Treximet (formerly Trexima)

The drug now known as Treximet has been approved for sale in the USA (on the 15th of April, 2008).  It’s expected to hit the shelves any time now, as a prescription medicine.

But what is Treximet (formerly Trexima)?  And is it worth all the hype?

Actually, I’ve written about Treximet several times before (here for example) – it’s been in the testing phase for a long time.  It’s a combination drug – containing sumatriptan succinate (Imitrex) and naproxen sodium (Aleve).  You can expect to see more drugs like this in the future, as Triptans such as sumatriptan go generic and companies look for new things to sell.

With the approval, I thought it would be a good time to summarize the good and the bad about this much talked about drug.

First, the good.  Tests have shown that it seems to work well.  Tests were done on a mostly female Caucasian group with migraine.  Results?  Noticeable relief from pain both short term (after 2 hours) and longer term (up to 24 hours).  And better relief than from either key ingredient alone, or a placebo.  In the end, Treximet seems to work a little faster and better than either drug alone.  Trexima uses something called RT Technology, which gets the ingredients into action in your body quickly.

The other benefit is that it also seems to help with nausea, and sensitivity to light and sound.

Sounds great, right?  Well, there are a few concerns about Treximet.  Most of these come from the fact that it’s a combination drug.

For example, sharp readers will notice that Treximet was compared to sumatriptan succinate and naproxen sodium in the clinic trials – each by itself, but not in combination.  With the expected price of the pills, we have a right to ask – is Treximet really that much better than just taking sumatriptan succinate and naproxen sodium together?  With the changes over the next few months, it looks like that option would be far cheaper.

Speaking of cost, will insurance companies be willing to cover Trexima prescriptions?

Another good question – do you need Trexima every time you feel you need to take an abortive medication?  In other words, might you want the sumatriptan alone sometimes, and would your doctor and insurance company allow you to have both?  And if you take Treximet in the first dose, do you need the combination again for the second dose? (Good discussion on that here)

Being a combination drug, you do get the potential for side effects from both ingredients – for example, increased risk of stroke and gastrointestinal problems (from the naproxen sodium – typical for this type of drug).

So, might Treximet help you?  Yes.  But proceed with caution to avoid both over-paying and over-drugging.  Keep informed on this discussion.  And feel free to join in with your comments.

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50 comments… add one
  • Tom Jun 17, 2008

    I have obtained samples of Treximet as I am a Cluster Headache sufferer. I have just begun a cluster period and had used about 4 doses of Imitrex. I always get releif from the “triptans” but it is short lived.

    I used the Treximet (85mg/500mg) and have had a 36 hour period (so far) pain free.

    Side effetcs were very noticable – flushing, dizziness and almost nausea but only lasted about 2 or 3 hrs.

    This is a strong medicine. Although under study at Harvard and McCleans Hospitals – no one has approved or can even really advocate the use of indole-ring hallucinigens for chronic vascular headaches. I typically have one 5 to 12 week cycle of headaches every year. For the last 3 years I have been able to obtain and ingest “magic mushrooms” – trust me I am almost 60 and have no interest in recreational drug use. The mushrooms in each instance after 5 days (2 doses) have eliminated the headaches fo up to one year. Unfortunatly I can not find any anymore. I hope the resarchers will continue to advocate this totally organic solution. If you have an interest there is a terrific web site see: http:/

  • Mike Jul 17, 2008

    Precisely the answers I was looking for.

    Thank you

  • Kim Aug 13, 2008

    I suffer from cluster headaches and menstraul migraines. OTC drugs worked for a while. Now, I have rebound headaches from taking them too much. My Dr. gave me a sample of treximet to try. Wow! Worked great. No side effects. Normally my stomach kicks everything out. So, I priced the RX to get it filled. OMG! At Wal-mart it would have cost $25 a pill! Who can afford that? Even with insurance, it only took it down to $20. I will keep searching for a more affordable solution.

