Same Gift... New Wrapping?
Inhaled, injected or taken by mouth….it seems that manufacturers of migraine medications are constantly looking for new ways to speed up or alter the delivery of medications, some of which have been on the market for a long time. When a manufacturer looks to change the formulation of a drug, they have to test it and prove that the new way of giving it is safe, effective and potentially offers some advantage over existing methods of administration. For migraine sufferers, reducing the time it takes for a medication to work can potentially have a significant impact on the duration and severity of their migraine attack. Sometimes, altering the way a drug is delivered that bypasses the stomach can also help relieve nausea and vomiting symptoms experienced by many people with recurring migraines.
Sumatriptan, the drug found in Imitrex and the first drug in the triptan class of migraine medications was introduced to the U.S. market in 1991 and became available generically in 2009. Since that time, various formulations of sumatriptan have been marketed including both oral and injectable syringes that migraine patients can use to manage their acute attacks. Recently, a Kentucky based company, US WorldMeds, announced the availability of yet another injectable formulation of sumatriptan called Alsuma which works very much like the type auto-injectors used by people who need emergency epinephrine due to severe allergic reactions. While sumatriptan is not new, the thought is that by giving the medication quickly via a pre-filled injector subcutaneously in the thigh or upper arm, relief could be achieved more rapidly. In two U.S. clinical trials involving over 1000 migraine patients with moderate or severe migraine pain, a 6-mg injection resulted in a relief in as early as 10 minutes. Side effects and warnings are similar to those seen with other dosage forms of sumatriptan.
Other Medications Given New Ways
Dihydroergotamine (DHE) has recently been re-evaluated in a new delivery form as well. While still investigational, the manufacturer has completed its clinical testing and plans to submit a New Drug Application (NDA) to the FDA in the first half of 2011. Similar to inhalers used for treating asthma for example, DHE given by this type of inhaled device (Levadex) has been shown in a phase III clinical trial to provide quick and sustained pain relief for migraine headaches. While this formulation is new, DHE is also not a new drug and is currently available in other dosage forms including as an injection as well as a nasal spray.
Over the course of the past year, medications not traditionally used for migraine have also been introduced and approved for prevention or relief of migraine symptoms. Most notably, Botox was noticed to have beneficial effects on preventing migraine when it was being used for other purposes. The intravenous form of aspirin, a drug most commonly given by mouth, has been studied for treating acute migraines in hospitalized patients. And Cambia, a non-steroidal anti-inflammatory drug known as diclofenac was re-introduced in dissolvable form specifically for acute migraine. While for the most part, the recent expansion of medication options for migraine have not produced significant new chemical entities, new routes of administration may offer relief for people who may have tried these drugs in the past and found them lacking.
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