Imitrex Migraine Patch and Gnarly Latin

Sumatriptan patch is an alternative method of taking your Imitrex. Or GImitrex, as the case might be.

It's called NP101 and it's being developed by NuPathe Inc. Apparently, some data on Phase 1 clinical trial was presented on 50th Annual Scientific Meeting of the American Headache Society of which yours truly provided an extensive coverage. It's good to hear about it later than never.

The Press Release contains lots of Latin words and none of them is Salsa. So, lets translate.

The Pluses:

• The Sumatriptan patch delivers the drug into the bloodstream faster that a pill or a nasal spray with the same ingredients.
• It's also more reliable than a pill or a nasal spray that depend on patient's condition.
• Side-effects, such us flushing or pain and pressure sensations were not reported with the patch, while present after injection and the pill.

The Minuses:

• Skin-itch. (Presented in the report as pruritus.)
• Skin-irritation. (Presented in the report as erythema.)
• The people who market the patch apparently can't speak proper English without hiding the negative bits behind Latin words (see above) and as such cannot be trusted :P .

The report did not specify the amounts of Sumatriptan in the patch while stating the amounts of it in other formulations of Imitrex (20 mg nasal spray, 100 mg oral tablet, 6 mg subcutaneous injection). The study was conducted on healthy individuals, not migraine patients.

The NP101 patch is going into Phase III clinical trials son. That is unless they realize that migraine people have more sensitive skin than normals and will have to re-formulate the patch with extra Aloe Oil.

Other than that, the future FDA approval seems to be a done deal. We can reasonably predict Sumatriptan Patch will hit the pharmacies inside a year's time.

Related Articles:

Imitrex - Powder Nasal Delivery vs Subcutaneous Needle-less Injections

Your Hair Hurts? Read This

Link: NuPathe Reports Positive Phase I Results for NP101, a Novel Transdermal Patch for Acute Migraine

Imitrex - Powder Nasal Delivery vs Subcutaneous Needle-less Injections

Imitrex is going cheap and generic. As a result, a whole lot of pharma research is concentrated on how to make it more expensive again.

Now, just because it sounds like a bad news for us, the end-consumer, it not necessarily is. For example, the alternative methods of sumatriptan delivery can finally be exploited.

The OptiNose AS (that is the real company name, it's not a joke), has tested powder nasal drug delivery with a doohickey of their own invention.

We already mentioned the benefits of the through-the-nose method. It lowers the dosage amount (read - less side effects) and reduces the strain on our livers. The results OptiNose is reporting are pretty much in line with our previous observations - it's better than chugging a pill.


If the snorting isn't your style and you like Star Trek, here's the thing for you. Zogenix, Inc. has one of those little gadgets that can inject the meds into your arm while making that hissing noise. Without a needle. It's pretty neat if you are afraid of needles or just want to look cool.

The drug is delivered directly through the skin into the subcutaneous space. That helps it to reach the bloodstream faster than going through the stomach. Thus - faster relieve and, once again, less side-effects due to a lower dosage.

Both methods are shown to be preferable to the traditional pill-form delivery. So far no firm grounds to distinguish between the two as far as benefits go. Most likely, when these products hit the market, it will be up to the patient's preference or to the doctor's bias.

related articles:
Treximet or TrickThem-et?
Doing Imitrex Lines
link: Zogenix Announces Clinical Study Results for sumatriptan DosePro(TM), a Novel Migraine Treatment
link: OptiNose presents data on highly effective migraine treatment

Treximet Street Prices

Treximet is finally appearing in the pharmacies all around the country. The price-tag is, as expected, matches that of Imitrex, GlaxoSmithKline's flagship migraine abortive. Unfortunately for them, sumatriptan (Imitrex) is going generic later this year. Thus the introduction of Treximet, a "new" medicine to take it's place.

The going price is around $200 for 9 pills:


Comes November 2008, the prices for generic sumatriptan are going to plummet - see Generic Imitrex Price Projection .

Wonder what will will happen to Treximet then. Especially considering that Treximet=Imitrex+Naproxen(Advil) - see Time Traveling Treximet Trip .

Well, here's the plan - we live till November and find out. Meanwhile, my gentle readers, beware of doctors Treximet prescribing...

