TREXIMET/SUVEXX (Sumatriptan/Naproxen)

TREXIMET/SUVEXX (Sumatriptan/Naproxen)

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What is this medication?

Sumatriptan+Naproxen, Treximet(US)/Suvexx(CDN)
Analgesic, Nonopioid; Antimigraine Agent; Nonsteroidal Anti-inflammatory Drug (NSAID), Serotonin 5-HT1B, 1D Receptor Agonist

Brand Name US: Treximet
Canadian Equivalent: Suvexx

“Alert: US Warning
The use of NSAIDs around 20 weeks’ gestation or later in pregnancy may cause fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment, which may be fatal. NSAIDs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. Sumatriptan/naproxen is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.  NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.”

How does this medication work?

Sumatriptan is a selective 5-hydroxytryptamine (5-HT1) receptor subtype agonist that binds to intracranial blood vessels and sensory nerves of the trigeminal system; causes vasoconstriction and reduces neurogenic inflammation associated with antidromic neuronal transmission correlating with relief of migraine.  Naproxen is a nonsteroidal anti-inflammatory that reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which result in decreased formation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties

How should I take this medication? 

Usual (Oral):  Initial dose of sumatriptan 85 mg/naproxen 500 mg. If a satisfactory response has not been obtained at 2 hours, a second dose may be administered (maximum: Sumatriptan 170 mg/naproxen 1,000 mg in 24 hours).

Note: The safety of treating an average of >5 migraine headaches in a 30-day period has not been established.

How to Take: May be administered with or without food. Swallow tablet whole; tablet should not be divided, crushed, or chewed.

What should I watch for while using this medication? 

Before using sumatriptan/naproxen make sure your physician is aware of any allergies or medications you currently take, pre-existing medical conditions and activities you perform.  NSAIDs cause an increased risk of serious (and potentially fatal) adverse cardiovascular thrombotic events, including MI and stroke. Risk may occur early during treatment and may increase with duration of use. Cerebral/subarachnoid hemorrhage and stroke (may be fatal) have been reported with 5-HT1 agonist administration; discontinue use if a cerebrovascular event occurs. Significant elevation in blood pressure, including hypertensive crisis with acute impairment of organ systems, has also been reported on rare occasions in patients with and without a history of hypertension, monitor blood pressure; contraindicated in patients with uncontrolled hypertension.  NSAIDs cause an increased risk of serious GI inflammation, ulceration, bleeding, and perforation (may be fatal); elderly patients and patients with history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events. Excessive use of triptans > 10 or more days per month may lead to worsening of headaches (medication overuse headache); withdrawal treatment may be necessary in the setting of overuse.  NSAIDs can also cause hepatotoxicity and renal toxicity, serious skin reactions including exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) which can be fatal.  Do not use sumatriptan/naproxen in patients with aspirin-sensitive asthma, coronary artery disease, heart failure, severe hepatic and renal impairment.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

Chest discomfort, chest pain, hot flash, dyspepsia, nausea, sore throat, xerostomia, dizziness, drowsiness, hypertonia, paresthesia, jaw pain, jaw pressure, jaw tightness, neck pain, neck pressure, neck tightness, pharyngeal edema

Note this is not a complete list of side effects, only the most common.