What is Suvexx?
Suvexx is a combination of two commonly used acute migraine [1] medications in a single tablet: sumatriptan [2] 85 mg and naproxen sodium 500 mg. This product has been available in the U.S. for many years under the brand name Treximet.
Combining a triptan and an anti-inflammatory [3] (NSAID) is a common approach for migraines that won’t be successfully controlled by one medication alone. See here to read more about combinations (see this post [4]).
The recommended dose is 1 tablet of Suvexx taken at the start of migraine pain. The maximum dosage is 2 tablets per 24 hours, taken at least 2 hours apart. This medication may be taken with or without food and should not be split, crushed, or chewed.
Does Suvexx work to treat migraine attacks?
Because Suvexx contains two medications that work differently to treat migraine, some people may find it more effective than using a triptan or NSAID alone.
A large analysis of studies evaluating the combination of sumatriptan plus naproxen found that 58% of people with moderate or severe attacks reported significant pain reduction or relief after 2 hours with the combination of sumatriptan and naproxen, compared to 52% with sumatriptan alone, 44% with naproxen alone and 27% with placebo.
The combination of sumatriptan and naproxen was also more effective in treating other migraine symptoms (nausea, sensitivity to light or sound) and allowing return of function.
Are there side effects or contra-indications to Suvexx?
Side effects [5] can relate to sumatriptan or naproxen and may include: dizziness [6], sleepiness, nausea, indigestion, dry mouth, tingling or burning of the skin and chest discomfort.
Suvexx has the same restrictions and risks as triptans [7] and NSAIDs and should not be used in the following situations (read more HERE [8])
- Hemiplegic or basilar migraines
- Active bleeding into the stomach or bowels
- Uncontrolled high blood pressure [9], heart disease, kidney disease or a history of stroke.
- Pregnancy, especially the third trimester
- In combination with DHE (dihydroergotamine)
What could be the pros and cons of this new option?
PROS: For people who already use or are considering combination therapy to increase effectiveness of acute migraine treatments, Suvexx offers the convenience of taking just one tablet at migraine onset.
CONS: Possible downsides include a higher cost than sumatriptan or naproxen purchased individually and lack of dosing flexibility as only one tablet strength is available.
References
Law S, Derry S, Moore RA. Sumatriptan plus naproxen for the treatment of acute migraine attacks in adults. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD008541. DOI: 10.1002/14651858.CD008541.pub3.
Product Monograph [Suvexx]. Health Canada Drug product database. Available from: https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=98619 [10]. Accessed online Sept 29, 2020.
Brandes JL, Kudrow D, Stark SR, et al. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA. 2007 Apr 4;297(13):1443-54. doi: 10.1001/jama.297.13.1443.