Naproxen/Sumatriptan

DEA Class;  Rx

Common Brand Names; Treximet

NSAIDs; 

Serotonin 5-HT-Receptor Agonists

Aspirin allergy or triad

Hypotension with prior NSAID or aspirin use

History or suspected ischemic heart disease, CVA/TIA, peripheral vascular disease

Vasospastic CAD

Uncontrolled hypertension

Basilar or hemiplegic migraine

Post CABG

Hepatic impairment

Within 24 hr of ergot-type drugs (eg, methysergide, dihydroergotamine) or other 5-HT1 agonists

Concomitant or within 2 wk of using MAO-A inhibitors

3rd trimester pregnancy

>10%

Gastric erosion (19%); compared with 38% for equal naproxen dose without PPI

Dyspepsia (18%); compared with 27% for equal naproxen dose without PPI

Gastritis (17%)

1-10%

Diarrhea (6%)

Abdominal pain (6%)

Nausea (5%)

Hiatal hernia (4%)

Abdominal distension (4%)

Flatulence (4%)

Esophagitis (4%)

Constipation (3%)

Headache (3%)

Dysgeusia (2%)

Erosive duodenitis (2%)

Hemorrhagic gastritis (1%)

Not recommmended for patients with likelihood of unrecognized CAD, severe renal impairment (CrCl <30 mL/min), or women who are breast feeding

Use NSAIDs with caution with underlying cardiovascular disease, active/history of peptic ulcer, inflammatory bowel disease, GI disease, bleeding disorder, renal/hepatic impairment, anemia, asthma, heart failure, edema, dehydration, HTN, or seizure disorder

Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs

Overuse of acute migraine drugs (eg, ergotamine, triptans, opioids, or a combination of drugs for 10 or more days per month) may lead to exacerbation of headache (medication overuse headache); medication overuse headache may present as migraine-like daily headaches, or as a marked increase in frequency of migraine attacks

Pregnancy; Avoid use of NSAIDs in pregnant women at about 30 weeks gestation and later; NSAIDs increase risk of premature closure of fetal ductus arteriosus at approximately this gestational age

Lactation:

The naproxen anion has been found in milk of lactating women at a concentration equivalent to approximately 1% of maximum naproxen concentration in plasma

Sumatriptan is excreted in human milk following subcutaneous administration; there is no information regarding sumatriptan concentrations in milk from lactating women following administration of sumatriptan tablets

naproxen/sumatriptan

tablet

• 60mg/10mg
• 500mg/85mg