Treximet is a brand-name prescription drug used to treat migraine with or without aura.

Migraine is a neurological condition, which means that it affects your nervous system. Migraine can include painful and severe headaches, and symptoms such as nausea and being sensitive to light and sound. An aura is a sensation you may have just before or during migraine. Auras can include dizziness and hearing or seeing things that aren't there.

Treximet is approved to be used in adults as well as children ages 12 years and older.

Treximet is a combination drug, which means it contains more than one drug. The first is sumatriptan, which belongs to a drug class called triptans. (A class of drugs is a group of medications that work in a similar way.) Triptans are also known as selective serotonin receptor agonists. The second drug is naproxen, which is a nonsteroidal anti-inflammatory drug (NSAID).

Treximet comes as a tablet that you swallow and is available in two strengths:

  • 85 mg sumatriptan/500 mg naproxen
  • 10 mg sumatriptan/60 mg naproxen

You'll typically take one tablet when you have a migraine headache. If needed, adults can take a second tablet at least 2 hours later.

Effectiveness

In a clinical study, adults with migraine either took Treximet or a placebo (treatment with no active drug).

Researchers looked at how well the drugs eased migraine pain 2 hours after a dose. Treximet was found to be more effective than a placebo. Two hours after taking a dose, 29% of people who took Treximet were completely pain-free. This was compared with 11% of people who took a placebo.

For more information about how effective Treximet is in treating migraine, see the "Treximet for migraine" section below.

Treximet is available in both brand-name and generic drug forms. You'll need a prescription for either form.

Treximet contains two active drug ingredients: sumatriptan and naproxen. (An active drug is an ingredient in the medication that affects how the medication works.) Sumatriptan comes in generic form, and it requires a prescription. Naproxen also comes as a generic. The drug is available both over the counter and as a prescription, depending on the strength.

The Treximet dosage your doctor prescribes will depend on several factors. These include:

  • your age
  • your liver function
  • other medical conditions you may have

Your doctor will most likely start you on a low dosage. Then they'll adjust it over time to reach the amount that's right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Treximet comes as a tablet that you swallow. It's available in two strengths:

  • 85 mg sumatriptan/500 mg naproxen
  • 10 mg sumatriptan/60 mg naproxen

Dosage for migraine

The recommended dose of Treximet for adults with migraine is one 85-mg/500-mg tablet.

The maximum dose of Treximet for adults is two 85-mg/500-mg tablets, taken at least 2 hours apart, in 24 hours.

If you have certain medical conditions, your doctor may give you a different dose of Treximet. These conditions include liver disease and artery diseases in your brain, heart, or blood vessels. It's important to tell your doctor your complete medical history so they can prescribe the dose that's right for you. This history includes all prescription and over-the-counter medications, and supplements that you take.

Pediatric dosage

The recommended dose of Treximet for children ages 12 to 17 years is one tablet of 10 mg/60 mg. The maximum dose in 24 hours is no more than one 85-mg/500-mg tablet.

What if I miss a dose?

Treximet isn't a scheduled medication, meaning that you don't have to take it every day. You should take it only when you have migraine. Because of this, check the drug's expiration date on a regular basis. If the Treximet tablets have expired, dispose of the medication.

Will I need to use this drug long term?

Treximet isn't meant to be used as a long-term treatment. If you and your doctor find that the medication works for you, you'll use it only when you get migraine. The safety and effectiveness of Treximet hasn't been tested on more than an average of five migraine headaches per month in adults and two in children.

If you find yourself taking Treximet on a regular basis, talk with your doctor about ways to help prevent migraine.

The Food and Drug Administration (FDA) has approved Treximet to treat migraine with or without aura. The drug is used in adults as well as children ages 12 years and older.

Migraine is a neurological condition, which means that it affects your nervous system. This common condition usually has four phases, but not everyone goes through all of them.

The first stage is called the prodrome. In this phase, you may have:

The second phase is called aura, and its symptoms can include:

  • hearing or seeing things that aren't there
  • vertigo (dizziness)
  • tingling or numbness in your arm, leg, face, or tongue
  • trouble speaking
  • vision problems

The third phase is known as the headache phase. It involves head pain, usually on only one side of the head. This pain may be throbbing and get worse with physical activity. The headache phase can often last for 4 hours or longer.

Finally, the last phase of migraine is called the postdrome. It can include fatigue, lack of concentration, and mood changes.

Treximet isn't used to help prevent migraine. The drug also isn't used to treat cluster headaches.

Effectiveness

In a clinical study, adults with migraine either took Treximet or a placebo (treatment with no active drug). Researchers looked at how well the drugs eased migraine pain 2 hours after a dose. Treximet was found to be more effective than a placebo. Two hours after taking a dose, 29% of people who took Treximet were completely pain-free. This was compared with 11% of people who took a placebo.

The study also looked at whether the drugs provided extended migraine relief. This was measured by the number of people who were pain-free between 2 and 24 hours after taking a dose. In the group of people who took Treximet, 24% were completely pain-free. This was compared to 9% in the group of people who took a placebo.

