Sumatriptan and Naproxen Sodium for the Acute Treatment of Migraine

Smith, Timothy R.; Sunshine, Abraham; Stark, Stuart R.; Littlefield, D.; Spruill, Susan E.; Alexander, W. James

doi:10.1111/j.1526-4610.2005.05178.x

Cited by 142 publications

(133 citation statements)

References 15 publications

(19 reference statements)

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“…There is however no study comparing the relative efficacy of rizatriptan and NSAIDS. Triptans, especially sumatriptan, have been compared with naproxen, indomethacin, aspirin and ibuprofen [14][15][16]. In an RCT, ibuprofen resulted in headache relief in 62.5%, sumatriptan in 55.8% and headache freedom was 33.2% and 37.1% patients respectively, which were not significant [14].…”

Section: Discussionmentioning

confidence: 99%

Rizatriptan vs. ibuprofen in migraine: a randomised placebo-controlled trial

2007

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The objective of this study was to compare the efficacy of rizatriptan and ibuprofen in migraine. The study was a randomised placebo-controlled trial in a tertiary care teaching hospital. Migraine patients with <8 attacks/months were included. One hundred and fifty-five migraine patients were randomised to rizatriptan 10 mg (53), ibuprofen 400 mg (52) and placebo (50). Efficacy was assessed by headache relief, and headache freedom at 2 h and 24 h. Two-hour headache relief was noted in 73% in rizatriptan, 53.8% in ibuprofen and 8% in placebo groups. Headache freedom was achieved in 37.7% in rizatriptan, 30.8% in ibuprofen and 2% in placebo groups. Rizatriptan was superior to ibuprofen and placebo in relieving headache at 2 h but not at 24 h. Side effects were noted in 9 patients in rizatriptan, 8 in ibuprofen and 3 in placebo, all of which were nonsignificant. Rizatriptan and ibuprofen are superior to placebo. Rizatriptan is superior to ibuprofen in relieving headache, associated symptoms and functional disability.

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Section: Discussionmentioning

confidence: 99%

Rizatriptan vs. ibuprofen in migraine: a randomised placebo-controlled trial

2007

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“…In addition, sumatriptan plus naproxen was significantly better than monotherapy in the 2-hour headache response, 2-hour pain-free and sustained pain-free responses (p<0.001) AEs were similar in all treatment groups. 53 A total of 12 randomised, double-blind, placebo-or active-controlled studies of sumatriptan plus naproxen to treat an episode of migraine headache have been reviewed. 54 Patients (n=3,663) were treated for mild, moderate or severe pain attacks with sumatriptan (85 or 50 mg) plus naproxen (500 mg).…”

Section: Sumatriptanmentioning

confidence: 99%

“…Accordingly, treatment of migraine with a triptan and NSAID class, which have different mechanisms of action, can give better relief of migraine. 53 This strategy was evaluated in a multicentre, randomised, double-blind, double-dummy, placebocontrolled, four-arm study in 972 patients. A single moderate or severe migraine attack was treated with either naproxen sodium (500 mg), sumatriptan (50 mg), a combination of sumatriptan and naproxen (50 and 500 mg, respectively) or placebo.…”

Section: Sumatriptanmentioning

confidence: 99%

Overview of Triptans in the Treatment of Acute Migraine

Cortelli¹,

Allais²,

Benedetto³

2017

European Neurological Review

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T he advent of triptans for effective relief of migraine represented a therapeutic breakthrough. Triptans are serotonin (5-hydroxytryptamine, or 5-HT) agonists with high affinity for 5-HT 1B and 5-HT 1D receptors. There are, at present, seven commonly used triptans: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan. Some controversy still surrounds the mode of action of this class. When first studied, it was thought that triptans provided relief from migraine through cranial vasoconstriction, probably via action at postsynaptic 5-HT 1B receptors on the smooth-muscle cells of blood vessels. More recently, however, triptans have also been demonstrated to block release of vasoactive peptides from the perivascular trigeminal neurons owing to their action at presynaptic 5-HT 1D receptors on the nerve terminal. Triptans may also facilitate descending pain inhibitory systems. However, it is not certain whether or not the activation of vascular 5-HT 1B receptors is essential for relieving migraine. Many drug characteristics need to be taken into account when selecting the best triptan for an individual patient. Clinical characteristics of the migraine attack and the patient's lifestyle and medical history are also important. Despite their biochemical similarity, triptans have distinct pharmacokinetic and pharmacodynamic profiles. Frovatriptan and naratriptan, for example, have a longer half-life and therefore a delayed onset of action and prolonged duration compared with the other triptans, which are fast acting, with a rapid dose-dependent efficacy and higher risk of adverse events and migraine recurrence. Migraine recurrence is affected by the pharmacological and pharmacokinetic properties of the triptan but is unrelated to initial clinical efficacy. Triptans with a longer half-life and largest 5-HT 1B receptor affinity have the lowest rates of headache recurrence.

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“…According to IMS health, a leading provider of pharmaceutical market intelligence and analytics, recent prescription data for migraine treatment indicates that triptans are the most prescribed active agents followed by NSAIDs. Triptans and NSAIDs given together elicit a synergistic effect by treating both vascular and inflammatory components of pain and result in higher pain relief (5). Oralfixed dose combinations of sumatriptan and naproxen (Treximet®) have been developed based on this premise (5).…”

Section: Introductionmentioning

confidence: 99%

“…Triptans and NSAIDs given together elicit a synergistic effect by treating both vascular and inflammatory components of pain and result in higher pain relief (5). Oralfixed dose combinations of sumatriptan and naproxen (Treximet®) have been developed based on this premise (5).…”

Section: Introductionmentioning

confidence: 99%

Duel-Acting Subcutaneous Microemulsion Formulation for Improved Migraine Treatment with Zolmitriptan and Diclofenac: Formulation and In Vitro-In Vivo Characterization

Dubey

Martini

Christie

2013

AAPS J

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Abstract. Subcutaneous triptan provides immediate analgesia in migraine and cluster headache but is limited by high pain recurrence due to rapid drug elimination. A dual-acting subcutaneous formulation providing immediate release of a triptan and slow but sustained release of a nonsteroidal antiinflammatory drug may provide a longer duration of relief. A microemulsion-based technology has various advantages over other technically complex dosage forms. Oil-in-water microemulsions of zolmitriptan and diclofenac acid using Labrafac Lipophile, Tween 80, Capryol 90 and water were prepared. One formulation was characterised in vitro and found to have uniformly dispersed nanosized globules. The formulation provided differential release of zolmitriptan and diclofenac acid both in vitro as well as in vivo that may be potentially beneficial to migraine patients.

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Sumatriptan and Naproxen Sodium for the Acute Treatment of Migraine

Cited by 142 publications

References 15 publications

Rizatriptan vs. ibuprofen in migraine: a randomised placebo-controlled trial

Rizatriptan vs. ibuprofen in migraine: a randomised placebo-controlled trial

Overview of Triptans in the Treatment of Acute Migraine

Duel-Acting Subcutaneous Microemulsion Formulation for Improved Migraine Treatment with Zolmitriptan and Diclofenac: Formulation and In Vitro-In Vivo Characterization

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