  • Vickie Aug 21, 2008

    OMG-Kim! And i thought maxalt was way expensive at about 13 dollars a pill without ins.
    I just don’t understand why meds have to cost so much-i have tried about every all natural relief thing out there and some have helped -and that is about it–best to you

  • Vickie Aug 21, 2008

    oh, wheni said helped i meant a little relief, but nothing takes away the pain totally

  • James Aug 22, 2008

    Wow, that is incredibly expensive! And insurance not much of a help. I hope the price drops soon.

  • Vickie Aug 23, 2008

    And they wonder why people take the chance on buying presriptions online from different countries.
    It is way cheaper that way.
    I have not done that but know people that have.

  • Carol Aug 27, 2008

    I agree – – the pain medications that seem to work the best also cost the most. I take Amerge for migraine pain, and it is so expensive, the insurance company only issues six pills every three weeks. I can’t control how many headaches I have! Once, I ran out of Amerge on Christmas Day, and I had a migraine (who wants a migraine on Christmas?). The pharmacist offered to sell me ONE pill (2.5 mg) for $25.00 until the insurance company could be contacted for a renewal. What could I do? I bought it.

  • Becky Aug 28, 2008

    I tried a sample of treximet today and I felt absolutely horrible. It made my head and neck prickle, I felt pressure in my chest, tightness in my neck, and had just a general “strange” feeling. Over an hour later (now) my head still hurts. Only now I’m nauseous too. It was rather scary….

  • Kimberly Aug 30, 2008

    I haven’t tried treximet and don’t have any plans to because of side effects of sumatriptan. However I do take Axert and 400mg of Lodine (an anti-inflammatory) together for my migraines. This comboination works much better than either of the drugs alone. It is the same idea of the Treximet but using a triptan that works for me.

  • James Sep 2, 2008

    Thanks for the comments! It is frustrating that things need to cost so much. Hopefully someday we won’t need to buy them!

    Combination drugs (and taking combinations) is so tricky. I’ll continue to research and write on this one. Hopefully more studies will be done on the combinations.

  • Jen Sep 4, 2008

    Tried my first dose of Treximet (from a sample pack, thank goodness) today. Unfortunately I had a similar experience as Becky’s. About 15 minutes later I started feeling a dull ache in my jaw and a tightening in my neck. The ache has since moved to my whole mouth but thankfully no signs of breathing trouble. I don’t have a history of allergic reactions other than to bee stings, so this is quite a surprise. This whole experience is so uncomfortable…. I’d rather have the headache.

  • Judy Sep 10, 2008

    I, too, had a severe migraine for days and took one of these pills and felt sweaty, weird, my chest felt like I couldn’t breathe and I still had a headache. I was slurring my speech and my eyes were drooping. Very odd medicine.

  • JJ Oct 10, 2008

    I have noticed the weird neck tightness and the jaw discomfort as well. It is a very unusual feeling, but taking Treximet relieves my headaches every time. For anyone who is talking about how expensive it is, I agree. This is my solution for the high cost and what I myself have been doing. I break the pill in half (asked pharmacy to do it, they wouldn’t), so had to do it myself. The pill lasts twice as long for me now, and I get the same effect. Just letting you know what I do, in hopes that it helps someone else.

    • Petra Hicks Feb 19, 2011

      Be careful when breaking pills in half. This one specificly says never to break in half.

  • Patty Nov 2, 2008

    My 15 year old daughter was just diagnosed with migraines within the past week. The doctor gave us a sample pack of Treximet to try but so far we haven’t had to. I much prefer alternative methods of relief (i.e. identifying and eliminating triggers, etc.) but it’s way too early in this process to have explored anything yet.

    She has always been somewhat hyper-sensitive to certain OTC meds and after reading what others have experienced with this drug combo I’m even more hesitant to subject her to its possible side effects. One blogger brought up a good point, about cutting the pills in half – one option I will definitely entertain.

    Thanks everyone for your input. Very informative and most appreciated by us “Trexi” newbies.

  • Kelly Nov 5, 2008


    Have you tried over the counter medications for your daughter yet? I started getting migraines when I was about 15 and back then a couple of regular Aleve would do the trick. If that doesn’t work maybe Excedrine will do it. Migraines in women tend to worsen once they hit their 30’s and 40’s so you don’t want her to build up a tolerance to stronger, prescription med’s yet. It wasn’t until the last couple of years that I had to get prescription med’s and I’m 30 now.

