sumatriptan / naproxen
Treximet helps treat migraine in people age 12 years and older. It's a tablet that has two main ingredients: sumatriptan and naproxen. Sumatriptan is a triptan, and naproxen is a nonsteroidal anti-inflammatory drug (NSAID). These ingredients work together to treat migraine symptoms. Treximet is taken by mouth at the first sign of a migraine. Side effects aren't common but can include dizziness, sleepiness, and nausea. Treximet is available as a brand-name and generic medication.
What is Treximet?
What is Treximet used for?
- Treatment of migraine attacks with or without aura in people age 12 years and older
How Treximet works
Treximet is a combination of two ingredients that work together to treat migraine headaches.
- Sumatriptan is a triptan. It works by attaching to serotonin receptors in the brain. It lessens blood vessel swelling in the brain, which is thought to help with migraine pain. Sumatriptan also stops other pain signals from releasing through the nervous system.
- Naproxen is a nonsteroidal anti-inflammatory drug (NSAID). It blocks a protein in the body called cyclooxygenase (COX) that causes pain and swelling. This helps relieve migraine pain.
Drug facts
Side effects of Treximet
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults:
- Dizziness (4%)
- Sleepiness (3%)
- Nausea (3%)
- Chest pain or discomfort (3%)
- Pain, tightness, or pressure in the neck, throat, or jaw (3%)
- "Pins and needles" feeling (2%)
- Indigestion (2%)
- Dry mouth (2%)
Children:
- Feeling hot all of a sudden, flushed (up to 2%)
- Muscle tightness (up to 2%)
Less Common Side Effects
Treximet serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Stomach bleeding: feeling faint, vomiting blood, bloody or dark stools, severe stomach pain or discomfort
- Heart attack: chest pain or tightness that spreads up to your shoulder, arm, neck, or jaw; difficulty breathing; sweating
- Stroke: severe headache, weakness in one part of your body or face, slurred speech, blurred vision, confusion
- Heart failure: difficulty breathing, swelling, sudden weight gain, tiredness, dizziness
- Irregular heart rhythm (arrhythmia): slow heartbeat, skipped heartbeats, pounding in the chest, a fluttering feeling in the chest, chest pain, dizziness, weakness, trouble breathing
- Narrowing of blood vessels in the body: bloody diarrhea; severe stomach pain; partial or permanent blindness; tightness, weakness, numbness of legs or feet
- Serotonin syndrome: fast heart rate, sweating, flushing, tremor (shakiness), muscle stiffness or twitching, uncoordinated movement, hallucinations
- Liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
- Kidney problems: tiredness, dry and itchy skin, urinating less than usual, foamy or bloody urine, muscle cramps
- Serious allergic reaction: hives; rash; swelling of the face, lips, or tongue; difficulty breathing
- Serious skin reaction: skin redness, blisters, rash
- Seizure
More on Treximet side effects
The following Treximet side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Burning, pain, tingling, or color changes in the hands, arms, legs, or feet
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- High potassium level—muscle weakness, fast or irregular heartbeat
- Increase in blood pressure
- Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Rash, fever, and swollen lymph nodes
- Raynaud syndrome—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Round red or dark patches on the skin that may itch, burn, and blister
- Seizures
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
- Vision loss
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dizziness
- Fatigue
- Headache
- Loss of appetite
- Nausea
- Upset stomach
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Pros and cons of Treximet
Pros
- Combines two first-choice options for treating migraines into one pill for convenience
- Okay for children as young as 12 years old to take
- Can take with or without food
Cons
- Not for preventing migraines from happening
- Migraines can get worse if you take this medication too often
- Not the best option for people who are taking certain antidepressants or for people who have asthma, certain heart conditions, or serious liver problems
Pharmacist tips for Treximet
- You can take Treximet with or without food. Be sure to swallow the tablets whole with water. Don't split, crush, or chew the tablet because it can affect how well the medication works. Talk to your prescriber if you have trouble swallowing the tablet.
- For adults: Take Treximet at the first sign of a migraine. If your migraine comes back or if it doesn't relieve your symptoms, you can take one more dose of Treximet. Wait at least 2 hours after your first dose to take another. Talk to your prescriber for more options if your migraine doesn't get better after two doses of the medication. Don't take Treximet to treat an average of more than 5 migraines within a 30-day period.