Treximet and children

In addition to being used in adults, Treximet is approved to treat migraine with or without aura in children ages 12 years and older.

One study looked at children ages 12 to 17 years with migraine. They were given one of three strengths of Treximet or a placebo. Here are the different groups and how many children had migraine relief 2 hours after a dose:

  • 10 mg/60 mg of Treximet: 29% of children
  • 30 mg/180 mg of Treximet: 27% of children
  • 85 mg/500 mg of Treximet: 24% of children
  • placebo: 10% of children

A second study looked at children ages 12 to 17 years with migraine. In this study, the children were given either the highest strength of Treximet (85 mg/500 mg) or a placebo. Two hours after a dose, 37% of children who took Treximet were completely pain-free. This was compared to 18% of children who took a placebo.

It's not known if Treximet is safe and effective in children younger than age 12 years.

Treximet can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Treximet. These lists don't include all possible side effects.

For more information on the possible side effects of Treximet, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you've had with Treximet, you can do so through MedWatch.

More common side effects

The more common side effects of Treximet in adults can include:

  • dizziness
  • sleepiness
  • nausea
  • chest pain or discomfort
  • pain or pressure in your neck, throat, or jaw
  • tingling or numbness in your hands or feet
  • dry mouth
  • indigestion (upset stomach)

Most of these side effects may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Treximet aren't common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Serious side effects and their symptoms can include:

  • Heart attack.* Symptoms can include:
    • tightness, pressure, or pain in your chest, jaw, neck, arms, or back
    • cold sweat
    • feeling short of breath
    • suddenly feeling dizzy or lightheaded
    • nausea
  • Stroke.* Symptoms can include:
    • weakness in an arm
    • drooping of your face, especially on one side
    • trouble speaking or slurred speech
  • Bleeding in your digestive system.* Symptoms can include:
    • vomit that looks like coffee grounds or is bright red
    • stool that's bright red or black and tarry
  • Ulcers or tears in your digestive system.* Symptoms can include:
    • pain in your stomach
    • not feeling like eating due to pain
    • weight loss
    • nausea or vomiting
  • Arrhythmia (heartbeat that's too fast, too slow, or uneven). Symptoms can include:
    • chest pain
    • feeling short of breath
  • Brain hemorrhage or subarachnoid hemorrhage (types of bleeding in and around the brain). Symptoms can include:
    • an intense headache that occurs suddenly
    • nausea or vomiting
    • losing consciousness
    • seizures
  • Problems with blood flow. Symptoms can include:
    • painful cramping in your leg muscles after activity
    • numbness, weakness, or coldness in one part of your body
    • erectile dysfunction in men
    • belly pain along with bloody diarrhea
    • white or blue color in the tips of your fingers, especially when it's cold
  • Liver damage. Symptoms can include:
    • jaundice (yellowish color of your skin and the white of your eyes)
    • nausea
    • diarrhea
    • flu-like symptoms
  • High blood pressure. Symptoms can include:
    • intense headache
    • pain in your chest
    • problems seeing
    • trouble breathing
  • Heart failure and edema (fluid buildup). Symptoms can include:
    • feeling short of breath, especially when you lie down or strain yourself
    • swelling in your feet, ankles, and legs
    • belly swelling
    • fast weight gain
  • Medication overuse headache from taking Treximet too often. Symptoms can include:
    • more frequent migraine
    • headaches that occur every day
  • Serotonin syndrome (high levels of the chemical serotonin). Symptoms can include:
    • feeling restless or agitated
    • lack of coordination
    • rapid heart rate
    • sweating
    • changes in blood pressure
    • seeing or hearing things that aren't there
  • Kidney damage. Symptoms can include:
    • less urine when you go to the bathroom
    • swelling of your feet, ankles, and legs
    • fatigue (lack of energy)
    • high blood pressure
    • coma
    • seizure
  • Hyperkalemia (high levels of potassium). Symptoms can include:
    • tiredness or weakness
    • heartbeat that's too fast, too slow, or uneven
  • Skin reactions, such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Symptoms can include:
    • blisters
    • rash
    • itching
  • Seizures. Symptoms can include:
    • not being able to control the movement of your arms and legs
    • losing awareness or consciousness

Other serious side effects, explained in more detail below in "Side effect details," include:

* Treximet has boxed warnings for serious heart, blood vessel, and digestive system problems. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings: Serious heart, blood vessel, and digestive system problems" at the beginning of this article.

Side effects in children

In addition to being used in adults, Treximet is approved to treat migraine with or without aura in children ages 12 years and older. While a clinical study has shown only two side effects in children, it's possible that they could experience some of the same side effects that occur in adults.

Hot flashes and muscle tightness can occur in children who take Treximet. In a study of children ages 12 to 17 years with migraine, the children were given one of three strengths of Treximet or a placebo. The strengths of Treximet were: 10 mg/60 mg, 30 mg/180 mg, and 85 mg/500 mg.

