Migraine Heachache Therapy Drugs
We are committed to helping facilitate quality pharmaceutical care for your patients who are our members. Our pharmacy services program is designed to promote appropriate utilization of migraine medications.
Evidence from clinical studies published in current medical literature suggests that:
- many patients who use medications to relieve symptoms of a migraine headache may also benefit from taking one of several drugs that help prevent or reduce the number of headaches, and
- patients should have a follow-up meeting with their doctor to make ongoing treatment decisions.
When your patient fills a migraine medication prescription exceeding the quantities shown in the table below, the pharmacist will be alerted by a message on his or her computer system. Your patient will receive a 30-day supply of medication to minimize any disruption in your patient's therapy. We will send your patients some educational information encouraging them to talk with you about their current medication before they request further refills. We ask that you, the physician, review the patient's medications and determine whether or not the prescription treatment should be adjusted. If, in your medical opinion, the patient requires an exception to these limits, please contact us at 1-888-261-1756, Option 2, or fax us the attached form.
Note: Requesting an exception will make things easier for your patients. If the patient tries to refill the same migraine medication and you have not requested an exception, the pharmacy will receive another alert message and will be unable to fill the prescription until we receive a phone call from you.
| Migraine Headache Medications | ||
| Drug Name, Strength, and Dosage Forms | Quantities Allowed Without Requesting An Exception | Quantities Allowed Without Requesting An Exception |
| Amerge© 1mg and 2.5mg tablets | 23mg | 23 & 9 tablets, respectively |
| Axert© 6.25mg, 12.5mg tablets | 100mg | 16 & 8 tablets, respectively |
| Frova© 2.5mg tablets | 30mg | 12 tablets |
| Imitrex© 25mg, 50mg and 100mg tabs, kits, vials, nasal spray | 1200mg orally or its therapeutic equivalent* | 48, 24 & 12 tablets, respectively, OR 4 injectable kits (8 injections), OR 12 nasal sprays |
| Maxalt© 5mg and 10mg | 120mg | 24 & 12 tablets, respectively |
| Migranal© 4mg/ml Nasal Spray | 8 ampules | 8 ampules |
| Stadol© Nasal Spray | 3 canisters | 3 canisters |
| Zomig© 2.5mg and 5mg tablets | 45mg | 18 & 9 tablets, respectively |
* Imitrex 300 mg. orally is deemed equivalent to 12 mg. by injection or 60 mg. by nasal spray. The above quantity limit is adequate to treat at least four episodes of headache in a 30-day period.
For further information about managing migraine patients, you may wish to review the references below. If you have any questions regarding this program, please call Pharmacy Services at 1-888-261-1756.
REFERENCES: See also product information for each agent.
- Silberstein SD, for the US Headache Consortium. Practice Parameter: Evidence-based guidelines for migraine headache (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2000;55 (September):754-763.
- Rapoport AM and Adelman JU. Cost of Migraine Management: A Pharmacoeconomic Overview. Am J Managed Care 1998; 4(4):531-545.
- Tepper SJ. A Primary Care Approach to Migraine and Chronic Headache. Primary Care Reports. 1996; 2 (17):151-160.
- Gaist D et al. Is overuse of sumatriptan a problem? A population-based study. J Clin Pharmacol 1996; 50:161-165.
- New "Triptans" and Other Drugs for Migraine; Medical Letter 1998; 40 (Issue 1037):97- 100.
Below is a link for obtaining the Migraine Medication Fax-Back Form:
LifeWise – Migraine Medication Form