- For children age 12 to 17 years old: Take Treximet as soon as the migraine starts. Children can only take Treximet once per day since it isn't known if taking the medication more than once in the same day is safe and works well. Ask a healthcare professional about what to do if the migraine doesn't go away or comes back. Don't take Treximet to treat an average of more than 2 migraines within a 30-day period.
- Keep track of how often you take migraine medications, including Treximet. Try not to take migraine medications more than 9 days in a month. You could get rebound headaches (also called medication-overuse headaches). It can lead to more migraine-like headaches or more migraine attacks. If you get migraines often, talk to your prescriber about other ways to manage them.
- You might feel tightness, pressure, or pain in the chest, throat, jaw, or neck after you take Treximet. These symptoms typically don't last long (up to an hour) and usually go away. But keep in mind that they can be a lot like signs of a heart attack or other heart problems. Get medical help right away if these symptoms are worsening, don't go away, or worry you.
- Get medical help as soon as possible if you have severe stomach pain, have bloody or dark stools, or vomit blood. Treximet raises the risk of stomach bleeding, which needs to get treated right away.
- Limit the amount of alcohol you drink or avoid alcohol while you're taking Treximet. Alcohol can raise your risk for stomach bleeding, other stomach-related side effects, dizziness, and sleepiness. It can also trigger more migraines.
- Don't take Treximet at the same time as other NSAIDs, such as ibuprofen (Motrin, Advil). Treximet contains an NSAID. And taking more than one NSAID at the same time raises your risk for stomach bleeds, stroke, and heart attack. Keep in mind NSAIDs are common in over-the-counter pain and cold medications. Talk with a pharmacist if you're not sure whether you're already taking an NSAID.
- If you're taking low-dose aspirin for your heart, ask your primary care provider if it's safe for you to also take Treximet. Taking both medications together raises your risk for side effects.
- Let your healthcare team and pharmacist know about all the other medications you're taking (including vitamins and supplements). Treximet contains naproxen and sumatriptan, and both ingredients have many drug interactions that can lead to harmful side effects. Your care team can help check that all your medications are safe to take together.
Common questions about Treximet
There's a generic for the Treximet tablets that contain 85 mg of sumatriptan and 500 mg of naproxen. But the Treximet tablets that have 10 mg of sumatriptan and 60 mg of naproxen is only available under the brand name.
No. Treximet isn't a narcotic. Narcotics is a term that commonly refers to opioid medications. Treximet isn't an opioid medication.
Take Treximet only when you feel a migraine starting. For adults, you can take Treximet again at least 2 hours later if your migraine doesn't get better or comes back. But don't use Treximet to treat more than 5 migraines in a month since it's not known if that's safe. For children age 12 to 17 years, take Treximet only once in a 24-hour period. Don't use Treximet for more than 2 migraines in a month because we don't know if it's safe. If you need more relief from migraines, talk to your prescriber about other treatment options. Also remember that taking migraine medications more than 9 days in a month can make your headaches worse (rebound or medication-overuse headaches).
Dizziness, sleepiness, and nausea were some of the most common side effects that people taking Treximet had. Avoid driving until you know how Treximet affects you. And make sure to sit or lie down if you feel dizzy after you take it until it goes away to avoid falling. Taking Treximet with food can help lessen the risk of nausea and other stomach upset from the medication. Talk to your prescriber if you have a side effect from Treximet that bothers you.
Yes, some people can feel sleepy after they take Treximet. But it's not very common. In clinical studies, only about 3% of people who took Treximet said that they felt sleepy. When you take Treximet, wait and see how this medication makes you feel before driving or doing anything that requires concentration. Contact your prescriber if you feel too sleepy to go about your day.
Treximet contains two active ingredients: sumatriptan and naproxen. It takes about 10 hours for sumatriptan and about 4 days for naproxen to leave your body after a single dose. This time frame is estimated based on the half-life of each ingredient. Ask your prescriber or pharmacist if you have more questions about how long Treximet stays in your system.
No, don't take Treximet and ibuprofen together. Treximet contains naproxen. Both naproxen and ibuprofen are nonsteroidal anti-inflammatory drugs (NSAIDs). Taking more than one NSAID at the same time can raise your risk for serious problems with your kidney, stomach, and heart. If you need more pain relief, ask a healthcare professional for options that are safe for you. For example, it's usually okay to take acetaminophen (Tylenol) unless you have liver problems since it can harm the liver.