Here are the different groups and how often hot flashes occurred:

  • 30 mg/180 mg of Treximet: 2% of children
  • 85 mg/500 mg of Treximet: less than 1% of children
  • 10 mg/60 mg of Treximet: 0% of children
  • placebo: 0% of children

Of the children who took the highest dose of Treximet (85 mg/500 mg), 2% had tightness in their muscles. In comparison, no children who took the other strengths or a placebo had muscle tightness during the study.

If you have questions about Treximet side effects in your child, talk with their doctor.

Side effect details

You may wonder how often certain side effects occur with this drug. Here's some detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Treximet. But it's unclear how many people are allergic to Treximet. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • shortness of breath, wheezing, or trouble breathing
  • fainting
  • trouble swallowing

Call your doctor right away if you have a severe allergic reaction to Treximet. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Digestive system problems

Digestive system problems such as nausea, indigestion, and dry mouth can occur with Treximet.

Clinical studies looked at adults with migraine and compared 85 mg/500 mg of Treximet, its ingredients (85 mg of sumatriptan or 500 mg of naproxen), and a placebo.About 3% of people had nausea while taking Treximet or sumatriptan. This is compared with 1% of people who took a placebo and less than 1% of people who took naproxen.

Indigestion was also reported in the studies. The results showed that 2% of people had indigestion while taking Treximet or sumatriptan. In comparison, 1% of people who took naproxen or a placebo developed indigestion.

In addition, people in studies also reported having dry mouth. The results showed that 2% of people had dry mouth while taking Treximet or sumatriptan. This is compared with 1% of people who took a placebo and less than 1% of people who took naproxen.

If you have nausea, indigestion, or dry mouth while taking Treximet, talk with your doctor. They may be able to recommend ways to help you feel more comfortable.

Pain, discomfort, or pressure

Chest pain or discomfort as well as pain or pressure in your neck, throat, or jaw can occur with Treximet.

Clinical studies looked at adults with migraine and compared 85 mg/500 mg of Treximet, its ingredients (85 mg of sumatriptan or 500 mg of naproxen), and a placebo. The results showed that 3% of people had chest discomfort while taking Treximet, and 2% of people had chest discomfort with sumatriptan. About 1% of people developed chest discomfort with naproxen, compared with less than 1% of people who took a placebo.

The studies also showed that about 3% of people had pain or pressure in their neck, throat, or jaw while taking Treximet or sumatriptan. About 1% of people developed this discomfort with naproxen or a placebo.

If you're taking Treximet and have chest pain or discomfort, or pain or pressure in your neck, throat, or jaw, tell your doctor. They can suggest ways to help you feel better, such as changing your dosage or switching medications.

Other drugs are available that can treat migraine. Some may be a better fit for you than others. If you're interested in finding an alternative to Treximet, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

Alternatives for migraine

Examples of other drugs that may be used to treat migraine include:

  • Triptans, such as:
    • almotriptan (Axert)
    • eletriptan (Relpax)
    • frovatriptan (Frova)
    • naratriptan (Amerge)
    • rizatriptan (Maxalt)
    • sumatriptan (Imitrex)
    • zolmitriptan (Zomig)
  • Ergot alkaloids, such as:
    • dihydroergotamine (DHE-45 injection, Migranal)
    • ergotamine (Ergomar)
  • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
  • Prescription NSAIDs, such as:
    • flurbiprofen (Ansaid)
    • diclofenac (Cataflam, Cambia)
    • indomethacin (Indocin)
  • Combination products, such as:
    • aspirin/acetaminophen/caffeine (Excedrin Migraine)
    • acetaminophen/isometheptene/dichloralphenazone (Duradrin)

You may wonder how Treximet compares to other medications that are prescribed for similar uses. Here we look at how Treximet and Imitrex are alike and different.

Ingredients

Treximet contains the drugs sumatriptan and naproxen. Imitrex contains the drug sumatriptan.

Uses

Both Treximet and Imitrex are approved to treat migraine with or without aura.

Migraine is a neurological condition, which means that it affects your nervous system. Migraine can include painful and severe headaches, and symptoms such as nausea and being sensitive to light and sound. An aura is sensation you may have just before or during migraine. Auras can include dizziness and hearing or seeing things that aren't there.

Treximet can be used in adults as well as children ages 12 years and older, while Imitrex is for use only in adults.

In addition, the injectable form of Imitrex is approved to treat cluster headaches.

Drug forms and administration

Here's some information about the forms of each drug and how you take them.

Treximet form

Treximet comes as a tablet that you swallow. The recommended dose of Treximet for adults with migraine is one 85-mg/500-mg tablet. The maximum dose of Treximet for adults is two 85-mg/500-mg tablets, taken at least 2 hours apart, in 24 hours.

If you have certain medical conditions, your doctor may give you a different dose of Treximet. These conditions include liver disease and artery diseases in your brain, heart, or blood vessels.

The recommended dose of Treximet for children ages 12 to 17 years is one tablet of 10 mg/60 mg. The maximum dose in 24 hours is no more than one 85 mg/500 mg tablet.

