Are you aged between 18-65?

Are you currently taking any of the following medication (including over the counter, prescription or recreational drugs)?

The migraine medications Ergotamine or Methysergide Any other ‘triptan’ migraine medication taken within last 24 hours (e.g. naratriptan, rizatriptan, zolmitriptan, almotriptan or eletriptan (NOTE: we advise different types of ‘triptans’ should not be taken within 24 hours of one another) MAOIs (monoamine oxidase inhibitors) or if you have taken an MAOI in the last 2 weeks (e.g. Mocobemide, Phenelzine, Isocarboxazid and Tranylcypromine) SSRIs, usually used to treat depression (Selective Serotonin Reuptake Inhibitors – e.g. Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline and Priligy) SNRIs used to treat depression (Serotonin Noradrenaline Reuptake Inhibitors e.g. Duloxetine, Dapoxetine, Venlafaxine and Mirtazapine) Reboxetine, Tryptophan or Flupentixol Lithium Selegiline St John’s Wort (Hypericum perforatum) Cimetidine (for indigestion or stomach ulcers) Propranolol (beta-blocker) Any current antibiotics (antibiotic course needs to be completed at least 72 hours before taking a triptan) Antifungals (e.g. Ketoconazole, Itraconazole) The combined oral contraceptive pill (not the progesterone only mini pill)

Do you agree to the following?

You will read the patient information leaflet supplied with your medication You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment. The treatment is solely for your own use You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.

Have you previously been diagnosed with migraines by your GP and have you experienced relief when taking medication containing 'triptans' such as Imigran (Sumatriptan), Rizatriptan (Maxalt), Zomig (Zolmitriptan) ?

When you have taken a ‘triptan’ medication in the past, within the first few hours of taking it have you experienced sensations such as heaviness, pressure or tightness in the body (especially chest or throat), or have you experienced palpitations, flushing, dizziness, rash, a feeling of weakness, worsening nausea and vomiting or a temporary rise in your blood pressure?

Are you breastfeeding or pregnant or possibly pregnant?

Do you have an allergy (hypersensitivity) to Imigran/Sumatriptan, Maxalt/rizatriptan, Zomig/zolmitriptan?

Have you been diagnosed with any of the following?

Heart disease or heart problems such as narrowing of the arteries (ischaemic heart disease) or chest pains (angina), or have already had a heart attack Stroke or a mini-stroke (also called a transient ischaemic attack or TIA) High blood pressure Coronary Vasospasm (including Prinzmetal’s angina) Wolff-Parkinson-White Syndrome (a type of abnormal heartbeat) Peripheral Vascular Disease Previous Gastrointestinal or Splenic infarction Ischaemic Colitis Epilepsy or history of seizures Liver problems Kidney problems Allergy or sensitivity to antibiotics called sulphonamides (e.g. trimethoprim) Any serious medical condition which may require immediate hospitalisation

Do you experience migraines for more than 10 days a month?

Do your migraines last less than 4 hours without treatment or last longer than 24 hours?

Do your migraines follow a broadly similar pattern each time?

Are you experiencing any of the following along with your migraine?

unilateral motor weakness double vision clumsiness or uncoordinated movements tinnitus (ringing in the ears) reduced level of consciousness seizure-like movements (fits) a recent rash with a headache headache confined to the back of the head recent marked deterioration in migraine (duration, severity or frequency of attacks)