  • Kelly Nov 5, 2008

    Has anyone tried chiropractic care for their migraines? I know a chiropractor who insists that most migraines can be eliminated with regular adjustments. I have been skeptical to try because my insurance will not cover it.

    • sam May 6, 2011

      I have done the chiropractic rout, and although my back and neck felt better for a day or two it never even slowed down the migraines i was having and i consistantly went for a year every week to every other week. Hope this helps, if i were you i would try a few visits and if they dont decrease i dont think they would.

    • Margie May 14, 2015

      I went to chiropractor for two years and did not help my menstrual migraines. Treximet is best medication I have ever taken. I have also cut pills in half and have had great success. I am going to try generic Imitrex with 2 alleve and see if it works. Will keep you posted.

  • Vickie Nov 6, 2008

    If you are going to cut the medication in half, please make sure that there is a line on it to do so.
    I was tol to never cut in half prescription meds if it does not have a line, because they are not made to be cut in half and you will not be getting equal amts of the medication in each half .I have noticed that some meds do not have a line, but a lot do.

  • James Nov 7, 2008

    Thanks for all the great ideas. JJ, that’s a really great idea, and thanks for your input too, Vickie. I would recommend checking with your doctor on the specific medication. Vickie is right – there are many circumstances when you certainly should not do it. But if you can, and the medication is still effective, there are a number of advantages.

    Kelly, I have had success with chiropractic care, but there are different kinds and often they are mixed with other therapies such as mayofascial trigger point therapy.

    Here is an article on migraine and chiropractic treatment, with a link to an interview with a chiropractor I have used.

  • joyce Nov 21, 2008

    I haven’t tried treximet, but I’ve been taking Imitrex with 200mg ibuprofen for years. I get migraine relief, and the ibuprofen helps with the side effects: aching jaw, sore muscles, sensitive scalp. I sometimes cut the imitrex in half if I catch the migraine early – less side effects and “hangover”.

  • Sara Nov 21, 2008

    I have been taking Treximet for the last few months and for me it is a ‘wonder drug’. Imitrex eventually stopped working but Treximet takes away my migraine every time. The only problem that I have is that it totally knocks me out. Within 45 minutes of taking it I am asleep. However, when I wake up, my migraine has gone and does not come back. I only wish they gave you more than 9 at a time. The only side effects I have experienced are a burning in my throat and it makes my nose run?!

  • Laura Nov 22, 2008

    I began taking 85mg/500mg of Treximet and was so excited about this new medication. My experience with it was not good. The burning in my throat and stomach actually made me vomit during migraine bouts. I can take the normal coated Aleve. Why wouldn’t they think of that when they know we are very sensitive and prone to vomit?? Treximet needs to be a coated tablet. I’d rather take Imitrex with a coated Aleve and save some $$.

  • Jim Jan 22, 2009

    Treximet has proven to be nothing more than a very expensive, minimally effective, replacement for Imitrex. Treximet costs 4 x more than Imitrex. A more effective pain reliever is Treximet combined with 2 Aleve (Naproxen). Treximet contains 80mg/500mg Triptan/Naproxen, compared to Imitrex 100mg and Aleve 400mg. Now that Imitrex has gone generic, the cost is a much wider margin. Also, I am insured by BCBS. BCBS imposes a very small limit on Imitrex, while allowing endless refills of Treximet. They are the same basic medication.

  • Jacob Feb 5, 2009

    Hmm I dunno about this.. sounds potentially gimmicky since yeah once things go generic they gotta make $ somehow. I think I’ll stick to my Midrin regimen ( with Indomethacin, and Maxalt when absolutely necessary.

  • Sandy Feb 17, 2009

    I have tried every migrane med known to man for the last 20 years. Treximet works for me and I will not try anything else, now that I have found it. It can be expensive, but I have Cigna insurance it covers it completely.

  • James Feb 23, 2009

    Wow, quite a variety of experiences with Treximet!

    I’m still amazed by the cost, though. I agree with Jacob, it does sound like there’s a little too much emphasis on making money and a little too little emphasis on actually helping migraine sufferers.