Imitrex forms

Imitrex is available in several forms:

  • A tablet that you swallow. The recommended dose for Imitrex tablets is 25 mg, 50 mg, or 100 mg. If you don't have pain relief within 2 hours, you can take another tablet. But you shouldn't take more than 200 mg of Imitrex within 24 hours.
  • Injection. Imitrex comes in prefilled, single-dose syringe cartridges that you use with an Imitrex STATdose pen. Imitrex also comes in a single-dose vial that you use with a syringe. The maximum single dose of an Imitrex injection is 6 mg. The maximum dose within 24 hours is two 6-mg injections given at least 1 hour apart.
  • A nasal spray. The recommended dose for Imitrex nasal spray is 5 mg, 10 mg, or 20 mg. The maximum single dose of the nasal spray is 20 mg. The maximum dose within 24 hours is 40 mg. The two doses must be given at least 2 hours apart.

Side effects and risks

Treximet and Imitrex both contain the drug sumatriptan. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Treximet, with Imitrex, or with both drugs (when taken individually).

  • Can occur with Treximet:
  • Can occur with Imitrex:
    • mild headache
    • flushing (warmth and redness in your skin)
    • vomiting
    • drooling
    • nose or throat discomfort after using the nasal spray form of Imitrex
    • unusual taste in your mouth after using the nasal spray form of Imitrex
  • Can occur with both Treximet and Imitrex:
    • dizziness
    • sleepiness
    • nausea
    • chest pain or discomfort
    • pain or pressure in your neck, throat, or jaw
    • tingling or numbness in your hands or feet

Serious side effects

These lists contain examples of serious side effects that can occur with Treximet, with Imitrex, or with both drugs (when taken individually).

* Treximet has boxed warnings for serious heart, blood vessel, and digestive system problems. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings: Serious heart, blood vessel, and digestive system problems" at the beginning of this article.

Effectiveness

The only condition both Treximet and Imitrex are used to treat is migraine with or without aura in adults.

The use of Treximet and Imitrex in treating migraine with or without aura has been directly compared in two clinical studies. The first study showed that 65% of people who took 85 mg/500 mg of Treximet had migraine relief within 2 hours. In comparison, 55% of people who took 85 mg of Imitrex had migraine relief within 2 hours.

Also in this study, 25% of people who took 85 mg/500 mg of Treximet had pain relief that lasted 2 to 24 hours after the first dose. In comparison, 16% of people who took 85 mg of Imitrex had migraine relief for that time frame.

The second study had very similar results. Researchers found that 57% of people who took 85 mg/500 mg of Treximet had pain relief after 2 hours. This pain relief lasted for up to 24 hours in 23% of the people. In comparison, 50% of people who took 85 mg of Imitrex had pain relief after 2 hours. This pain relief lasted for up to 24 hours in 14% of the people.

Costs

Treximet and Imitrex are both brand-name drugs. There are currently generic forms of both drugs. The generic form of Treximet is called sumatriptan/naproxen. The generic form of Imitrex is called sumatriptan.

According to estimates on GoodRx.com, brand-name Treximet tablets cost significantly more than brand-name Imitrex tablets. Generic Treximet tablets also cost significantly more than generic Imitrex tablets. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like Imitrex (above), the drug Zomig has uses similar to those of Treximet. Here's a comparison of how Treximet and Zomig are alike and different.

Ingredients

Treximet contains the drugs sumatriptan and naproxen. Zomig contains the drug zolmitriptan.

Uses

Both Treximet and Zomig are approved only for the treatment of migraine with or without aura.

Migraine is a neurological condition, which means that it affects your nervous system. Migraine can include painful and severe headaches, and symptoms such as nausea and being sensitive to light and sound. An aura is sensation you may have just before or during migraine. Auras can include dizziness and hearing or seeing things that aren't there.

Treximet can be used in adults as well as children ages 12 years and older. Zomig nasal spray can also be used in adults as well as children ages 12 years and older. Other forms of Zomig, which are taken by mouth, are for use only in adults.

Drug forms and administration

Here's some information about the forms of each drug and how you take them.

Treximet form

Treximet comes as a tablet that you swallow. The recommended dose of Treximet for adults with migraine is one 85-mg/500-mg tablet. The maximum dose of Treximet for adults is two 85-mg/500-mg tablets, taken at least 2 hours apart, in 24 hours.

If you have certain medical conditions, your doctor may give you a different dose of Treximet. These conditions include liver disease and artery diseases in your brain, heart, or blood vessels.

The recommended dose of Treximet for children ages 12 to 17 years is one tablet of 10 mg/60 mg. The maximum dose in 24 hours is no more than one 85 mg/500 mg tablet.

Zomig forms

Zomig is available in two different tablet forms: a tablet that you swallow and a tablet that dissolves in your mouth. The recommended starting dose of Zomig is 1.25 mg or 2.5 mg. The maximum single dose is 5 mg. If you still need pain relief after the first dose, you can take another dose after 2 hours. You shouldn't take more than 10 mg within 24 hours.

Zomig is also available as a nasal spray. The recommended dose of Zomig nasal spray is 2.5 mg. The maximum single dose is 5 mg. If the first dose doesn't provide pain relief, you can repeat the dose after 2 hours. You shouldn't take more than 10 mg within 24 hours.

