went to Doctor, in May 2014, sugar level was high he prescribed ISRYL 1mg (1-0-1) and Newtel H 40 reduced to (1/2-0-0) and other medicines continued. BP was 110/80. Took this medication for 5 months there was occassional migraine attack. Went to Dr. for periodic check during Oct 2014. Sugar was well in control, dr. reduced Isryl 1mg dosage (1-0-0). Also changed Newtel H40 to Newtel 20mg (1-0-0). BP was 130/80. Added TRYPTOMER 10mg (0-0-1). Started taking the prescribed medicines. Gradually migraine attack increased. It is almost returned to 1-2 attacks per week. Earlier it used to get controlled easily by 1 vasograin tablet. Last 2-3 days it became so severe it took 2-3 vasograin (with a gap of 4-5 hours)to get it control. Today again started at noon 12 o clock. Severe ache on top of the head. Went to neary Dr. he presecribed Meftal Forte for 3 days. I really became depressed. was happy that Head ache almost reduced, but again come back. Pls advice.
I am a working woman of 42 years of age. having severe head ache (Migraine). Head ache started from Dec 2007 onwards. Also diabetic since 2006. head ache was severe 4-6 times monthly and lasts for 1-3 days. vomiting sensation, heavy eyes. are the symptoms. tried Homeopathy did not find any use. in Dec 2013 wend to dr. who is physician and Cardiologist. that time (Dec 2013) BP was 170/90. He presecribed Grenil F10 (0-0-1), Newtel H 40 (1-0-0), Bigomet 850mg (1-0-1). Vasograin/dispirin/Grenil plain in case of SoS. Pluse iron tablets. Used this medication for 6 months head ache came down drastically. Went to Doctor, in May 2014, sugar level was high he prescribed ISRYL 1mg (1-0-1) and Newtel H 40 reduced to (1/2-0-0) and other medicines continued. BP was 110/80. Took this medication for 5 months there was occassional migraine attack. Went to Dr. for periodic check during Oct 2014. Sugar was well in control, dr. reduced Isryl 1mg dosage (1-0-0). Also changed Newtel H40 to Newtel 20mg (1-0-0). BP was 130/80. Added TRYPTOMER 10mg (0-0-1). Started taking the prescribed medicines. Gradually migraine attack increased. It is almost returned to 1-2 attacks per week. Earlier it used to get controlled easily by 1 vasograin tablet. Last 2-3 days it became so severe it took 2-3 vasograin (with a gap of 4-5 hours)to get it control. Today again started at noon 12 o clock. Severe ache on top of the head. Went to neary Dr. he presecribed Meftal Forte for 3 days. I really became depressed. was happy that Head ache almost reduced, but again come back. Pls advice.
Brief Answer:
Use Grenil rather than Tryptomer for prevention/Avoid trigger factors.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I appreciate that you have provided such an elaborative medical history.The conclusion I have drawn from your case history is that-
You are having chronic migraine which is responsive to flunarizine (Grenil) as a preventive medicine, rather than amitriptyline(tryptomer).This goes well with migraine as migraine headache may respond to different class of drugs in different individuals.
So,I advise you to start again on Grenil(flunarizine) as preventive therapy and along with vasograin,rizact(rizatriptan) or sumatriptan as abortive therapy.
Changes in antihypertensive or diabetes medicines should not be the cause of headache,till blood pressure is normal.You should continue with antihypertensive and diabetes medicines,monitoring your blood pressure and blood sugar,respectively and simultaneously.
Lastly,It is very crucial to identify what are your trigger factors which precipitates your migraine episodes.These can be stress,sunlight,smoke,food items like cheese,tea,coffee or any other factor.A trigger factor can be anything and it can vary from individual to individual.Please try to identify your trigger factor and eliminate it from your life style.It is the actual cure of the headache.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Use Grenil rather than Tryptomer for prevention/Avoid trigger factors.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I appreciate that you have provided such an elaborative medical history.The conclusion I have drawn from your case history is that-
You are having chronic migraine which is responsive to flunarizine (Grenil) as a preventive medicine, rather than amitriptyline(tryptomer).This goes well with migraine as migraine headache may respond to different class of drugs in different individuals.
