Comparison of a fixed combination of domperidone and paracetamol (Domperamol (R)) with sumatriptan 50 mg in moderate to severe migraine: A randomisedUK primary care study

Migraine is a common and debilitating condition routinely managed in primar y care. A number of treatment options - both acute and prophylactic - are c urrently available but may differ in terms of efficacy, tolerability and co st. The aim of this study was to compare the effectiveness and tolerability of a fixed combination of domperidone and paracetamol (Domperamol; Servier ), which has anti-nauseant and anti-emetic activity with sumatriptan 50 mg in moderate to Severe migraine. To do this, 120 patients were recruited fro m 23 primary care practices throughout the UK and were enrolled into the si x-month trial. Patients were randomised at entry to one of the comparator r egimens (used to treat their first migraine attack) and then crossed over t o the alternative treatment for their second attack. Detailed diary cards w ere completed for each attack using a scale of pain severity. At two hours and four hours post-dose, the two treatments showed comparable efficacy (le ss than or equal to 15% difference) in relieving headache and reducing naus ea and vomiting. Both were well tolerated and there were no serious adverse effects. In the management of migraine patients typically seen in routine general practice, this trial showed that the effects of Domperamol and suma triptan 50 mg were broadly comparable. Since Domperamol is considerably les s expensive than sumatriptan (and other triptans), a first-line role for th is agent appears appropriate.