Related article: Treximet or TrickThem-et?

technorati tags: Treximet Trexima Imitrex Naproxen sumatriptan migraine abortive migraine hacks migraine migraines headache headaches

Cymbalta and Maxalt MLT in Migraine News

First item today is a good news for our New Zealand readers. In case you missed it on morning news, Maxalt MLT, a triptan that has proved to be a good alternative to Imitrex, is now fully funded through PHARMAC to all the patients with prescriptions for it.

For those who wonder, the MLT part might as well stand for "melty" since this particular formulation of Maxalt is in form of a "wafer" that dissolves on the tongue and does not require water.

So, get you prescriptions lined up and give it a try. It's free, you can't loose.


Second bit of news that deserves our attention today is that Eli Lilly and Company, makers of Cymbalta® (duloxetine HCl), is seeking approval from FDA for a new indication of their wonder drug for management of chronic pain, money.cnn.com reports.

"The submission is based on outcomes of clinical trials in chronic osteoarthritis pain of the knee and chronic low back pain, in addition to data from previously completed pain studies in diabetic peripheral neuropathic pain (DPNP) and fibromyalgia," the company says.

If your doc tries to get you on Cymbalta for your migraines and/or headaches or any other of your ails, do be careful. Aside from the usual side effects, that are common to many painkillers, this one is a serotonin-norepinephrine reuptake inhibitor and as such, might cause Serotonin Syndrome if taken with triptans such as Imitrex or Maxalt mentioned above.


Think healthy, my gentle readers. And if that's a no-go, think of New Zealand, the land of free triptans.

link: Maxalt MLT Now Fully Funded For Migraine Sufferers
link: Migraine drugs to be fully funded
link: Lilly Submits Cymbalta(R) Supplemental New Drug Application for Chronic Pain to U.S. Food and Drug Administration

technorati tags: Imitrex Maxalt PHARMAC Cymbalta migraine abortive migraine migraines headache headaches

Treximet or TrickThem-et?

As yours truly has reported earlier, Treximet is making a landing in the pharmacy near you. Brought to you by the good people of GlaxoSmithKline, the makers of Imitrex. And priced accordingly, no doubt.

Debbie, who runs Down The Rabbit Hole blog, has noticed something interesting - a little subversive disinformation campaign as propagated by sloppy journalists and uninformed patients alike. There are plenty of little news blips if you care to search for them that say pretty much the same as this little article: New Drug Could Be Best Migraine Medicine On Market.

So that you don't get switched to a more expensive meds by your doctor just because he or she gets their medical news from pharmas press releases, once again here are the facts about Treximet from the horse's mouth, so to speak:

"Treximet contains 85 mg sumatriptan, formulated with RT Technology(TM), and 500 mg naproxen sodium. Sumatriptan is the active ingredient in Imitrex(R) Tablets, available in 25 mg, 50 mg and 100 mg strengths. In clinical trials, Treximet provided a significantly greater percentage of patients migraine pain relief at two hours compared to sumatriptan 85 mg or naproxen sodium 500 mg alone. In addition, Treximet provided more patients sustained migraine pain relief from two to 24 hours compared to the individual components."

Those who follow the rantings of this humble scribe have already heard the call; as for the readers who are only now joining us, here it is again, yours truly's recommendation:

"As this Fall rolls in, change your Imitrex prescription to the generic Sumatriptans and Naproxen and you'll have you own hand-rolled generic Treximet."

Not that you need to heed it, my gentle readers, but just because we are talking medication, it does not mean we should tune out the voice of our inner wallet.

related articles: Time Traveling Treximet Trip

FDA approves of butch names, not so sure of new drugs

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Generic Imitrex Price Projection

A tiny bit of info has surfaced that might help us learn how much generic Imitrex or sumatriptan (or GImitrex, if you will :P ) might cost us come this fall. Here's the scoop:

Dutch medical insurance companies decided to stop co-pay on a bunch of different medications unless they are in a generic form. While this issue was debated, some numbers got thrown around a bit and this is what yours truly have found:

Right now Imitrex is €30 or 47 U.S. dollars for 6 pills, making it $7.8 a pop for the Dutch. That makes it pretty darn cheap as compared to what we pay in the U.S. The dose was not specified but seeing as we pay pretty much the same for 100mg or 50mg pill packages, it probably doesn't matter much. Let's assume 50mg tablets (worst-case scenario) for the purpose of this exercise.

