In the US, a drug combination for treatment of migraines has been released called Treximet – sumatriptan (Imetrix) 10 mg and Aleve (Sodium Naproxen) 25 mg. It has been approved for use in adolescents 12-17. In Canada you’d have to cut sumatriptan 25 mg and Aleve 220 mg tablets or take liquid of latter.
Another Option for Adolescents with Migraine
May 28/2015
http://headacheandmigrainenews.com/another-option-for-adolescents-with-migraine/
- In States there has been a combination of 85 mg sumatriptan and 500 mg sodium naproxen called Treximet for adults for migraines
- Now there is an approved version of Treximet for 12-17 yr olds with sumatriptan 10 mg and sodium naproxen 25 mg.
- Naproxen 5 mg/kg in 5-16 year old gives similar blood levels to giving an adult 500 mg.
naproxen (Naproxen) suspension
http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=5701
average weight of a 12 year old is 20 kg so could take 100 mg if not underweight. - A statement on use of tritans in adolescence was written quite some years ago and stated:
“While none of the “triptan” agents are currently approved for use in children, extensive trials in adolescents have been completed, and early reports have demonstrated excellent safety profiles in patients 12 to 18 years of age.Off-label use of sumatriptan (Imitrex), using 25-mg tablets or a 20-mg nasal spray, rizatriptan (Maxalt, Maxalt-MLT), in a dosage of 5 to 10 mg administered via tablets or oral dissolving wafers, and zolmitriptan (Zomig), in a dosage of 2.5 to 5 mg, may be considered for use in adolescents with moderate to severe migraine headaches who are unresponsive to conventional analgesics.”
Headaches in Children and Adolescents.
DONALD W. LEWIS, M.D.
Am Fam Physician. 2002 Feb 15;65(4):625-633.
http://www.aafp.org/afp/2002/0215/p625.html
Comment – combo of an NSAID and triptan has always worked better – the latter takes care of the pounding blood vessel pounding while the NSAID takes care of the skin sensitization inflammatory response. Given that there is no Treximet in Canada would suggest:
- Sumatriptan 25 mg – 1/2 tablet in younger and maybe 25 mg in older
- Sodium naproxen either suspension 100 mg or aleve 220 mg 1/2 tablet
- In US, might be cheaper than the treximet
- In adolescent cases check diet, smoking, sleep, stress, and gum chewing:
Teenage Chronic Headaches – 1/2 Might Be Chewing Gum
http://painmuse.org/?p=3532 - Now, having your head down texting, can cause neck pains and subsequent headaches as well
- Using this is not a panacea with 1/3 much better and 2/3 satisfied in adults:
Triptan Plus NSAID – Not as Great as One Would Like For Migraine Relief
http://painmuse.org/?p=3026