Acute medication is used to abort an attack, while prophylactic medications reduce attack frequency and thus modify migraine disease or susceptibility

of the nervous system to migraine. Many migraine medications approved, as either an acute or prophylactic http://www.selleckchem.com/products/XL184.html treatment, have demonstrated ability to function as both acute and prophylactic treatments.1-3 There has been little research on the use of acute migraine medications in populations with frequent episodic or chronic migraine. Yet these patient populations arguably have the greatest need for effective relief from episodes of migraine. While many acute medications have clinical efficacy as being effective at relieving headaches in patients with high-frequency episodic and chronic migraine, it is widely

accepted that too frequent use of acute medications can result in medication overuse headache (MOH).[4] Efforts to control use of acute medication in high-need populations either by providers or pharmacy benefit plans are complicated by the fact that there are many acute migraine medications available over-the-counter (OTC). Consequently, Deforolimus datasheet many patients utilize a combination of prescription and OTC medications in an effort to adequately treat their pattern of frequent migraine. This makes the control of acute medication a challenging clinical dilemma. In addition, little is known about the risks and benefits of using these products in combination with one another. Population-based epidemiological studies suggest that opioids, caffeine, and butalbital combination products carry the highest risk of transforming episodic to

chronic migraine.[5] Triptans and nonsteroidal anti-inflammatory drugs (NSAIDs) carry less risk.[5] In fact, one epidemiological study found that NSAIDs appear to have a protective effect when used with a frequency of less than 10 days per month.[6] Cytidine deaminase Yet, this study did not consider the use of multiple classes of acute pharmacological treatments in a single subject as a risk factor for migraine chronification. The possibility exists that different classes of acute medication, when used together, may interact and produce different levels of risk or benefit. In phase 3, regulatory trials of a combination of sumatriptan 85 mg and naproxen sodium 500 mg (SumaRT/Nap) with subjects who experienced 2-6 migraine attacks per month, SumaRT/Nap was superior in 2-hour efficacy to sumatriptan or naproxen sodium alone.[7] In addition, there was less recurrence of migraine than with either component of this product used alone. In a 12-month safety study, SumaRT/Nap was well tolerated in subjects who treated an average of 5 migraine attacks with an average of 6 days between attacks.[8] Migraine attack frequency increased slightly over baseline for both 6 and 12 months completers (4.3 vs 5.0 vs 4.