After GImitrex rolles out, the prices for it will be €4 or 6.27 U.S. dollars for 6 pills, which is roughly $1.05 a pill.

So, the Dutch are looking at saving more than 6/7th of the current price if switching to generic sumatriptan. If that's the shape of things to come, it paints a pretty rosy picture for the Imitrex-junkies around the world.

link: Switch to generics slashes drugs bill

technorati tags: Imitrex Sumatriptan migraine abortive prices migraine migraines headache headaches

Triptans Alone Could Cause Life-Threatening Condition

In 2006, 38 cases of serotonin syndrome associated with triptans (Imitrex, Maxalt, etc). Out of them, "27 were in patients taking the headache drugs and antidepressants and 11 in people taking headache drugs alone," said Offie Soldin, an associate professor at Georgetown University Medical Center in Washington who conducted a new study for FDA. This study is the first to use the FDA Adverse Event Reporting System which is a fancy name for a database that monitors all drugs and therapeutic biologic products after they have been FDA-approved.

It's a well known fact that if one is on Valiums or Prozacs or whatever similar drugs that are out there that play a number on one's serotonin level, one should be careful with triptans. There even was an FDA warning about it in 2006. At least it's supposed to be. Many a doctor prescribe both antidepressants and triptans to migraine patients without as much as butting an eyelash.

That particular nuisance aside, this is the first time someone publicized the cases of serotonin syndrome from triptans alone. "In the 11 reports of serotonin syndrome, five patients were hospitalized and two cases were classified as life threatening," said study.

Considering the origins of the triptans as LSD derivatives, that comes as small surprise. It is, however, a good reminder to us all that triptans are a serious medicine that's has to be taken carefully and if there's any notable after-effects, one has to pay close attention to them. Here's a short primer on what to be on look-out for:

Mild symptoms of serotonin syndrome include Mild symptoms may only consist of tachycardia, and shivering, diaphoresis (sweating commonly associated with shock), mydriasis (dilated pupils), myoclonus (intermittent tremor or twitching), as well as overactive or overresponsive reflexes. In addition moderate intoxication includes abnormalities such as hyperactive bowel sounds, hypertension and hyperthermia; a temperature as high as 40 °C (104 °F) is common in moderate intoxication. The overactive reflexes and clonus in moderate cases may be greater in the lower limbs than in the upper limbs. Mental status changes include hypervigilance and agitation.

Severe symptoms include severe hypertension and tachycardia that may lead to shock. Severe case often have agitated delirium as well as muscular rigidity and high muscular tension. Temperature may rise to above 41.1 °C (105.98 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation.

(source: wikipedia.com, serotonin syndrome, symptoms)

So, not to OD on LSD, do watch out for the above-mentioned abnormalities, my gentle readers.

link: Migraine Medicines May Cause Potentially Deadly Brain Syndrome

technorati tags: Imitrex Prozac Valium Serotonin serotonin syndrome antidepressants migraine abortive migraine migraines headache headaches

Time Traveling Treximet Trip

I've been on Treximet for years without realizing it. Even when it was called Trexima and even before FDA approved it, I was loading on it every time the migraine attack hit.

Treximet is expected to be available in U.S. pharmacies by mid-May, 2008. I've been taking it for years. Inconsistency? Not at all. Even without an ability to time-travel (one looses it as one grows older, as you know) it was made possible by combining good old Imitrex and even gooder and older Naproxen.

There goes the mystery... Or does it? Let's check the facts the good people of GlaxoSmithKline and POZEN Inc. laid out for us.

"Treximet contains 85 mg sumatriptan, formulated with RT Technology(TM), and 500 mg naproxen sodium. Sumatriptan is the active ingredient in Imitrex(R) Tablets, available in 25 mg, 50 mg and 100 mg strengths. In clinical trials, Treximet provided a significantly greater percentage of patients migraine pain relief at two hours compared to sumatriptan 85 mg or naproxen sodium 500 mg alone. In addition, Treximet provided more patients sustained migraine pain relief from two to 24 hours compared to the individual components."

