Combining sumatriptan and naproxen relieves menstrual migraines

Sumatriptan and naproxen used in combination delivered both 2-hour and sustained pain relief to women with dysmenorrhea who were suffering menstrual migraine headaches, according to a pair of studies reported in the July issue of Obstetrics & Gynecology.

Lisa K. Mannix, MD, of Headache Associates in West Chester, Ohio, and colleagues conducted two similar studies in which adult women with menstrual migraine and dysmenorrhea were treated early in their episode with a combination of sumatriptan (85 mg) and naproxen sodium (500 mg) or with placebo. The primary study end point was the percentage of subjects who experienced cessation of pain within 2 hours.

In both studies, the researchers found that the sumatriptan-naproxen subjects had better pain relief than placebo both at 2 hours and up to 24 hours. In study one, 42% of sumatriptan-naproxen subjects had 2-hour pain relief compared with 23% for placebo, while in study two, the percentages were 52 and 22, respectively. The authors further note that, in study one, 29% of sumatriptan-naproxen subjects had 2- to 24-hour sustained pain relief compared with 18% for placebo, while in study two, the percentages were 38 and 10, respectively.

“Sumatriptan-naproxen provided an effective pain-free response at 2 hours, which was maintained up to 48 hours in menstrual migraineurs with dysmenorrhea. Sumatriptan-naproxen was well tolerated and resulted in decreased rescue medication use and relief of non-painful menstrual symptoms,” the authors write.

Both studies were supported with grants from GlaxoSmithKline. Study authors reported receiving research grants from and serving as consultants and speakers for GSK and a number of other pharmaceutical companies.

Mannix LK, Martin VT, Cady RK, et al. Combination treatment for menstrual migraine and dysmenorrhea using sumatriptan-naproxen: Two randomized controlled trials. Obstet Gynecol. 2009;114:106-113. doi: 10.1097/AOG.0b013e3181a98e4d.