    But here’s hoping things will calm down a bit and the price will get to a reasonable level.

  • Jenn Feb 25, 2009

    I actually loved Treximet. I have tried nearly everything in the book (from medications, to b2 and magnesium, yoga, biofeedback, etc!). While I do experience similar side effects mentioned from Treximent (mainly nausea, some stiff neck, pressure in the jaw) – I find that these side effects FAR outweigh being completely miserable 3-4x a week and unable to function at work. I was given Treximet when it first became available in April 08, but since then my insurance has changed and I’m no longer covered for what I considered my “dream pill.” I still take an Imitrex injection which works nearly as well, but is much more inconvenient to take (at work, social situations..). Ideally, I would find a medication to prevent my migraines… but I guess one thing at a time…

    All in all, if you can get Treximet covered by your insurance, try it!!! I’m going to visit my neurologist to see if he can combine the ingredients of Treximet for me.

  • jenny Feb 25, 2009

    I haven’t tried Treximet yet, but am always interested in new treatments for migraines. I started getting them around the age of 15, but wasn’t diagnosed until I was about 20. The first thing I tried to treat them was Imitrrex (mostly pill, injection for when nausea prevented taking a pill). I thought it was amazing since it was the first thing I tried that got rid of my headaches. What I hated about it was all the side effects (racing heart, temperature fluctuations, stiff neck, exhaustion), so I would try not to take it. When I did take it, I basically had to lay down for 2 hours while I waited for it to kick in and for the side effects to lessen. Then a family friend told me about Relpax and I asked my doctor if I could try it. It gets rid of my migraines just as well as Imitrix, but without ANY noticeable side effects. I still like to lay down when I take it since it takes 30 minutes or so to kill the headache, but I don’t need to. I would definitely recommend it to other migraine sufferers who might be looking for something new to try (I have family members and friends who are really happy with it also now). Unfortunately, it’s also pretty expensive and only comes 6 to a pack, but it seems like its covered by insurance for a lot of people.

  • JAG Mar 12, 2009

    I tooked Treximet and after one hour felt a tightness in my neck and lower jaw. Although it did get rid of my migraine, it was just too scary with the neck pain. I definately rather deal with my migraine symptoms rather than the symptoms I received after using Treximet!

  • Nate Mar 15, 2009

    I took Treximet twice before, and it did little for my headaches. I just took it again 2 hours ago, and I have the neck/jaw pain and tightness every one is talking about. It’s freaking me out, but I can still breathe. I’m also taking Relaten this time with the Treximet, so maybe that is the reaction. Headache is less severe, but nausea is worse. I don’t think I’ll take this drug again.

  • Lynn Mar 17, 2009

    My neurologist, who is a women’s migraine specialist, agreed that Treximet is nothing more than Imitrex with Naproxen. She suggested taking 500 mg Naproxen with an Imitrex at the onset of a migraine which has worked much better than Imitrex alone for me. MUCH cheaper for the same medicine. Also, I started getting migraines when I was 13-14 and have recently been diagnosed with Menstrual Migraines. Does anyone know anything about using oral contraceptives to treat older women (I’m 44 – excellent health – no risk factors)? My neurologist, who thinks it’s a good idea, and my GP, who thinks it is NOT, are currently arguing over the risks vs. benefits while I suffer…

  • James Mar 18, 2009

    Thanks for sharing your experiences!

    Lynn, here is some information on menstrual migraine for you:
    hormonal headache
    Menstrual migraine

  • Sue May 19, 2009

    I also have received a sample of Treximet from my doctor and took it with the hopes of relieving my migraines. A typical migraine for me last anywhere from 18 to 24 hours. After taking the pill, my pain was relieved about 75%, but experienced tightening in my neck, jaw and had teeth pain. It has been over 48 hours since my dose of the medication and I am still having jaw discomfort. The jaw pain is the better of two evils, but I will still continue to look for relief in the future without the side effects.