The above basically says that either Imitrex OR Naproxen alone don't work as well as Imitrex AND Naproxen taken together. That's has been known for a while (ask your doctor).

So, why mix two in the same pill when you can get a prescription for both and get the same result, you ask.

The only answer one can think is that GlaxoSmithKline is not too keen on loosing all those profits from the sale of Imitrex come November 2008 on the account of Sumatriptan going generic. Naproxen (Aleve) has had this status for longer than there has been recorded history, it seems.

By combining the two, GlaxoSmithKline and POZEN can still sell brand-name drug that's sufficiently different (an extra ingredient and the dosage) from your ran-of-the-mill generic Sumatriptans. Sufficiently different to charge the premium for the brand-name alone.

Not to put down GSK, P. and Company but seriously... We've been paying sometimes up to $30 a pop for those Imitrex pills. We've been holding our collective breaths for GImitrex to get here so we could actually have money on something else besides Migraine Abortives. Now they going to introduce "the latest and the greatest", premium-priced drug that one has got to have.

And people are going to buy into that, and doctors are going to start prescribing it, and no one would know any better.

Of course, the ones who've read this article will have the option of saving at least 2/3 of the cost on the migraine abortives. As this Fall rolls in, change your Imitrex prescription to the generic Sumatriptans and Naproxen and you'll have you own hand-rolled generic Treximet.

As for the people who haven't read it, well, you should have :P .

Related articles:

FDA approves of butch names, not so sure of new drugs

Generic Imitrex coming out sooner than expected

War on Generic Drugs

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Imitrex and Sailing Don't Mix

Imitrex and operating heavy machinery just don't mix. There's a good reason Imitrex is called a "stupid pill" - you take it and in about 5 minutes you have cognitive abilities of a new-born kitten.

Here's a good example: Associated Press reports that "The pilot of a freighter that caused a huge oil spill in the San Francisco Bay was confused about where he was headed and immediately regretted setting off that foggy morning." They are talking about John Cota, a pilot managed to guide
"Cosco Busan", container ship, smack into San Francisco-Oakland Bay Bridge on November 7, 2007.

The follow-up investigation by National Transportation Safety Board (NTSB), reveled that capt. Cota was on quiet a few prescription drugs, including Imitrex for his migraines. He was also taking Valium as a sleep aid.

On a side-note - kids, take some time and write it down - DO NOT mix Valium and Imitrex. It might seem like fun but it does a number on the serotonin levels in your brains. Not only you will feel "blue" (read - depressed) 24/7, your mental concentration will drop right through the floor.

Even taking Provigil (Modafinil), a hardcore stimulant, did not help capt. Cota in this particular instance.

Taking Imitrex alone is a trip. If you are caught in a situation when you have to, say, land a plane, fire a rocket or, I don't know, pilot a huge freighter through San Francisco Bay in a midst of a fog, wait with that Imitrex until you are done. And if you already taken it, just call it in, the results most likely be the same as if you were actually doing it.

The rule of the thumb recommendation for operating heavy equipment after taking Imitrex is - don't. The largest piece of machinery you can effectively handle for a while would be a remote control. If you can remember where you've put it that is, seeing as you just took the "stupid pill".

link: Pilot, Crew Lost in Fog Before Spill

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War on Generic Drugs

At the end of 2008 (this year, if you're still keeping count), several prescription medicines for migraine patients should be available in a generic form. Among those are Imitrex, triptan used to abort acute migraines and Efexor, psychiatric drug prescribed as a migraine preventive.

It's a good news for our valets - generics cost less than one-third of the price-tag of the brand-name drugs.

There is, however, a caveat - recently, more and more patients, organizations and medical professionals are questioning the validity of The Generic Pharmaceutical Association's slogan: "Same Medicine. Same Results."

Cardiologists, endocrinologists, physicians who care for organ transplant recipients, all actively resist using certain genetic substitutes. In 2004, The American Association of Clinical Endocrinologists, the Endocrine Society and the American Thyroid Association issued a warning that patients with hypothyroidism could be harmed by switching to generics.

