FORMULARY DRUG REVIEWS

650 Volume 43, August 2008

Sumatriptan Succinate/Naproxen SodiumDennis J. Cada, PharmD, FASHP, FASCP (Editor)*; Terri L. Levien, PharmD†;

and Danial E. Baker, PharmD, FASHP, FASCP‡

INDICATIONSThe combination sumatriptan

succinate and naproxen sodium

tablet is indicated for the acutetreatment of migraine attacks withor without aura in adults.1

CLINICAL PHARMACOLOGYSumatriptan succinate 85 mg

and naproxen sodium 500 mghave been formulated in a single,fast-disintegrating tablet formula-tion using RT Technology. RTTechnology is designed to enhancedispersion and dissolution ofsumatriptan, even in the presenceof gastric stasis, allowing the drugto be absorbed more quickly.2,3

Naproxen sodium is a non-steroidal anti-inflammatory drug(NSAID); the sodium salt is a morerapidly absorbed salt used primar-ily as an analgesic.4 Sumatriptan isa vascular 5-hydroxytryptamine 1

(5-HT1) receptor agonist that pro-duces vasoconstriction and, there-by, migraine relief.4

PHARMACOKINETICSWith the combination tablet

using RT Technology, the suma-triptan component disintegratesrapidly and empties from the stom-ach faster, allowing the sumatrip-tan to be absorbed more quicklythan the naproxen, following oraladministration.5 Peak sumatriptanconcentrations occur approxi-mately 1 hour after oral Treximetadministration compared with a1.5-hour time to peak for suma-triptan 100 mg tablets (Imitrex).1

Peak naproxen concentrations arereached approximately 5 hoursafter Treximet administration, a 4-hour delay compared with naprox-en sodium 550 mg tablets(Anaprox DS).1 Administrationwith food has no effect on thebioavailability of either compo-nent but can delay the absorptionof the sumatriptan component by40 minutes.6

With the combination tablet,sumatriptan peak concentrationsare reached a median of 53 min-utes faster than a similar, fast-dissolving formulation of suma-triptan that does not contain thenaproxen component.7 The suma-triptan peak concentration andoverall exposure did not differbetween the 2 formulations despitethe more rapid time-to-peak con-

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Through the cooperation of The Formulary, Hospital Pharmacy pub-lishes selected reviews in this column. If you would like information aboutThe Formulary Monograph Service or The F.I.X., call The Formulary at800-322-4349. The August 2008 monograph topics are on alvimopan,tolvaptan, liraglutide, iclaprim injection, and alogliptin. The DUE is onalvimopan.

*Executive Editor, The Formulary; †Clinical Associate Professor of Pharmacotherapy, Drug Information Center, Washington StateUniversity Spokane, WA; ‡Director, Drug Information Center and Professor of Pharmacy Practice; College of Pharmacy, Wash-ington State University Spokane, PO Box 1495, Spokane, WA 99210-1495.

Generic Name: SUMATRIPTANSUCCINATE/NAPROXENSODIUMProprietary Name: Treximet(Pozen, GlaxoSmithKline)Approval Rating: 4STherapeutic Class: Serotonin 5-Hydroxytryptamine 1 (5-HT1)Receptor Agonists, MigraineCombinationsSimilar Drugs: Sumatriptan,NaproxenSound- or Look-Alike Names:Torecan, Tricon, Trisenox

Hospital PharmacyVolume 43, Number 8, pp 650-6602008 Wolters Kluwer Health, Inc.

FORMULARY DRUG REVIEWS