Migraine polypharmacy and the tolerability of sumatriptan: a large-scale, prospective study

Polypharmacy (the prescription of more than one therapy for a single patien t) and subcutaneous (s.c.) sumatriptan tolerability were prospectively stud ied in 12,339 migraineurs, each followed for up to 1 year. Inclusion/exclus ion criteria were minimal and mirrored United States Imitrex(R) labeling. D rug usage and compliance monitoring were automatically interfaced with pres cription refill. Concomitant drugs were used by 79% of patients, with analg esics, antidepressants, and sedatives used most commonly. No adverse intera ctions between sumatriptan and neurological drugs were found, possibly refl ecting relative inability of the former to cross the blood-brain barrier. N o difference in cardiovascular adverse events was associated with oral cont raceptive use, which was more common than expected. No other drug class inf luenced adverse event probability, although sample sizes for these comparis ons was sometimes <400 patients. This study confirms the prevalence of poly pharmacy in migraine, identifies the drugs used, and concludes that, on a p opulation basis, the tolerability of s.c. sumatriptan, when used according to labeled instructions, is unaffected by these concomitant drugs.