How hard is it to get a pharmacist to dispense Actiq (fentanyl
lozenges) to a non-cancer patient?  I recently read a study in the
journal Headache that supported their use in intractable migraine as an
alternative to going to the emergency room, and I plan to discuss that
with my neurologist when I see her next week.  I suffer from
debilitating migraines, and take Keppra and Inderal LA for prophylaxis,
but that just managed to get the number down from 6-8 per month to 2-3
per month.  I take a number of drugs prn on an acute basis, but they
often fail, and the standard opioids don't touch the bad migraines.
Additionally, I need non-oral formulations, as I get severe vomiting
with my migraines.  Right now, we're using Dilaudid suppositories.
Still, I'm often not able to get rid of the migraines after 3 days or
so, and I wind up in the emergency room about 3-4 times a year, and
even there, it can take several rounds of various drugs to get the
migraines to remit.  I think that Actiq is definitely worth a try for
those situations, to save the time, hassle, and expense of a trip to
the ER, even some of the time.  I just wanted to inquire before talking
to my neurologist about how hard it might be to get the script filled,
should she choose to prescribe it.  One of the other opioids we tried
earlier was methadone, and I found that could be difficult to get
filled for acute pain, and many pharmacies in the area choose not to
stock it at all.

Thanks.