Side effects and risks

Treximet and Zomig both contain a type of drug called a triptan. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Treximet, with Zomig, or with both drugs (when taken individually).

  • Can occur with Treximet:
    • indigestion (upset stomach)
    • muscle tightness (in children)
  • Can occur with Zomig:
    • unusual taste in your mouth after using the nasal spray form of Zomig
    • weakness
    • nose or throat discomfort after using the nasal spray form of Zomig
    • warm or cold feeling on your skin
  • Can occur with both Treximet and Zomig:
    • chest pain or discomfort
    • dizziness
    • sleepiness
    • nausea
    • pain or pressure in your neck, throat, or jaw
    • tingling or numbness in your hands or feet
    • dry mouth
    • hot flashes (only in children with Treximet use)

Serious side effects

These lists contain examples of serious side effects that can occur with Treximet, with Zomig, or with both drugs (when taken individually).

* Treximet has boxed warnings for serious heart, blood vessel, and digestive system problems. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings: Serious heart, blood vessel, and digestive system problems" at the beginning of this article.

Effectiveness

The only condition both Treximet and Zomig are used to treat is migraine with or without aura.

These drugs haven't been directly compared in clinical studies, but studies have found both Treximet and Zomig (tablet and nasal spray forms) to be effective for treating migraine with or without aura.

Costs

Treximet and Zomig are both brand-name drugs. Treximet is available in a generic form. The generic form of Treximet is called sumatriptan/naproxen.

The tablet forms of Zomig are also available as generics. The generic form of Zomig is called zolmitriptan.

According to estimates on GoodRx.com, brand-name Treximet tablets generally cost about the same as brand-name Zomig tablets. Generic Treximet tablets cost significantly more than generic Zomig tablets. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

It isn't known whether Treximet is safe for use in the first two trimesters (months 1 to 6) of pregnancy. In the third trimester (months 6 to 9), Treximet shouldn't be used because it may cause heart defects in babies.

If you're pregnant or are planning to become pregnant, talk with your doctor before taking Treximet. They can review the pros and cons of the medication with you and recommend treatments other than Treximet, if needed.

It isn't known whether Treximet is safe for use in the first two trimesters (months 1 to 6) of pregnancy. In the third trimester (months 6 to 9), Treximet shouldn't be used because it may cause heart defects in babies. If you're sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you're using Treximet.

It's unknown whether it's safe to breastfeed while taking Treximet. Both of the ingredients (sumatriptan and naproxen) in Treximet can pass into breast milk. However, the American Academy of Pediatrics says it's usually fine for women to breastfeed while they're taking sumatriptan and naproxen.

If you're planning to breastfeed, talk with your doctor before taking Treximet. They can help you decide whether to breastfeed while taking the medication and may recommend treatments other than Treximet, if needed.

Don't consume alcohol while taking Treximet. Naproxen, one of the drugs in Treximet, may interact with alcohol and increase your risk for stomach bleeding.

If you're taking Treximet and have any symptoms of bleeding, call you doctor right away. These symptoms can include black, bloody, or tarry stool and vomit that looks like coffee grounds.

Treximet can interact with several other medications. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Treximet and other medications

Below is a list of medications that can interact with Treximet. This list doesn't contain all drugs that may interact with Treximet.

Before taking Treximet, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Treximet and diuretics

One of the drugs in Treximet, naproxen, can make diuretic drugs less effective. Diuretics are given to help your body lose more water, usually because you have fluid buildup or high blood pressure. But naproxen can stop diuretics from having this effect.

Also, a side effect of naproxen is increased blood pressure. This can also cancel out the effect of diuretics.

Examples of diuretics include:

  • hydrochlorothiazide (Microzide)
  • furosemide (Lasix)
  • spironolactone (Aldactone)

If you're taking a diuretic, talk with your doctor before taking Treximet. They may recommend an alternative or monitor your blood pressure more closely.

Treximet and monoamine oxidase-A inhibitors (MAOIs)

Taking Treximet with medications called monoamine oxidase-A inhibitors (MAOIs) can increase the amount of sumatriptan in your blood by up to seven times. (Sumatriptan is one of the drugs in Treximet.) This can result in more severe side effects. For details, see the "Treximet side effects" section above.

Examples of MAOIs include:

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • tranylcypromine (Parnate)

You shouldn't use Treximet at the same time as an MAOI, or if you've taken an MAOI within the past 2 weeks.

If you're taking an MAOI, talk with your doctor before taking Treximet. They may recommend treatment options other than the MAOI or Treximet.

Treximet and cyclosporine

Using Treximet with the drug cyclosporine (Sandimmune) may increase your risk for kidney damage.

If you're taking cyclosporine, talk with your doctor before taking Treximet. They may recommend a drug other than cyclosporine or Treximet. They may also monitor your kidney function and have you keep taking both drugs.

Treximet and medications that contain ergot

Treximet and medications that contain ergot may both cause blood flow problems. If you take these medications together, you're more likely to have serious side effects. For more about side effects, see the "Treximet side effects" section above.