  • Sara May 20, 2009

    I was given samples of Treximet from my dr. I did not have any of the side effects that are listed, it took about an hour for me to have no pain what so ever. My 11 yrdaughter was diagnosed with migrains alittle while ago and now takes the full dose. They work wonders for her at the full dose.

  • Kristen May 23, 2009

    I suffer from cluster headaches that stem from bulgng disc in my neck. Today I have a headache that starts at the base of my head and wraps around my entire head and into my eye mostly on the right side. My doctor just prescribed Treximet to me and I took it at 6:30pm for the first time. I’ve never taken a miagrane medicine before now. We’ll see how it works…

  • JB Jul 22, 2009

    Had my first headache on July 3rd, 2009 which took me down for 10 hours with no relief. This is the first one I have ever had in my life. Had eight more before I could get in to see a Neurologist who gave me a two pill sample of Treximet after telling me I was suffering from “Cluster Headaches”! I am 54 and not ready for these things at this time in my life. Anyway, today 22 July started feeling the pressure and one coming on. Took one of the pills and 30 minutes later, pressure gone, pain gone and can see clearly, tearing has also stopped. I did get the neck and jaw stuff that everyone else does, but that only lasted about an hour. I am retired military and hope I can get these filled at the base pharmacy!

  • Rick Jul 23, 2009

    I’ve had these migraines for 3 years, rear-ended on the Interstate, wrapped my head around the headrest. Tried everything, some things work for a while, but so far nothing is great and wonderful, except my Chiro appts.
    It was recommended to me by my sister once and later an old friend. No twisting, snapping or popping. Its all very gentle, no pain. Basically they immobilize your head and minutely tap your top neck bone, C1, or your Atlas bone(you know, atlas held the world up on his shoulders). Its called Atlas Orthoganal technique.
    I probably wouldn’t have tried it if I wasn’t at my wits end.
    It hasn’t made them go away, but they don’t happen as often, and they don’t escalate into full blown grand maul migraines anymore.
    Dude also fixed my wifes painful hip and knee problems, but thats a story for another blog…

  • Mar Aug 16, 2009

    I’ve remember having headaches since about 5th grade. Nothing too severe, just normal headache pain. I am now 22, and about six months ago the headaches started getting stronger, longer, and more frequent, accompanied by nausea. Head pain I can handle, but nausea? That was kind of the last straw. Went to my doctor and he diagnosed me with migraines. He prescribed Treximet and gave me a sample. That day I had been suffering from a headache for 24 hours, and 30 minutes after taking one sample pill, the headache was gone. I was really amazed. The only side effect I had was neck pain for about an hour, but it was worth it.

    The price for Treximet ($200 for 9 pills) is a little excessive. However, as long as I can afford it I’ll continue paying it. It’s not ideal, but $20 to get rid of a headache is a low price to pay compared to the alternative.

    Sad to hear some haven’t had good experiences with it, goes to show everyone’s body is different. Good luck in finding something that works for you!

  • Tammy Sep 19, 2009

    I usually get several headaches a week and I get horrific migraines anywhere from 2-3 times a year. The last time I went to the urgentcare place the NP I saw wrote me a prescription for Treximet. I had taken the samples they had given me on previous visits and they worked as long as I took it at the START of a migraine. If it’s a full-blown migraine, forget it, it didn’t work. The person above me said it cost 200 for 9 pills which is precisely correct!

    Go to their website and you can print off a coupon to get your FIRST PRESCRIPTION FREE (have to actually have a signed prescription) which is what I did. I was SO shocked to see the “your insurance saved you 209.99”. Also I saw something where you can save around $25 if you are already taking it.

    But…I don’t get terrible migraines that much so this prescription will probably last me 2 years.

  • Katrina Feb 22, 2010

    I have had migraines for year. I have tried several different drugs that don’t work that well. Takes the edge off, but the headache always comes back. And the side effects of these drugs was almost not worth taking. When the Dr. gave me Treximet last week and I took one, I could not believe how well I felt so quickly! I printed off the $50 off coupon and used it and with insurance they told me it would be $318.00! I freaked out! I said no way will I pay that for 30 pills! I love this drug and it works wonderfully, but that is rediculous to pay that much for a pill! Is there no way to get these costs down for the average American to take this wonder drug???!!!!