No. One of the ingredients of Treximet is sumatriptan. Taking too much sumatriptan raises your risk for side effects like dizziness and pain in your chest, neck, or jaw. If Treximet isn't helping enough with your migraine, ask your prescriber about other treatment options.
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Risks and warnings for Treximet
Treximet can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk for stomach ulcers and stomach bleeding
- Risk factors: Older adults | History of peptic ulcer disease | History of stomach bleeding | Bleeding problems | Severe liver problems | Drinking alcohol | Smoking | Poor overall health | Taking other medications that raise your risk of bleeds (e.g., NSAIDs, blood thinners) | Taking Treximet for a long time
Treximet contains naproxen, which is an NSAID. NSAIDs can raise the risk for stomach problems, like inflammation, stomach ulcers (sores), and bleeding. These serious problems can happen at any time while you're taking Treximet. They're serious problems that should get treated as soon as possible.
Tell your prescriber and pharmacist about your health conditions and any other medications you take. They can help check your risk for stomach ulcers and stomach bleeding.
Let your prescriber know if you have symptoms of a stomach ulcer, like burning stomach pain that doesn't go away, burning feeling in the chest, acid reflux, nausea, vomiting, or feeling full too quickly. For stomach bleeds, people often don't have any symptoms. But you should get emergency help if you feel faint, vomit blood, or have bloody or dark stools.
Risk for heart attack, chest pain (angina), and stroke
- Risk factors: Heart problems | Taking higher doses of Treximet | Taking Treximet for a long time | Past or planned heart surgery | Taking multiple NSAIDs
Treximet might raise your risk of blood clots, which can lead to a heart attack or stroke. Some people also had chest pain (angina) after taking Treximet. Talk to your prescriber about your health conditions before taking Treximet so they can check your risk for these problems. Don't take Treximet if you've had or will have heart surgery because your risk is much higher after surgery.
To lower your risk, take the lowest dose of Treximet for the shortest time needed for migraine. Don't take other NSAIDs with Treximet. Call 911 right away if you have signs of a heart attack like chest pain that spreads to the arm, neck, or jaw; shortness of breath; sweating; or nausea. Also get medical help right away if you have symptoms of a stroke, like weakness on one side of your body, a drooping face, or trouble speaking or walking.
High blood pressure, swelling, and risk for heart failure
- Risk factors: High blood pressure | Heart failure
NSAIDs like the naproxen in Treximet can cause your body to hold onto extra fluid. This might raise your blood pressure and also cause swelling in the legs or feet. Fluid buildup can also put you at risk for heart failure. Let your prescriber know about your medical history and the medications you take so they can check your risk for these problems.
Call your primary care provider if your blood pressure stays higher than usual while you're taking Treximet. Also let them know if you have any swelling in the legs or ankles or other signs of heart failure, like difficulty breathing, sudden weight gain, tiredness, dizziness, or chest pain with physical activity.
Irregular heart rhythm (arrhythmias)
Some people who've taken a triptan, like the sumatriptan in Treximet, have had serious heart rhythm problems (arrhythmia). This can happen within a few hours after taking the medication. Don't take Treximet if you have a condition that causes arrhythmia. Tell your prescriber if you have a slow heartbeat, a fluttering or pounding heart, chest pain, dizziness, weakness, or trouble breathing. These can be signs of an arrhythmia.
Extreme narrowing of blood vessels
Sumatriptan, an ingredient in Treximet, can cause the blood vessels in certain areas of your body to become very narrow. This can prevent certain parts of your body from getting enough blood, which can lead to problems.
For example, it can sometimes cause symptoms similar to Raynaud's phenomenon. This can appear as color changes in your hands and feet (can turn pale or more reddish depending on how much blood is flowing through). Other times, the blood vessels in the stomach can narrow and cause stomach pain or bloody diarrhea. And although rare, narrowing of the blood vessels in the eye can cause vision problems.
Let your prescriber know if you have any of these symptoms. Don't take any more Treximet until your prescriber checks that it's safe for you.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels
Some people who take Treximet can get a rare but serious condition called serotonin syndrome. This happens when there's too much serotonin in the brain. The risk is higher if you take Treximet with other medications that can raise your serotonin levels, like some antidepressants. Tell your prescriber about all the medications you take so they can check your risk.