"A switch from a long-used brand-name drug to its generic equivalent can, on occasion, bring a shifting profile of side effects. In a number of cases documented in medical journals and recounted in interviews with physicians, a generic version of what is often called a "pioneer" drug simply doesn't appear to work as well for many patients."

If you are switching from a brand-name medication to a generic form of the same, do pay attention to those "little" details. And here's hoping that the generic Imitrex will work just as well as the real deal. Lets wait and see, only 6 or 7 months left till the GIMITREX lift-off.

In the mean time, think healthy thoughts, my gentle readers.

Link: Copycat drugs aren't always created equal

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Quitting Imitrex Worked - Lori O'Connell's Story

She has tried everything.

Botox injections, acupuncture, yoga, vitamins and herbs and almost got a hysterectomy. Four neurologists and countless medications. Imitrex, the wonder-drug, has worked well, but "over several years the headaches increased in frequency - to 15 days or more a month - and severity".

Since 2001, Lori O'Connell has been searching for a better way to deal with migraines and she finally found something that worked.

On the advise of her new doctor at Headache and Orofacial Pain Program at Cedars-Sinai Medical Center she discontinued Immitrex and adapted a new multi-directional approach:

• behavioral action plan
• daily stretching and posture exercises
• relaxation techniques
• pacing skills for all the daily activities
• cardiovascular exercise
• healthy diet

Mrs. O'Connell said - it's "becoming a way of life. My headaches are becoming more manageable and less frequent, my sleep is more restful and I'm more energetic and productive."

Yet another great example that multi-disciplinary approach to migraines and carefully balanced preventive and abortive medications can significantly improve migraine sufferer's quality of life.

link: Migraines required a new approach

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technorati tags: multidisciplinary migraine prevention migraine preventive migraine abortive behavioral diet relaxation Imitrex

This is your brain. This is your brain on Imitrex.

Here's something interesting - Dr. Edith Hamel of Montreal Neurological Institute and Hospital, while talking about a recent experiment performed by herself and some doctor-friends of her's, happened to mention, and I quote:

"No previous study in migraine patients had looked at the effect of sumatriptan, or triptans in general, on the brain serotonergic system, even though these drugs are known to activate receptors for serotonin that modulate the activity of this neurotransmitter system that has been repetitively implicated in migraine pathophysiology."

Translating it into human language this means that our doctors have been feeding us Imitrex, Maxalt, Naramig, Frova, Zomig, Relpax, etc, with practically no experimental data to explain how those drugs help with the migraines.

But thanks to the good doctor and her colleagues, now it is all better. The report they put up is a bit technical so I'll summarize it for you:

1. In general, most migraine patients have low Serotonin level.
2. Serotonin level goes up during migraine attack.
3. Sumitriptan (Imitrex) lowers serotonin level.
4. Migraine patients feel better, ta-da!

This is not all, however. If you ever Wikied Sumatriptan (Imitrex, Imigran), you might have seen this passage:

"Often, serotonin levels in the brain become extremely low before the onset of a migraine. Sumatriptan is administered to aid in leveling the serotonin levels in the brain."

Doesn't it give you an impression that Sumatriptan is taken to actually raise the serotonin levels? Being obscure like that only leads to the raise of people who start shouting that "Serotonin is the only natural cure for migraines". (Yes, you can get it in a pill form, google it.)

Good to have it straightened out, finally. Those who can afford Imitrex, rejoice. And yah, way to break the Wiki, Dr. Hamel.


link: Dr. Edith Hamel

link: Sumatriptan normalizes the migraine attack-related increase in brain serotonin synthesis

link: Sumatriptan (Wiki)

Generic Imitrex coming out sooner than expected

GlaxoSmithKline's (GSK) patent on Imitrex is set to expire in February, 2009. Yet Aurobindo Pharma, a large generic drug manufacturer, has received the FDA's approval to start selling generic version of Imitrex several month before that date. Why the rush, one might ask, it's only a couple of month. Well, Imitrex brings about $80 mil. in sales monthly in the US alone - you do the math.

Corporate greed aside, it's a good news for migraine patients - the faster we get generic version into our local pharmacies, the less we'll have to pay.


link: Aurobindo gets USFDA nod for generic Imitrex