Migraine Drug Is in Demand : Health: Despite the high price tag of the newly available Imitrex, headache sufferers are flocking to doctors’ offices to get prescriptions for the medication.

The last time Lynn Hanson got a migraine headache, it lasted two days and she threw up repeatedly. She went to a hospital emergency room, waiting an hour with a sweat shirt draped over her head to shield her eyes from the light before giving up and going back home.

Then a week ago, when Hanson felt another migraine coming on, her husband drove her from their Long Beach home to the office of a Newport Beach neurologist, who tried a new drug on her. “I didn’t believe it was really going to work,” Hanson recalled.

But just 10 minutes after the drug sumatriptan was injected into her thigh, she started feeling relief, and Hanson joined the migraine sufferers who are beginning to flock to doctors’ offices throughout Orange County to get prescriptions for the medication--sold under the name Imitrex--that went on pharmacy shelves nationwide two weeks ago.

The relatively high price of the drug, which costs patients about $69 for a starter kit containing the injection mechanism and two doses, and about $32 for each subsequent dose, is expected to restrict its use among the poor and those without medical insurance covering prescription drugs.

But for many with acute migraines--there are about 27 million sufferers in the United States--price is no object.

“A lot of my customers say, ‘I don’t care how much it is if it will take away the pain,’ ” said Charles Bonner, pharmacist at Steven’s Pharmacy in Costa Mesa.

“It is definitely in demand,” said Karen Wiley, spokeswoman for Bergen Brunswig Inc., a large pharmaceutical wholesale company based in Orange. “Doctors and patients had been calling our customer service representatives since January asking for the delivery date.”

Wiley said the company sold its first shipment of the drug within a week and had to restock.

“I bought 50 kits the first day and I have gone through half already,” said Kasper Kinosian, owner of three pharmacies at Newport Center Medical Plaza in Newport Beach.

The prescription drug, marketed by Glaxo Pharmaceuticals, was approved for use in the United States by the Food and Drug Administration in December and has been available to physicians and pharmacists since March 29. It was already in use in Canada and Europe.

Dr. C. Philip O’Carroll, the Newport Beach neurologist who treated Hanson, specializes in treating headaches. He said most other drugs prescribed for migraines simply mask the pain, make headache sufferers sleep or, like caffeine, cause temporary relief followed by a greater rebound pain.

By contrast, he said, Imitrex “activates receptors in the brain which will close down the migraine cycle” by shrinking the dilated blood vessels in the brain that produce the headache. After an injection, a patient can go about daily chores without feeling drowsy.

Unlike narcotics, Imitrex is nonaddictive, according to O’Carroll. And unlike DHE 45, another blood-vessel-constricting drug used for migraines, Imitrex does not cause nausea. However, the drug can cause tingling, dizziness and other minor side effects, according to the manufacturer’s package insert.

Another major advantage of the new drug, O’Carroll said, is that it has been designed to be self-injected by patients in their own homes, eliminating the need for desperate visits to hospital emergency rooms when other remedies fail.

Dr. William Honigman, a staff physician in the emergency room at Kaiser Permanente Hospital in Anaheim, said that “finding relief for people with acute migraine headaches is a huge problem for us. Migraine is a bread-and-butter medical problem. We treat an awful lot.”

A Kaiser spokeswoman said Imitrex is being reviewed by a committee that determines what drugs can be prescribed by the huge health maintenance organization for its Southern California members. The committee, she said, will decide if the new drug is preferable to the drugs Kaiser is currently using.

Migraine patients on Medi-Cal, the state’s insurance for the medically indigent, can get Imitrex “no questions asked” for at least the next six months while the state tries to negotiate a contract with the manufacturer, said Scott Lewis, spokesman for the California Department of Health Services.

Although many poor people are covered by Medi-Cal, others have no insurance and aren’t likely to pay out-of-pocket for the expensive medication, according to health care providers.

Besides cost, another obstacle the poor face in obtaining the drug is that it must be prescribed by physicians who must educate their patients in its use, noted Dr. Mark Langdorf, assistant clinical professor of emergency medicine at UCI Medical Center. The facility treats many indigent patients in its emergency room.

“I think it will help the subset of patients that has a doctor who can prescribe it. But most of our patients at UCI don’t have a regular doctor they see and so our patients won’t really benefit,” Langdorf said.

Nor is Imitrex a panacea for migraines, O’Carroll cautioned.

O’Carroll, himself a migraine sufferer, said migraines will reoccur because of a genetic tendency that can be triggered in individuals by certain foods--such as red wine or ice cream--or by physical or emotional stress.

Migraines are most prevalent in females, with 21 million women diagnosed with the ailment in the United States compared with six million men, O’Carroll said. He attributes this difference primarily to society’s “oppression” of women, including that of overpowering husbands. Also, migraines can be prompted in women by the hormonal changes of the menstrual cycle.

While the new medicine can provide relief for the occasional severe migraine, O’Carroll said, chronic migraine sufferers need more comprehensive treatment, including help to withdraw from narcotics, caffeine and over-the-counter medications that can backfire by speeding up the pain cycle.

O’Carroll also advocates relaxation techniques, physical therapy and psychological counseling. He said he has discovered that many of his patients who have chronic migraines were victims of childhood sexual abuse or had alcoholic parents.

“There is no golden bullet that will relieve chronic headaches,” he said.