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Combination of Sumatriptan and Naproxen for Migraine
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To the Editor: The trial by Dr Brandes and colleagues1 demonstrated superior efficacy of the sumatriptan–naproxen sodium single fixed-dose tablet compared with monotherapy with either sumatriptan or naproxen sodium for acute treatment of migraine. Their findings support earlier work2 showing the concurrent administration of sumatriptan and naproxen sodium as an effective treatment.
However, we find the discussion of the advantages and disadvantages of a single fixed-dose tablet to be incomplete. The authors suggest that the use of separate tablets of sumatriptan and naproxen sodium would lead to the less desirable "step care approach," in which definitive treatment could be delayed while the optimal dose and combination of medications is found. We believe that although adherence to 2 tablets may be an issue for some patients, the use of 2 separate tablets taken together still allows for "stratified care" for migraine when medication and dose are geared toward disease severity.3
Cost . . . [Full Text of this Article]
Kevin P. Hill, MD
kevin.hill@yale.edu
Omotola Hope, MD
Yale University School of Medicine
New Haven, Connecticut
RELATED LETTER
Combination of Sumatriptan and Naproxen for Migraine—Reply
Jan Lewis Brandes, David Kudrow, Stuart R. Stark, C. Phillip O’Carroll, James U. Adelman, Francis J. O’Donnell, W. James Alexander, Susan E. Spruill, Pamela S. Barrett, and Shelly E. Lener
JAMA. 2007;298(11):1276-1277.
EXTRACT
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RELATED ARTICLE
Sumatriptan-Naproxen for Acute Treatment of Migraine: A Randomized Trial
Jan Lewis Brandes, David Kudrow, Stuart R. Stark, C. Phillip O’Carroll, James U. Adelman, Francis J. O’Donnell, W. James Alexander, Susan E. Spruill, Pamela S. Barrett, and Shelly E. Lener
JAMA. 2007;297(13):1443-1454.
ABSTRACT
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