מספר מזהה: 6842

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imitrex – sumatriptan- advice for Yom Kipur

שאלה:

A talmidah has been diagnosed with hormonally triggered migraine headaches. By the second day of her flow they are debilitating and are a daily occurrence through the day following the end of her flow. Her physician prescribed imitrex and it has been a lifesaver. At the first sign of symptoms of the headache she takes the pill with a significant amount of water and after a short period of time is fully functional. 

She takes fasting seriously but has had to forgo the rabbinic fasts when they coincide with her flow. However, she did not feel comfortable with ingesting the amount of water necessary for swallowing the pill and its effective dissolution into her body for relief on Tisha B'Av. As a result she was bedridden in excruciating pain early in the day continuing into the evening and even acetaminophen suppositories did not bring relief. 
The challenge is that for the medication to be effective it must be administered under two conditions: Sufficient water and at the onset of symptoms. If the symptoms set in, the medication has some effect but she is still miserable. 
Yom Kippur is coming up rapidly and I would like to figure out a way for her to function on Yom Kipur and still fast so that she could feel comfortable with the day. 
Thanks

תשובה:

Sumatriptan can be administered into a nostril and if necessary the dose can be doubled by inserting into both nostrils. She should speak to her physician if she could use this for Yom Kippur. If the answer is yes, I would suggest that she starts to use it for a day or two before so that she gets used to it