So,I advise you to start again on Grenil(flunarizine) as preventive therapy and along with vasograin,rizact(rizatriptan) or sumatriptan as abortive therapy.
Changes in antihypertensive or diabetes medicines should not be the cause of headache,till blood pressure is normal.You should continue with antihypertensive and diabetes medicines,monitoring your blood pressure and blood sugar,respectively and simultaneously.
Lastly,It is very crucial to identify what are your trigger factors which precipitates your migraine episodes.These can be stress,sunlight,smoke,food items like cheese,tea,coffee or any other factor.A trigger factor can be anything and it can vary from individual to individual.Please try to identify your trigger factor and eliminate it from your life style.It is the actual cure of the headache.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I am already on Grenil F10. following are the medicines i am taking.
1) Tab ISRYL 1mg 1-0-0
2) Tab BIGOMET 850mg 1-0-1
3) Newtel 20mg 1-0-0
4) Grenil-F 10mg 0-0-1
5) Ecosprin 75mg 1-0-0 Ecosprin was started some time during early 2008. Suddenly one day (Jan 2008) was not able see left most side from left eye. Went for eye test and head scan. Dr. said some minor blood clot in the brain which could be the reason for vision blurring (left eye only left most side) which cannot be repaired and some time it may become normal. prescribed Ecosprin to avoid future such things
6) tab SUPRADYN 0-0-1
7) tab FERSOLATE-CM 1-0-1
8) Tab Fol-5 0-0-1
9) Tryptomer 10mg 0-0-1 (for 3 months)
Tab Vasograin/Disprin 350mg/Grenil plain on SOS basis
In spite of above medicines are being taken from last 5 months still migraine attack is continuing. Dont know the reason
Two days back Dr. also prescribed INDERAL 40mg (0.5-0-0.5) yet to start this medicine (INDERAL)
some of the triggers which noticed was Stress (Since she is working teacher correction pressure), Long standing for teaching (Continuous teaching period)Intracourse, if you XXXXXXX the hair that day or next day it is sure to come, Sun light (Generally it starts in the day time 12 to 3 range), during mensuration, 1-2 days before mensuration and also 1-2 days after mensuration
My question is : 1) how to avoide these triggers
2) I am taking Grenil F 10, Tryptomer 10mg still migraine attack is there and now INDERAL 40mg (I understand it is Propranolol) is added which i am yet to start
Is it ok to take all 3 medicines (Grenil F 10, Tryptomer 10mg and INDERAL 40mg)
for long time as a preventive medicine?
3) Also can u detaile it out about abortive medicine which u have suggested with dosage details. is it required both vasograin, rizatriptan/sumotriptan both needs to be taken when it occurs. What is the dosage, shoud i repeat after few hours if it does not subside and any other medication
Some time feel very sad i am taking so many medicines at this age.
Pls advice
1) Tab ISRYL 1mg 1-0-0
2) Tab BIGOMET 850mg 1-0-1
3) Newtel 20mg 1-0-0
4) Grenil-F 10mg 0-0-1
5) Ecosprin 75mg 1-0-0 Ecosprin was started some time during early 2008. Suddenly one day (Jan 2008) was not able see left most side from left eye. Went for eye test and head scan. Dr. said some minor blood clot in the brain which could be the reason for vision blurring (left eye only left most side) which cannot be repaired and some time it may become normal. prescribed Ecosprin to avoid future such things
6) tab SUPRADYN 0-0-1
7) tab FERSOLATE-CM 1-0-1
8) Tab Fol-5 0-0-1
9) Tryptomer 10mg 0-0-1 (for 3 months)
Tab Vasograin/Disprin 350mg/Grenil plain on SOS basis
In spite of above medicines are being taken from last 5 months still migraine attack is continuing. Dont know the reason
Two days back Dr. also prescribed INDERAL 40mg (0.5-0-0.5) yet to start this medicine (INDERAL)
some of the triggers which noticed was Stress (Since she is working teacher correction pressure), Long standing for teaching (Continuous teaching period)Intracourse, if you XXXXXXX the hair that day or next day it is sure to come, Sun light (Generally it starts in the day time 12 to 3 range), during mensuration, 1-2 days before mensuration and also 1-2 days after mensuration
My question is : 1) how to avoide these triggers
2) I am taking Grenil F 10, Tryptomer 10mg still migraine attack is there and now INDERAL 40mg (I understand it is Propranolol) is added which i am yet to start
Is it ok to take all 3 medicines (Grenil F 10, Tryptomer 10mg and INDERAL 40mg)
for long time as a preventive medicine?
