How Do Health Care Professionals Use Prescription Medications Off
Sometimes health care professionals use medications in a way thats different from what the FDA has approved. Thats called off-label use. By choosing an off-label medication to treat overweight and obesity, your health care professional may prescribe
- a drug approved for treating a different medical problem
- two or more drugs at the same time
- a drug for a longer time period than approved by the FDA
You should feel comfortable asking whether your health care professional is prescribing a medication that is not approved for treating overweight and obesity. Before using a medication, learn all you need to know about it.
What Are The Different Types Of Migraine Medications
Migraine medications fall into two major categories.
- The first contains drugs that abort or stop migraines from progressing once they begin. The earlier these drugs are used in a migraine attack, the better they work.
- The second category contains drugs that prevent migraines from happening.
- Or combinations of these
One drawback to using analgesics and NSAIDs is that taking them daily can make headaches worse due to medication overuse.
Prescription drugs used to provide relief from pain include
- NSAIDs and
Like over-the-counter medications, prescription drugs often come in combinations.
- A barbiturate called butalbital is often used in combination with acetaminophen, and
- caffeine with or without codeine .
While analgesics, NSAIDs, and narcotics relieve pain, they don’t address the underlying physiology — primarily the dilation of blood vessels in the brain. Two classes of migraine drugs are:
- ergotamines and
Ergot alkaloids — such as ergotamine tartrate and dihydroergotamine mesylate — are potent drugs that constrict blood vessels. Because nausea is a possible side effect of these migraine drugs, some people take ergotamines in combination with other drugs to prevent nausea.
What Symptoms Must You Have To Be Diagnosed With A Migraine
Migraine with aura . This is a headache, plus:
- Visual symptoms or vision loss.
- Sensory symptoms .
Migraine without aura . A common migraine is a headache and:
- The attacks included pain on one side of your head.
- Youve had at least five attacks, each lasting between four and 72 hours.
Plus, youve experienced at least one of the following:
- Nausea and/or vomiting.
- Lights bother you and/or you avoid light.
- Sounds bother you and/or you avoid sounds.
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People Who Are Underweight Also Appear To Be At Higher Risk For Migraine
There is a modest increased risk for migraine in people who are underweight, according to Bond.
The same 2017 meta-analysis that show a higher risk of migraine in people with obesity also found that people who had a BMI of less than 18.5 generally considered the lower end of normal had a 13 percent greater risk for migraine compared with people of normal weight.
The risk in terms of weight status seems be greater for those who have obesity versus those who are underweight, Bond comments.
How Long Will I Need To Take Weight Management Medication
How long you will need to take weight management medication depends on whether the drug helps you lose weight and keep it off and whether you experience serious side effects.
If you have lost enough weight to improve your health and are not experiencing serious side effects, your health care professional may advise you to stay on the medication indefinitely. If you do not lose at least 5% of your starting weight after 12 weeks on the full dose of your medication, your health care professional will probably advise you to stop taking it. Your health care professional may also
- change your treatment plan or consider using a different weight management medication
- have you try different lifestyle, physical activity, or eating programs
- change your other medications that might be causing weight gain
- refer you to a bariatric surgeon to see if weight-loss surgery might be an option for you
Because obesity is a chronic disease, you may need to continue your new eating and physical activity habits and other behaviors for yearsor even a lifetimeto improve your health and maintain a healthier weight.
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How Should This Medicine Be Used
Phentermine and topiramate come as extended-release capsules to take by mouth. The medication is usually taken with or without food once a day in the morning. This medication may cause difficulty falling asleep or staying asleep if it is taken in the evening. Take phentermine and topiramate at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take phentermine and topiramate exactly as directed.
Your doctor will probably start you on a low dose of phentermine and topiramate and increase your dose after 14 days. After you take this dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, your doctor may tell you to stop taking phentermine and topiramate or may increase your dose and then increase it again after 14 days. After you take the new dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, it is not likely that you will benefit from taking phentermine and topiramate, so your doctor will probably tell you to stop taking the medication.
Phentermine and topiramate may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.