Some medications that contain ergot are used to treat migraines. It's important that you don't take these medications and Treximet within 24 hours of each other.

Examples of medications that contain ergot include:

  • ergotamine (Ergomar)
  • dihydroergotamine (Migranal)
  • methylergonovine (Methergine)

If you're taking a drug that contains ergot, tell your doctor before you start using Treximet. They may recommend treatment options other than the ergot medication or Treximet.

Treximet and drugs that affect blood clotting

Certain drugs can thin your blood and affect how well your blood clots, which can increase your risk of bleeding. Treximet can also increase your risk of bleeding,* so taking Treximet with such drugs makes bleeding even more likely.

Examples of drugs that affect blood clotting include:

  • warfarin (Coumadin)
  • acetylsalicylic acid (aspirin)
  • selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor XR), and desvenlafaxine (Pristiq)

If you're taking a drug that affects blood clotting, tell your doctor before you start using Treximet. They may recommend a different treatment option or monitor you more closely for bleeding.

* Treximet has boxed warnings for serious heart, blood vessel, and digestive system problems. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings: Serious heart, blood vessel, and digestive system problems" at the beginning of this article.

Treximet and SSRIs and SNRIs

Using an SSRI or SNRI at the same time as Treximet can increase the number and severity of side effects of both drugs. This includes the serious side effect of serotonin syndrome (high levels of the chemical serotonin). For more about side effects, see the "Treximet side effects" section above.

For examples of SSRIs and SNRIs, see the "Treximet and drugs that affect blood clotting" section right above.

If you're taking an SSRI or SNRI, tell your doctor before using Treximet. They can review your medications and advise you on the right treatment for you.

Treximet and certain blood pressure medications

Drugs called angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and beta-blockers can help lower blood pressure. But taking these medications with Treximet may decrease their effect on blood pressure.

And in certain people, taking Treximet with ACE inhibitors or ARBs may also cause kidney damage. These people include older adults, people who are dehydrated, and people whose kidneys aren't working well.

Examples of ACE inhibitors include:

  • lisinopril (Zestril)
  • benazepril (Lotensin)
  • enalapril (Vasotec)

Examples of ARBs include:

  • losartan (Cozaar)
  • irbesartan (Avapro)
  • valsartan (Diovan)

Examples of beta-blockers include:

  • propranolol (Inderal)
  • metoprolol (Kapspargo, Lopressor, Toprol XL)
  • atenolol (Tenormin)

If you're taking one of these drugs, tell your doctor before you use Treximet. They'll likely treat any issues, such as dehydration, before you start to take Treximet.

Treximet and digoxin

Using Treximet with a heart medication called digoxin (Lanoxin) can increase the level of digoxin in your blood. This can cause digoxin to work longer in your body than usual and result in serious side effects such as nausea, vomiting, confusion, anxiety, and even death.

If you're taking digoxin, talk with your doctor before using Treximet. They may monitor your digoxin levels or suggest other medications instead to help treat your migraine.

Treximet and lithium

If you take Treximet with a drug called lithium (Eskalith, Lithobid), Treximet may increase the level of lithium in your blood. This can cause serious side effects such as nausea, diarrhea, uncontrollable movements, drowsiness, and weakness.

If you're taking lithium, tell your doctor before using Treximet. They may monitor your lithium levels or suggest other medications instead.

Treximet and methotrexate

Taking Treximet with the drug methotrexate (Trexall, Otrexup) can increase the level of methotrexate in your blood, causing serious side effects. These side effects can include nausea, vomiting, bleeding in your digestive system, kidney damage, and lower counts of some blood cells, which can lead to infections.

If you're taking methotrexate, tell your doctor before using Treximet. They may monitor your methotrexate levels or suggest other medications instead.

Treximet and pemetrexed

Using Treximet with the drug pemetrexed (Alimta) may increase your risk for damage in your kidneys, stomach, and intestines. The drug combination may also decrease the amount of cells that your bone marrow makes.

If you're taking pemetrexed, tell your doctor before using Treximet. They may monitor your pemetrexed levels or suggest other medications instead.

Treximet and herbs and supplements

There aren't any herbs or supplements that have been specifically reported to interact with Treximet. However, you should still check with your doctor or pharmacist before using any of these products while taking Treximet.

Treximet and foods

There are aren't any foods that have been specifically reported to interact with Treximet. In addition, you can take Treximet with or without food, and it will work just as well.

As with all medications, the cost of Treximet can vary. To find current prices for Treximet in your area, check out GoodRx.com:

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Treximet. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Treximet.

If you're not sure if you'll need to get prior authorization for Treximet, contact your insurance company.

Financial assistance

If you need financial support to pay for Treximet, help is available. Currax Pharmaceuticals LLC, the manufacturer of Treximet, offers the Treximet Patient Savings Program. For more information and to find out if you're eligible for support, call 855-830-9254 or visit the program website.

You should take Treximet according to your doctor or healthcare provider's instructions.