3) Also can u detaile it out about abortive medicine which u have suggested with dosage details. is it required both vasograin, rizatriptan/sumotriptan both needs to be taken when it occurs. What is the dosage, shoud i repeat after few hours if it does not subside and any other medication
Some time feel very sad i am taking so many medicines at this age.
Pls advice
Brief Answer:
Grenil F,Tryptomer and Inderal can be taken together.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I appreciate that you have very well observed the trigger factors that precipitate your migraine headache.
Let me answer your questions point wise-
1)Some of the measures to alleviate your trigger factors-mental relaxation exercises/yoga/meditation to reduce stress levels.
Take an umbrella or some alternative method of shade to prevent sunlight triggered headache.
Use some alternative for hair XXXXXXX or see if changing the brand of hair XXXXXXX works for you.
1)You can start taking non steroidal anti-inflammatory drugs to stop menstrual migraine,as they are considered the drugs of choice.Otherwise,for preventive aspect,management follows the general protocols for migraine treatment.You just have to be regular in your preventive medicines or just may have a bit higher dose for those 3-4 days,like tryptomer 20 mg instead of 10 mg.I understand that this particular trigger factor can't be avoided.
2) Grenil F,Tryptomer and Inderal can be taken together in the doses you mentioned.These are just the starting doses which are unlikely to have any adverse effects.These drugs don't have any significant interactions among themselves.
3)It is not preferable to take both -vasograin and triptans.If vasograin is not working now,please try triptans.Try Rizatriptan 10 mg at at the time of headache.It can be taken 2-3 times a week.If still further medicine is required,Non steroidal anti-inflammatory drugs should be taken as add-on.Opioids like tramadol may also be taken as add-on.85 mg sumatriptan can be taken instead of rizatriptan.
PLEASE TAKE MEDICINES UNDER YOUR PHYSICIAN'S GUIDANCE.
Do not worry. Sometimes it is required to take medications in that quantity to keep the migraines at bay. Anyway there is no cross interaction between the drugs, so don't worry about it.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Grenil F,Tryptomer and Inderal can be taken together.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I appreciate that you have very well observed the trigger factors that precipitate your migraine headache.
Let me answer your questions point wise-
1)Some of the measures to alleviate your trigger factors-mental relaxation exercises/yoga/meditation to reduce stress levels.
Take an umbrella or some alternative method of shade to prevent sunlight triggered headache.
Use some alternative for hair XXXXXXX or see if changing the brand of hair XXXXXXX works for you.
1)You can start taking non steroidal anti-inflammatory drugs to stop menstrual migraine,as they are considered the drugs of choice.Otherwise,for preventive aspect,management follows the general protocols for migraine treatment.You just have to be regular in your preventive medicines or just may have a bit higher dose for those 3-4 days,like tryptomer 20 mg instead of 10 mg.I understand that this particular trigger factor can't be avoided.
2) Grenil F,Tryptomer and Inderal can be taken together in the doses you mentioned.These are just the starting doses which are unlikely to have any adverse effects.These drugs don't have any significant interactions among themselves.
3)It is not preferable to take both -vasograin and triptans.If vasograin is not working now,please try triptans.Try Rizatriptan 10 mg at at the time of headache.It can be taken 2-3 times a week.If still further medicine is required,Non steroidal anti-inflammatory drugs should be taken as add-on.Opioids like tramadol may also be taken as add-on.85 mg sumatriptan can be taken instead of rizatriptan.
PLEASE TAKE MEDICINES UNDER YOUR PHYSICIAN'S GUIDANCE.
Do not worry. Sometimes it is required to take medications in that quantity to keep the migraines at bay. Anyway there is no cross interaction between the drugs, so don't worry about it.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Answered by
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