Cambia® (Diclofenac Potassium for Oral Solution) in the Management of Acute Migraine
A small study comparing rizatriptan alone with combinations of rizatriptan, plus a COX-2 enzyme inhibitor (rofecoxib) or rizatriptan, plus a traditional NSAID (tolfenamic acid) showed decreased migraine recurrence rates in both treatment groups.52
However, another study of
patients with migraine-associated nausea found that the combination of therapy with triptan and NSAIDs appears to be less effective in relieving nausea than triptan monotherapy.53
Looking at the evidence-based advantage of early intervention,16,34,35 it makes sense to employ a rapidly absorbed anti-inflammatory medication such as Cambia with a triptan. From personal experience, such a strategy is beneficial for patients in whom Cambia alone or a triptan alone is insufficient to manage headaches.
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In summary, migraine is a disabling disorder for which treatment is often unsatisfactory. Clinical trial data have demonstrated that Cambia significantly improves pain-free symptoms even in moderate to severe headache with rapid efficacy, sustained relief, and reduction of the associated features of migraine compared with tablet form and placebo. In a busy headache practice, it has been useful as a first-line treatment for migraine, treatment of status migrainosus, use in patients who cannot tolerate triptans, treatment for patients who prefer medication in solution, treatment for patients in withdrawal from other medications, and as an adjunctive treatment to triptans. Cambia is a versatile and efficacious tool for migraine management, is a welcome addition to the treatment armamentarium, and can help us improve our ability to achieve the goal of patient satisfaction. n
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