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How Are Migraines Diagnosed
To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your familys, too. Also, they’ll want to establish a history of your migraine-related symptoms, likely asking you to:
- Describe your headache symptoms. How severe are they?
- Remember when you get them. During your period, for example?
- Describe the type and location of your pain. Is the pain pounding? Pulsing? Throbbing?
- Remember if anything makes your headache better or worse.
- Tell how often you get migraine headaches.
- Talk about the activities, foods, stressors or the situations that may have brought on the migraine.
- Discuss what medications you take to relieve the pain and how often you take them.
- Tell how you felt before, during and after the headache.
- Remember if anyone in your family gets migraine headaches.
Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An electroencephalogram may be ordered to rule out seizures.
For Most People With Migraine Exercise Wont Trigger An Attack
Exercise often gets a bad rap in the migraine community, says Bond. Vigorous exercise might be a trigger in a small subset of people with migraine, but overall, the benefits of physical activity far outweigh the risk for people with migraine, he says.
If exercise sometimes brings on a migraine attack for you, Bond suggests investigating potential environmental triggers that may be contributing. Heat, humidity, bright artificial lights in the exercise studio, and bright sunlight can all make an attack more likely, according to the American Migraine Foundation.
If you dont drink enough before and during your activity, exercise may also cause dehydration, which can also increase your risk for an attack, according to Bond.
Particularly on the hot days, try exercising in the early morning to avoid that heat and humidity, he suggests.
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How Long Does It Take To Flush Topamax Out Of Your System
Topamax has a half-life of about 21 hours. The half-life of a drug is the time it takes for the amount of the drug in your body to fall by half. It takes about five half-lives for a drug to be almost completely removed from your body. So for Topamax, most of the drug will be flushed out of your system within about 5 days after you stop taking it.
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What Questions Should I Ask My Healthcare Provider
- Will my child grow out of their migraines?
- What medications do you recommend for me?
- What should I change about my lifestyle to prevent my migraine headaches?
- Should I get tested?
- What type of migraine do I have?
- What can my friends and family do to help?
- Are my migraines considered chronic?
A note from Cleveland Clinic
Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.
Side Effects In Children
Side effects of Topamax in children are similar to those in adults. These side effects are described above and in Side effect details below.
- weight loss
- respiratory infections, such as colds
In other clinical studies, children ages 2 to 15 years took Topamax with other medications for epilepsy. The most common side effects in these studies were:
- loss of appetite
In clinical studies involving children ages 12 years and older who took Topamax for migraine, the most common side effects were:
- abdomen pain
- respiratory infections, such as colds
Children who take Topamax are less likely than adults to have speech problems, slow reactions, and trouble concentrating.
Serious side effect in children
One possibly serious side effect is more common in children than in adults. Children taking Topamax are more likely than adults to have fever and reduced sweating. These problems can lead to hyperthermia , which may need treatment in a hospital.
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What Causes A Migraine
The cause of migraine headaches is complicated and not fully understood. When you have a headache its because specific nerves in your blood vessels send pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. Its unclear why your nerves do that.
Depakote Er Or Valproic Acid
The last of the most common preventatives is valproic acid. The most convenient form for patients is Depakote ER®, a once daily migraine prevention agent. Depakote ER® can cause birth defects. In addition, valproic acid can cause weight gain and liver enzyme problems. Despite these warnings, the medication is generally well tolerated and can be used quite safely. However, given the issue with birth defects it is most commonly prescribed to males with migraines who are not overweight. Valproic acid is also widely used as an anticonvulsant to prevent seizures.
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What Are Clinical Trials For Prescription Medications To Treat Overweight And Obesity
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help health care professionals and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of prescription medications to treat overweight or obesity, such as
- the effect of the FDA-approved medication liraglutide on weight loss and gastric functions in people who are overweight or have obesity
- adolescents and young adults who dont achieve expected weight loss or who still have severe obesity after undergoing weight-loss surgery
- patients who have obesity and binge-eating disorder
- women who are overweight or have obesity and polycystic ovary syndrome
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