Treximet comes as a tablet that you swallow. You can take it with or without food.

When to take

Treximet should be taken only to treat migraine headache as needed. This means that you shouldn't take the drug when you don't have migraine.

Adults can take a maximum of two doses of Treximet (85 mg/500 mg in each dose) within 24 hours.

Children ages 12 to 17 years can take a maximum of one dose of Treximet (85 mg/500 mg in each dose) within 24 hours.

Taking Treximet with food

You can take Treximet with or without food. The drug will work just as well on an empty stomach as on a full stomach.

Can Treximet be crushed, split, or chewed?

No, don't crush, break, or chew Treximet tablets. You should swallow them whole.

Migraine trackers

If you have frequent or severe migraine headaches, a migraine tracker can be a valuable tool. A tracker can help you narrow down the cause of your migraine so that you can avoid triggers. These triggers can be something as simple as certain foods and drinks or more complex issues such as sleep cycles, temperature changes, and other environmental factors.

You can find a migraine tracker on the Treximet website. There are also several free migraine trackers available as phone apps. These apps can track how often migraine occurs, the length of migraine headaches, and potential triggers. You can see if any patterns develop and find what works best for you in relieving pain.

Migraine is a neurological condition, which means that it affects your nervous system. Migraine can include moderate to severe head pain that's often described as throbbing or pulsing. Migraine often occurs on just one side of the head. Other symptoms of migraine may include nausea, weakness, or sensitivity to light or sound.

Scientists believe that migraines are a result of overactive nerve cells that activate the trigeminal nerve. (This is the nerve that allows you to feel sensations in your face and head.) This activation causes the release of chemicals called serotonin and calcitonin gene-related peptide. The flow of these chemicals makes blood vessels in the brain swell and release chemical messengers called neurotransmitters. This results in more swelling and pain.

Researchers think that migraine may be due in part to genetics. There are also many possible triggers of migraine. These can range from stress and anxiety to certain foods and drinks, such as chocolate and alcohol.

Treximet is a combination drug that contains sumatriptan and naproxen. Sumatriptan works to narrow the blood vessels in the brain. It also blocks pain signals traveling from nerves to the brain, so you don't sense as much pain. Naproxen works to decrease inflammation (swelling) and relieve pain.

How long does it take to work?

You should feel migraine relief within 1 to 2 hours of taking the first dose. You can take another dose after 2 hours if the first dose doesn't provide enough pain relief.

Here are answers to some frequently asked questions about Treximet.

Is Treximet an opioid?

No, Treximet isn't an opioid. An opioid is a powerful type of drug often prescribed to treat pain.

Treximet is a combination drug, meaning that it contains more than one medication. The first is naproxen, which is a nonsteroidal anti-inflammatory drug (NSAID). The second drug is sumatriptan (Imitrex). Sumatriptan belongs to a drug class called triptans. (A class of drugs is a group of medications that work in a similar way.) Triptans are also known as selective serotonin receptor agonists.

Can I take ibuprofen with Treximet?

No, you shouldn't take ibuprofen with Treximet. Ibuprofen is an NSAID, which is in the same class of drug as naproxen. (Naproxen is one of the two drugs that make up Treximet.) If you take the same kinds of drugs together, you may have side effects that are more frequent and severe. For more information about possible side effects, see the "Treximet side effects" section above.

If Treximet isn't providing enough pain relief for your migraine, talk with your doctor. They may be able to suggest other treatments to help ease your symptoms.

Can I use Treximet to prevent migraine?

You should never use Treximet to prevent migraine. This medication is only for when you already have migraine.

Using a migraine tracker may help you pinpoint causes of migraine. (See "Migraine trackers" above.) You can also ask your doctor for tips on preventing migraine.

This drug comes with several precautions.

FDA warnings: Serious heart, blood vessel, and digestive system problems

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Treximet contains a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can increase the risk of cardiovascular (heart and blood vessel) problems such as heart attack and stroke, which can be fatal. The risk may occur early on in treatment with Treximet and may increase the longer you take the medication.
  • If you've had or are going to have a type of heart bypass surgery called coronary artery bypass graft, Treximet isn't right for you.
  • NSAIDs can also increase the risk of digestive system problems such as ulcers, bleeding, and gastrointestinal perforations (tears in the lining of your intestines or stomach). Older adults tend to have these problems more frequently. The problems also occur more often in people who have a history of peptic ulcer disease, bleeding in their stomach or intestines, or both. These digestive system problems can occur at any time during Treximet treatment without warning symptoms and can be fatal.

