On May 16, Glaxo-Smith-Kline Pharmaceuticals, the makers of Imitrex, announced that they were releasing a new drug for the treatment of migraines. The new drug was to be called Treximet and according to the makers, was to be a vast improvement over Imitrex. Like Imitrex, it is made to be taken at the onset of a migraine, but is supposed to work faster and better to reduce migraine pain. GSK has spent several years and millions of dollars researching and “pre-marketing" Treximet in anticipation of FDA approval and product launch.
So what's the deal? Is this really better than Imitrex alone? From a strict treatment point of view, yes, the medication probably is better than Imitrex alone for a migraine. The reason for this is twofold. First of all, several years ago, Dr. Silberstein of the Jefferson Headache Center was able to demonstrate through research, that Imitrex combined with naprosyn taken at the onset of a migraine was better in treating that migraine than either drug alone. Such a combination is deemed synergistic, meaning basically that two plus two equals ten. Naprosyn is the prescription form of Aleve which is sold over the counter and is an anti-inflammatory. Once this research was confirmed, GSK began to develop a combination drug.
The second reason this drug might be better is something called RT technology. GSK has developed this and uses it currently for its Imitrex tablets. Think of it as “burst" technology as the tablet does burst apart when it begins to dissolve. This may speed absorption, and speed is of the essence when treating a bad migraine.
All treatment benefits aside, is Treximet really a great deal? Well for some, maybe not. One of the reasons a combination drug is usually developed is because the patent on the original drug is about to expire. And sure enough, that is what is happening to Imitrex this year. Unfortunately, samples of Imitrex are rapidly disappearing from doctor's offices. For those who have prescription coverage, the best answer is to ask for a prescription for naprosyn and take both pills at the onset of a migraine. Failing that you could just take two Aleve tablets with your Imitrex.
For those with no prescription coverage, hang in there! Two pharmaceutical companies who make generic drugs have announced that they will be manufacturing sumatriptan (generic Imitrex) by the end of 2008. Once that is available, it will open up the availability of the drug for millions of migraineurs who previously could not afford the drug. Even with no prescription coverage, the generic may be cheap enough to afford by paying cash. The downside to generics is, different fillers which are cheaper are used in manufacture. GSK still holds the patent on RT technology so it most probably will not be available in the generic sumatriptan.
As will all medications in the class of triptans, you cannot take these medications if you are pregnant, have uncontrolled hypertension or heart problems such as coronary artery disease. Check with your provider to be sure before taking any new medication and remember, treat early and treat fast to get rid of migraines.
Mary K. Betz, MS RPA-C is a practicing Physician Assistant in neurology who specializes in headache medicine. For more information visit http://www.headache-adviser.com/abortive-headache-medications.html