Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Drs Hill and Hope indicate an apparent preference for coadministration of the separate components of sumatriptan–naproxen sodium for migraine attacks. We believe that our study provides evidence of efficacy and safety of the single fixed-dose table in replicated randomized controlled trials, whereas trials of coadministration of specific regimens of the individual components have not been replicated.
The practicalities of treatment remain at issue with migraine. Adherence to prescribing directions is often difficult during an acute migraine attack—hence, our concerns of relapse to a “step care” situation—and failure of adherence is unlikely to provide patients with the degree of efficacy reported in our study.1 The prescribing simplicity of a single sumatriptan–naproxen sodium tablet should help improve adherence.
Brandes JL, Kudrow D, Stark SR, O’Carroll CP, Adelman JU, O’Donnell FJ, Alexander WJ, Spruill SE, Barrett PS, Lener SE. Combination of Sumatriptan and Naproxen for Migraine—Reply. JAMA. 2007;298(11):1276–1277. doi:10.1001/jama.298.11.1276-b