Subject : A survey to assess the usage pattern of FDC of Naproxen and Domperidone in the treatment of migraine in India
Headache disorders are among the most prevalent neurologic disorders worldwide. Approximately 30% of adults in the age group 18-65 suffer from headache disorders and about 30% of these individuals have migraine. Female-to-male ratio of 3:1 and an estimated 1-year prevalence of approximately 15% in the general population
Despite a high level of disability and a strong desire for successful treatment, only a proportion of migraine sufferers seek professional advice for the treatment of attacks. The majority were not taking any preventive medication, although one-third met guideline criteria for offering or considering it. Nearly all migraineurs (98%) used acute treatments for attacks, with 49% using over-the-counter (OTC) medication only, 20% using prescription medication, and 29% using both. OTC medication included aspirin, other non- steroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), and paracetamol with caffeine Delayed gastric emptying, also known as gastroparesis, is associated with migraine attacks, and few studies have also shown that patients experience such delays (> 30 minutes) in gastric emptying during and outside of attacks suggesting that abnormal gastric motility is not limited to an acute event but is instead a clinical feature of migraine.
Naproxen is an NSAID first marketed in the mid-1970s, with confirmed efficacy in acute, and chronic pain. It is a propionic acid derivative (of the same family as ibuprofen), with analgesic, anti-inflammatory, and antipyretic properties. It has been widely used in treating arthritis, menstrual cramps, gout, sprains and strains, and a variety of acute pain conditions
Studies of gastric motility have suggested that a degree of gastric stasis exists during migraine attacks. Domperidone has actions, similar to those of metoclopramide, on the chemoreceptor trigger zone and upper gastrointestinal tract. However, because domperidone does not readily cross the blood-brain barrier, it is unlikely to have any adverse effect on the central nervous system or cause extra-pyramidal reactions, which would be an advantage in the treatment of migraine.
Naproxen and domperidone has been approved for acute migraine in 2019 by CDSCO. In a recent review of aspirin with or without an antiemetic for acute migraine, aspirin plus metoclopramide was significantly better than aspirin alone for headache relief and relief of nausea at two hours, but not for pain free at two hours or sustained pain-free during the 24 hours post dose.
Migraine-associated gastroparesis appears clinically important as it delays symptom relief with oral medications like NSAIDs (naproxen) due to delayed absorption. Antiemetic property of domperidone will help to relieve nausea and vomiting, whereas its prokinetic property may improve absorption of naproxen by increasing the rate of gastric emptying. Naproxen is effective in reducing headache intensity, improving migraine-symptoms and rendering pain-free at 2 hours. Hence, using naproxen in combination with domperidone will provide better efficacy and also improve compliance due to reduced pill burden
This survey is conducted to assess the usage pattern of FDC of Naproxen and Domperidone in the treatment of migraine in India
As you will be spending some extra time to give your feedback on the questionnaire based on your clinical experience, we offer to pay you by cheque a professional fee of Rs {{$contractAmount}}, on receiving the completed Survey Questionnaire Form from you.
We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
|
}}){kind=logo}
}})