NSAID

1 November 2019

AXS-07 – New Combination Drug for Migraine in the Pipeline

Axsome Therapeutics has a new combination abortive drug in the pipeline. At the moment it’s going by the name AXS-07.

Every new medication attempts to solve one or more problems. This one is focused on two – well, maybe three – different things. First, fast absorption. The medication needs to get into your system at full power as soon as possible.

Second, it needs to keep working long enough to really make a difference. And when we say “working”, that brings us to a third thing – alleviation of symptoms.

This medication is a combination of two medications. First, rizatriptan, an already well-known abortive drug that targets migraine specifically. The second is meloxicam, which is a type of NSAID, specifically a COX-2 NSAID. That would put meloxicam in the same class as Celebrex (celecoxib), which may be a little more familiar to you.

Axsome is using a special formulation of meloxicam (“MoSEIC™ meloxicam “) that is designed to get into your system faster and last longer. Since both of these medications attack migraine in different ways, they have the potential to attack different symptoms in a more complete way.

That’s what the developers hope. There are two trials that are starting, if you’re interested in being a party of the development of AXS-07. Both are in the USA, and all the contact information is here:

For more information, see Axsome’s site: AXS-07

10 December 2015

Toradol for Migraine

James Medications 0

In certain cases, Toradol for migraine is a good option. But there are some risks and side effects that should be considered.

Toradol is actually a brand name, one of many, for ketorolac tromethamine. There are many other brand names, although Toradol may be the most familiar. Toradol for Migraine

Ketorolac belongs to a group of drugs known as NSAIDs – nonsteroidal anti-inflammatory drugs. Other drugs in this category include ibuprofen and fenoprofen.

Toradol for migraine is probably most useful as an emergency treatment at the hospital. Ketorolac, along with diclofenac, are both recommended in the emergency department, although they are not necessarily the first option to try (see Sequence of Treatments in Emergency â€“ what works?).

In the journal Neurology‘s evidence-based guidelines, ketoprofen is one of the higher rated NSAIDs, considered to be “probably effective” according to clinical trials. There are, however, better treatments that should be tried first.

Common side effects with Toradol for migraine include swelling (in feet, ankles, face) and weight gain. As with most NSAIDs, there may be stomach issues such as diarrhea, nausea and stomach pain. Older adults seem to be more sensitive to side effects of ketorolac. It is not recommended for use during pregnancy.

There are some serious side effects, and your risk increases if you take the medication for a longer period of time. Usually ketorolac is recommended for one-time use in the emergency room, or for a brief time (a day or two) to stop a migraine attack at home.

To avoid some stomach related issues, a nasal spray may be prescribed (SPRIX).

If prescribed by your doctor, temporary use of ketorolac may help stop a migraine attack, and is often combined with other medications. However, it’s only a temporary solution.

For more information, see:

Ketorolac (Drugs.com)
Toradol for Migraine (MAGNUM)

10 September 2015

Drugs For Headache: Infertility?

James Medications 0

A report at the European League Against Rheumatism Congress 2015 is raising concerns about the use of certain anti-inflammatory drugs (NSAIDs). The study clearly showed the link between the medications and infertility.

cradle In this case, the connection was quite clear. While taking the medication (participants took it over a period of 10 days), the patients were much likely to ovulate – much less likely.

The drugs in the study were diclofenac, etoricoxib and naproxen. Of the control subjects (those taking none of the above), 100% ovulated. Of those taking etoricoxib, only 27.3%. Of those taking naproxen, 25%, and of those taking diclofenac, only 6.3%.

The good news is that the effect seems to be temporary – that is, only when the women were actually taking the medication (yes, they checked back a month later). But this and other previous studies do raise a number of questions. What about a lower dosage? What about one dose every couple of days? Is there a cumulative effect for someone frequently taking a NSAID? What about other NSAIDs, like ibuprofen?

This study is yet another reminder that we need to get away from “take two and call me in the morning” – no discussion of the alternatives or the risks. And headache/migraine treatment needs to be a lot more than masking pain.

