The new drug Trexima, a combination of Imitrex and Aleve (naproxen), “can provide faster, long-lasting relief of migraine pain than using either drug alone,” according to results of a study published in yesterday’s issue of the Journal of the American Medical Association.
In the study, Trexima relieved headaches within two hours in as many as 65% of participants, compared to 28% with the placebo. About 55% said Imitrex alone provided relief and as many as 44% said that naproxen did.
So it’s better than either drug alone, but is Trexima is more effective than taking Imitrex and naproxen at the same time? I’ve never seen this question answered. It’s a huge issue for patients because the Imitrex patent expires in 2009. Trexima extends profits from Imitrex because selling it in Trexima sales will cut into overall sales of Imitrex.
I get the arguments for using Trexima even if there’s no difference. Patients are more likely to take one medication than two. They also may have more faith in prescribed meds than over-the-counter drugs, which naproxen is. But would patients who can’t afford the brand-name drug be aware that they can get the same effect for much less money?
If Trexima is not more effective than taking Imitrex and naproxen in
separate pills, physicians assume responsibility for giving patients the
choice. At the very least, they should tell patients the different efficacy rates between the two. Some will for sure, but many others will follow the masses of drug rep cheerleaders.
GSK‘s foothold on the ethical side of the line is tenuous. I don’t begrudge a company earning money, but knowing the drug’s success rides on the pharmaceutical industry’s phenomenal marketing, patients will undoubtably lose.
I, too, was a participant in the study of Trexima. Unfortunately, I did not experience the same results. Imitrex alone (at 100 mg.) works about 75% of the time. The Trexima did not contain enough Imitrex to help. Last year I was put on a daily regimen of Depakote with marginal relief. Like others, I’m waiting for Imitrex to go off patent so I can stop paying $20/pill and having to ration my doses!
… a cure would be nice too. : )
I am a pharmacy student…and I usually try to tell customers/patients if the ingredients are generic and whether or not they can get a better price with 2 meds than 1 or if you have the same active ingredient (take zyrtec and XYZal)…one is more purified than the other…. I think the best thing to do is ask your doctor or pharmacist what the active ingredients are in the medication and if there are generics available for them,… or if there are other options… Sometimes the doctors will prescribe something new, even though there are a bunch of other meds out there that are in the same class and do basically the same thing. I think the best things for people to do is educate themselves on what they are taking,…and if you don’t know something…ask…
dear folks,
i was one of the persons in the study of trexima. i have fought with severe migranes all my life,and have been through a gambit of different medications including imatrex. imatrex by itself made me jumpy and numb feeling. the trexima study i was involved in was a god send!! not only did it stop my migranes in thier tracks it also got rid of the side affects that stopped me from taking the imatrex by itself. while i was waiting for the trials to be over for this i got another perscription for imatrex and took the naproxin with it it did not yeald the same results as when combined.
How many 50mg tablets of imitrex is too much per month. At what point should you take a preventative medication instead of imitrex?
What is the harm to split the 100 mg tablets in half to see if you rid the headache with just 50mg?
Many thanks for the reply and answers.
Five gold stars for your critical thinking skills, which, I predict, will exceed those of many in medicine.
No. That question, which desperately needs to be answered, has not been answered. That head-to-head study has not been done. Why? Nobody stands to gain financially from the answer. Nobody except, of course, you and me–the consumers.
True–there is not likely to be any advantage of Trexima over taking an Imitrex plus an equivalent dose of naproxen sodium. There is no voodoo in the combination.
Could there be harm, though? This is why the FDA is taking so long to look at Trexima. I don’t think the concept of sumatriptan (or any other triptan) plus naproxen sodium is inherently dangerous. Many of us recommend combining them–as an intial dose at headache onset. The potential danger could lie in a second or further subsequent dose. Do you need a naproxen dose every time you need a triptan dose?
I have concerns that in the hands of doctors and patients who do not understand the intricacies of medication overuse headache–i.e., most–this combination product could result in an increased risk of excessive dosing in the frequent headache sufferer, possibly resulting in an increased number of headaches.
And I think we all know how slim the likelihood is that an insurance carrier will reimburse both a prescription of Trexima and plain Imitrex in a given month.
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Not surprisingly, I agree with you completely. 😀 What you’ve said is so important that I’m going to turn it into its own post.
Kerrie
Hi Kerrie,
My headache specialist recommends that I take Aleve with every triptan I take, so for me, Trexima is just marketing. I can’t wait for Imitrex to go off patent!
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Glad to hear it!
Kerrie