  • Brooke Mar 10, 2010

    I’m a 23 year old female, and I’ve had chronic headaches and migraines since I was around eight years old. I went to my doctor today and she gave me a couple samples of treximet. I got a headache about 30 minutes before I had to go to work, so I decided to go ahead and try the treximet. As others described, it gave me an uncomfortable tightness and tingling in the back of my neck. It also made me so jittery that I had to lay down and close my eyes to try and relax. Now, four hours later, I still have the tightness in my neck and my head ache is back. I don’t think I will be trying it again.

  • jordyn Apr 6, 2010

    I’m curious about the cost for Treximet. I have read many different posts on the extreme cost that you seem to be getting told at the pharmacy. What insurances do you guys have? What pharmacies are you going to and what are they saying to you when you go to get a scripts filled? Cash paying for triptans is really expensive. Maxalt is 328 dollars… that’s crazy…. go to and you can get a discount card for prescriptions…

  • Diane Apr 30, 2010

    Wow. Great to read all of your findings. I’ve been suffering from mestrual migraines for several years, since the birth of my 4-year-old son. They seemed to get worse after I started taking Nuvoring birth control. My doctor just gave me a sample of Treximet this week. As usual, my monthly migraine showed up this week. I took one of the pills and felt as funky as the rest of you. It was sort of an out-of-body experience, combined with lethargy for about an hour. I, too, had the odd neck sensations. But after an hour, the side effects and headache were gone. Miraculous. My headaches knock me out for two full days, so to suffer mild side effects for an hour outweighs that entirely. However the cost …. UGHHH. I will try the Imitrex/naproxen combo that was described above to see if that works as well. I am certain my insurace will not cover the meds. But to have relief from these debilitating headaches was like the skies opening up. Amazing after so much suffering.

  • Kathy May 7, 2010

    My doctor gave me samples of Treximet to use. The first couple times I took it I had no problems. The third time I made a huge mistake and took and allergy med at the same time and it literally felt like I was having a heart attack. Had a hard time breathing and extreme tightmess in my lungs. My jaw felt like it was locking up on me.
    regardin the price, guess i will use the samples up and then figure out what else I can use.

  • Casey Jul 4, 2010

    I absolutely love this medicine, since I was about 12 I have had horribly painful headaches, doctors refused to say I had migraines as a child and so I self medicated every day with 2-6 Advil. I am now 23 and for the last year have taken 8 Treximet pills, only when I felt after a couple of hours that my headaches weren’t going away…the result…..amazing!! I used to have to take something everyday for a week when I would get headaches like this, they just kept coming back no matter what and I hated taking so much Advil, but when I take Treximet I generally don’t get another really painful headache for about a month or more, which is why I have only taken 8 in the last year. I wish this medicine wasn’t so expensive though, I have no insurance anymore so I know that when I run out I am going to be in pain or taking a lot of Naproxin everyday again. (My husband had me switch to naproxin about 4 years ago because he couldn’t stand watching me destroy my liver.)

  • Barya, Sep 24, 2010

    Yeah, i went to my doctor about my migraines, which started when I was 16 to see if anything was wrong. I usually take Excedrin Migraine for relief at the onset of pain, but she gave me a sample of Treximet, for my next migraine because the only come every 2 wks-1 month, maybe more, maybe less. She also said that if i found Treximet to be a tad expensive, assuming that I like how the meds work, then I can just take an Aleve with Imitrex at the same time and the effect will be the same, if not better, than Treximet. Its just something to think about when your tight on money, if if your insurance does the 80/20 deal…

  • Brian Sep 16, 2011

    If you took treximet once and hated it, my comment might help you.

    I received Treximet from my doctor a while back (maybe 6 months). The first time I took it I had the same experience as a lot of people who have commented: tightness, dizziness, etc… basically I thought I might die. I swore I would never take it again. Well, a few months later I just couldn’t handle the headaches any longer and decided to take another dose. To my surprise, a lot of the things that happened before weren’t so bad. Since then I have taken a few more and it seems that the really uncomfortable side effects have gone mostly away. Hope this helps people who are suffering.

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