For more information, see:

14 May 2015

Headache? Instead of a pill, rub this on your skin…

James Discoveries & Stats, Medications 2

Which would you prefer – taking a pill for headache pain, or rubbing something on your skin? It might be faster to swallow something, but why send something all the way to your stomach when the pain is in your head?

Of course, that’s a drastic over-simplification, but it does make a point. Often times, pills that are swallowed are not as “targeted” as we would like. Would it work better to apply something right where the pain is – on the head?

TOPOFEN for Migraine Achelios Therapeutics is working on that very thing with TOPOFEN, a gel that can be applied to the skin.

TOPOFEN is actually a formulation of ketoprofen, a nonsteroidal anti-infammatory drug (NSAID) which is sometimes used for hormonal related headache, as well as menstrual pain in general. It’s also used for other headaches, and pain from osteoarthritis.

At the 67th Annual Meeting for the American Academy of Neurology, a report was given on the latest trial of TOPOFEN for use in migraine treatment. 42 adults with migraine with aura and migraine without aura were given the gel. Each person was asked to take a pea-sized amount and rub it on the skin over the peripheral trigeminal nerve ends – that is, six points on the face, both sides (even if they headache pain was only on one side). 49 severe attacks were treated, 22 with TOPOFEN and 27 with a placebo.

77% of patients had some relief using TOPOFEN. After 4 hours, 23% were completely pain-free, and after 24 hours 50% were pain-free (double the success of those using the placebo).

At first these results may not seem too amazing. But remember, this is not a special migraine drug, this is a NSAID (ibuprofen or Advil is a NSAID as well, though a different type). Taking that into consideration, these are actually pretty good results. No pill was taken; all we’re talking about is a little gel rubbed on the skin.

Not only was their pain relief, patients also found relief from other symptoms, such as nausea and photophobia.

After 24 hours, the medication was still in the tissue – it was still working after 24 hours.

So what are the upsides and downsides to this kind of treatment?

The gel did cause temporary skin irritation in some people, usually moderate or mild. It could be there a small percentage of people would not be able to use this drug – but that’s common with any medication or treatment.

But a major downside of NSAIDs is avoided here – stomach problems. Applying the gel near where the actual pain is could be a much more direct way to calm migraine symptoms.

We still have a lot to learn about topical treatments for migraine, but so far TOPOFEN seems to be a great start – quickly absorbed and effective in the treatment of migraine pain and other symptoms.

6 March 2014

Ibuprofen: Dangers of a “mild” medication…

James Medications 2

Ibuprofen is one of the most common medications for headache in the world, part of a class known as NSAIDs – nonsteroidal anti-inflammatory drugs. It’s one of those things (along with paracetamol / acetaminophen and aspirin) that many of us take without thinking – before seeing a doctor or taking something more “serious”.

But the problem is that these drugs, although safer than many, are still not “harmless”.

For most people, taken an Advil for a headache really is no big deal. But if they do it again – and again – over time . . . it can do a lot more harm than most people think.

Of course every medication has a long list of possible side effects. Thankfully, despite the amount of ibuprofen taken around the world each day, there are comparatively few problems.

However, ibuprofen can have a cumulative effect if taken many times a month, for example. Problems with the digestive system are most common, but these can cause a chain-reaction of issues that can be quite serious.

Symptoms may include:

Blood in the stools / dark stool
Burning or sharp pain in the abdomen
vomiting
nausea
heart burn
weakness

These symptoms may come from conditions such as ulcers, gastrointestinal bleeding, and even kidney failure.

A study in 1999 (Anti-inflammatory and immunosuppressant drugs. Rang, Dale, Ritter) suggested that many patients with gastric damage have no symptoms (yet).

Ibuprofen stands as another reminder that headache patients need to talk to their doctors, unless their headaches are very rare. If you have new headache conditions, or a headache every month or more, you need to see a doctor right away. If the headaches continue, are disabling, or are more frequent, a visit to a specialist would be wise.

Even “safe” medications like ibuprofen can be dangerous if you take them frequently. And frequently may mean fewer than you think.

Also see An Overview of Clinical Pharmacology of Ibuprofen, Full Ibuprofen Dosage information for All Ages and ibuprofen, Advil, Children’s Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever etc.