Symptoms of serotonin syndrome include fever, sweating, shivering, fast heartbeat, muscle stiffness or spasms, and confusion. These symptoms can start within minutes to hours after starting a new medication that raises your serotonin levels. They can also happen when you switch to a higher dose of these medications. Get medical help right away if you have any symptoms of serotonin syndrome.
Liver damage
Some people who take NSAIDs, including the naproxen in Treximet, can have higher liver enzyme levels in their blood. This could be a sign of liver problems. In rare cases, these problems have led to liver failure. Don't take Treximet if you have severe liver problems.
Call your prescriber right away if you have nausea; diarrhea; upper right-sided stomach pain; yellowing of your skin or the whites of your eyes; stool changes (black, tarry, or bloody stools); or itchy skin. These could be signs of liver damage. Your care team might need to check your liver and might tell you to stop taking Treximet.
Kidney damage
- Risk factors: Age 65 or older | Kidney problems | Liver problems | Heart failure | Dehydration | Taking other medications that can cause kidney damage (e.g., diuretics, ACE inhibitors, ARBs)
Taking NSAIDs (like the naproxen in Treximet) for a long time can harm your kidneys. Your risk is higher if you're an older adult or have certain health issues like kidney problems or heart failure. The risk is also higher if you take other medications that can cause kidney damage. Call your prescriber if you notice any signs of kidney damage. They can include changes in how often you need to urinate, tiredness, dry and itchy skin, and muscle cramps.
Severe allergic reactions and skin reactions
- Risk factors: Aspirin allergy | NSAID allergy
Treximet can cause serious and sometimes life-threatening allergic reactions. They can include swelling of the face, shock, and a severe reaction called anaphylaxis. Tell your prescriber if you're allergic to aspirin or other NSAIDs. Since Treximet has an NSAID in it, you might be at risk of having an allergic reaction to the medication. Get medical help right away if you have hives; rash; swelling of your face, lips, or tongue; or trouble breathing after taking Treximet.
Although rare, the naproxen in Treximet can cause serious skin reactions. They can include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Stop taking Treximet and get medical care right away if you notice unusual changes in your skin, such as rash, blisters, or peeling skin.
Avoid during pregnancy because of risk of harm to an unborn baby
Treximet contains naproxen. Naproxen can cause harm to an unborn baby, especially if it's taken in the second half of pregnancy (after week 20). It can cause serious problems for your baby, like issues with the heart, kidney, or other organs.
Speak to your prescriber or obstetrician-gynecologist (OB-GYN) about the risks and benefits of taking Treximet if you're pregnant. Ask whether there are safer options for relieving your migraine.
Treximet dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 85mg/500mg | 9 tablets | $131.31 | $14.59 |
Typical dosage for Treximet
Each Treximet tablet contains 85 mg of sumatriptan and 500 mg of naproxen.
- Age 18 years and older: The typical dose is 1 tablet by mouth as a single dose for migraine. If your migraine comes back or doesn't completely go away, you can take another tablet at least 2 hours later. Don't take more than 2 Treximet tablets in a day.
- Age 12 to 17 years old: The typical dose is 1 tablet by mouth as a single dose for migraine. If the migraine comes back or doesn't fully go away, talk to your child's pediatrician about what to do. The most your child can take in one day is 1 Treximet tablet.
Your dose will differ if you have liver problems.
How much does Treximet cost?
Treximet contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Treximet will not be safe for you to take.
- Previous allergic reaction to sumatriptan or naproxen
- History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
- Right before or after coronary artery bypass graft surgery (CABG), a type of open heart surgery
- Uncontrolled high blood pressure
- Coronary artery disease (CAD)
- Coronary artery vasospasm, such as Prinzmetal's angina
- Certain conditions that cause an irregular heart rhythm (arrhythmia), such as Wolff-Parkinson White syndrome
- History of stroke or transient ischemic attack ("mini-stroke")
- History of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Severe liver problems
- Have taken an ergot-containing or ergot-type medications like dihydroergotamine (Migranal) in the last 24 hours
- Have taken a different triptans in the last 24 hours
- Currently take or have taken a monoamine oxidase inhibitor (MAOI), such as selegiline, in the last 14 days
What are alternatives to Treximet?
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