Other precautions

Before taking Treximet, talk with your doctor about your health history. Treximet may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Heart failure. People with heart failure are more likely to have serious side effects from Treximet. If you've been diagnosed with heart failure, talk with your doctor before starting to take Treximet. They may monitor your heart more closely or recommend a different migraine treatment.
  • Coronary artery disease or heart attack. If you have heart problems such as coronary artery disease or a history of heart attack, Treximet may not be the best migraine treatment for you.Your doctor should check your heart function before you start taking Treximet.
  • Stroke or mini-stroke. You shouldn't take Treximet if you're at high risk for stroke or transient ischemic attacks (TIAs), which are also called mini-strokes. Ask your doctor to recommend a different migraine treatment.
  • Arrhythmia. If you have an arrhythmia (a heartbeat that's too fast, slow, or uneven), Treximet may not be the best migraine treatment for you. Your doctor should check your heart function before you start taking Treximet.
  • High blood pressure. If you have high blood pressure that's not under control, you shouldn't take Treximet. And if you're taking medications for high blood pressure, they may not work as well if you take Treximet. Talk with your doctor about the best migraine treatment for you. Both you and your doctor will need to monitor your blood pressure if you do take Treximet.
  • Liver damage. Treximet may cause liver problems, so if you already have liver damage, the drug may not be right for you. Ask your doctor what medications are best for your situation.
  • Kidney damage. People with kidney damage are more likely to have serious side effects from Treximet. If you have kidney damage, talk with your doctor before starting Treximet. They may monitor your kidneys more closely or recommend a different migraine treatment.
  • Allergic reaction. If you're allergic to Treximet, any of its ingredients, aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs), you shouldn't take Treximet. Ask your doctor to recommend a different migraine treatment.
  • Asthma that's sensitive to aspirin or other NSAIDs. If you have an asthma attack when you take aspirin or any other NSAID, you shouldn't use Treximet. Ask your doctor to recommend a different migraine treatment.
  • Blood flow problems.If you have blood flow problems such as ischemic colitis or Raynaud's disease, Treximet may not be the best migraine treatment for you.Your doctor should check your heart function before you start taking Treximet.
  • Pregnancy. You shouldn't take Treximet in the third trimester (months 6 to 9) of pregnancy. It's unknown if Treximet is safe in the first two trimesters (months 1 to 6). For more information, please see the "Treximet and pregnancy" section above.
  • Breastfeeding. It's unknown whether it's safe to breastfeed while taking Treximet. For more information, please see the "Treximet and breastfeeding" section above.

Note: For more information about the potential negative effects of Treximet, see the "Treximet side effects" section above.

Using more than the recommended dosage of Treximet can lead to serious side effects.

Overdose symptoms

If you take too much Treximet or take it too often, you can have severe side effects.

Symptoms of an overdose can include:

  • fatigue (lack of energy)
  • nausea
  • vomiting
  • stomach pain
  • bleeding in your digestive system
  • drooping eyelid
  • muscle movements that you can't control
  • trouble breathing
  • dilated pupils (which are bigger than normal)
  • lack of coordination
  • changes to skin color, such as fingers, toes, or lips than turn blue or red
  • producing excess saliva
  • crying
  • paralysis (not being able to move part of your body)
  • death

What to do in case of overdose

If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Treximet from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Treximet at about 77°F (25°C). For short amounts of time, you can store the drug between 59°F and 86°F (15°C to 30°C). Keep Treximet in its original container along with the pouch that keeps the drug dry.

Disposal

If you no longer need to take Treximet and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Treximet is indicated only for the treatment of migraine with or without aura. Treximet should never be used to prevent migraine headache and should not be used to treat cluster headaches.

Mechanism of action

Because Treximet is a combination drug, it acts as a triptan and as a nonsteroidal anti-inflammatory drug (NSAID). The sumatriptan portion of Treximet binds to cloned 5-HT1B/1D receptors in intracranial blood vessels and sensory nerves, the end result being that cranial vessel constriction occurs as does inhibition of neuropeptide release.

Naproxen inhibits the production of prostaglandins, mediators of inflammation. The mechanism under which naproxen exerts its therapeutic effects on migraine may be due to the decrease in prostaglandins in peripheral tissues.

Pharmacokinetics and metabolism

Treximet 85 mg/500 mg, as a combination drug, has two Tmax points: one for sumatriptan, which is a median of 1 hours, and one for naproxen, which is a median of 5 hours.

Sumatriptan undergoes significant first-pass metabolism, and its bioavailability is approximately 15%. Naproxen has a bioavailability of 95%.

The plasma protein binding for sumatriptan is between 14% and 21%. More than 99% of naproxen is albumin-bound at therapeutic levels.

Sumatriptan has a volume of distribution of 2.7 L/kg. Naproxen has a volume of distribution of 0.16 L/kg.

Sumatriptan is primarily metabolized by the MAO-A isoenzyme to 2-{5-[(methylsulfamoyl)methyl]-indol-3-yl}acetic acid. Naproxen and its metabolite 6-0-deesmethyl naproxen do not induce any metabolizing enzymes.

About 60% of sumatriptan is excreted renally and about 40% is excreted in the feces. Sumatriptan has an elimination half-life of approximately 2 hours. Naproxen is mostly excreted in the urine (95%) and has a plasma half-life of about 19 hours.

Contraindications

Treximet is contraindicated in patients who:

Storage

Treximet should be stored at approximately 77°F (25°C). For short amounts of time, the drug can be stored between 59°F and 86°F (15°C to 30°C). Treximet should be stored in its original container along with the desiccant.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.