New combination triptan and NSAID approved for Migraine.
Symbravo is a new acute therapy drug for Migraine made up of two drugs-rizatriptan and meloxicam.
This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, Migraine textbook author, Podcaster, YouTube video producer, and Blogger.
General Statement. This is not the first time that a triptan has been combined with an NSAID. Sumatriptan was combined with naproxen previously and called Treximet. That drug still exists. Symbravo will be a similar drug. Triptans came out in 1991 and are still the best acute therapy drugs for migraine.
But some persons can’t take triptans due to existing medical issues such as severe hypertension, atherosclerotic heart disease or basilar artery syndrome. Also, Triptans don’t work for 20% of migraineurs.
New drugs such as Nurtec ODT, Quilipta, and Trudhesa do not have blood pressure or cardiac limitations for use, but they don’t work as well as triptans do
The name brand drug for rizatriptan was Maxalt and the brand name for meloxicam was Mobic.
Efficacy. In clinical trials a single dose of Symbravo got rid or migraine pain and returned the patient to normal in 2 hours. Relief lasted up to 48 hours without further treatment.
Side effects Rizatriptan may cause dizziness, somnolence, asthenia, numbness, stroke, or MI and Meloxicam may cause GI bleeding or perforation, ulcer, stroke or MI.
Usage. Symbravo should be taken, like any other triptan, at the very onset of a migraine or at the onset of a premonitory visual aura if it occurs. The drug should be used only 2 days a week as it can cause medication overuse headache at higher usage levels.
Symbravo is an acute therapy drug to be taken for a current migraine. It is not a drug for migraine prevention.
Summary Symbravo should be a good drug to treat migraine. It combines the 2 known elements that lead to successful treatment-a triptan and an NSAID. These 2 drugs work better when combined. In the days before Treximet was developed neurologists would often advise their patient to take over the counter Advil or Aleve with their doctor prescribed triptan. Symbravo should be another great combination drug for acute therapy for migraine.
It is not approved for use in children.
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