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Barriers to Treatment

Possible Barriers to Early Treatment

All triptans can be more effective when taken early on during a migraine attack. However, patients may delay taking their migraine medication for a number of reasons, especially if their headaches strike during the day. Click on the possible barriers below to see how you can help your patients overcome them.

Is it really a migraine? See how you can helpClose

Many times, patients may wait until their headache pain becomes moderate or severe before taking their migraine medication-just to be sure it really is a migraine. Since early treatment is associated with improved outcomes in triptan therapy, encourage your patients to keep a headache diary to become familiar with their symptoms, so they can treat at the earliest onset of a migraine attack. With a proven tolerability and efficacy profile, AXERT may be the option your patients need to treat their migraines earlier.

Concerns about Side Effects See how you can helpClose

In a survey of 1,160 migraineurs, concerns about adverse events led to a delay in taking medication in 37% of treated episodes. Feeling sleepy/tired was the most common and most bothersome side effect reported by a subset of triptan users who completed the survey.* This can be particularly problematic for patients who experience migraines especially during the day when they need to be more productive. Minimal side effects may give AXERT patients the confidence to treat early, which could result in improved outcomes.

* Gallagher RM, Kunkel R. Migraine medication attributes important for patient compliance: concerns about side effects may delay treatment. Headache. 2003;43:36-43.

Cost See how you can helpClose

In a survey of 1,160 migraineurs, 11% reported not filling a migraine medication prescription at some point. One of the major reasons was high costs (33%). AXERT free trial offer and discount program can help your patients save money. And with a proven efficacy and tolerability profile, AXERT may be an effective solution.

Insurance Coverage See how you can helpClose

Because of the limitations on pill quantity and reimbursements imposed by insurance companies and other healthcare organizations, patients may hesitate to use a triptan when pain is mild.* With the AXERT free trial offer and discount program , your patients can save up to $25 per prescription for up to 6 refills. AXERT tablets also come in a convenient 12-pack, so patients may treat their migraines earlier with less concern over quantity and cost.

* Dowson AJ, Mathew NT, Pascual J. Review of clinical trials using early acute intervention with oral triptans for migraine management. Int J Clin Pract. 2006;60,6:698-706.

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Indication
AXERT® tablets are indicated for the acute treatment of migraine with or without aura in adults. AXERT® tablets are indicated for the acute treatment of migraine headache pain in adolescents age 12 to 17 years with a history of migraine attacks with or without aura usually lasting 4 hours or more (when untreated). In adolescents age 12-17 years, efficacy of AXERT® on migraine associated symptoms (nausea, photophobia and phonophobia) was not established.

AXERT® is not intended for the prophylactic therapy of migraine or for use in the management of hemiplegic or basilar migraine. Safety and effectiveness of AXERT® have not been established for cluster headache which is present in an older, predominantly male population.

IMPORTANT SAFETY INFORMATION
AXERT® tablets should be used only when a clear diagnosis of migraine has been established. If a patient has no response for the first migraine attack treated with AXERT®, the diagnosis of migraine should be reconsidered before AXERT® is administered to treat any subsequent attacks. AXERT®, like other triptans, has been associated with coronary vasospasm and therefore should not be given to patients with ischemic heart disease or to patients who have symptoms or findings consistent with ischemic heart disease, coronary artery vasospasm (including Prinzmetal's variant angina), or other significant underlying cardiovascular disease. AXERT®, like other triptans in this class, should not be given to patients in whom unrecognized coronary artery disease (CAD) is predicted by risk factors (family history, high cholesterol, high blood pressure, diabetes, or obesity). Do not use AXERT® in patients with cerebrovascular syndromes including (but not limited to) stroke of any type as well as transient ischemic attacks. Certain cerebrovascular events and serious cardiac events have been reported in patients treated with triptans, and some events have resulted in fatalities. Do not use AXERT® in patients with peripheral vascular disease including (but not limited to) ischemic bowel disease. Because AXERT® may increase blood pressure, it should not be given to patients with uncontrolled hypertension.

In very rare cases, serious cardiovascular events have been reported in association with AXERT® use in the absence of known cardiovascular disease. If treatment is considered, patients should first have a cardiovascular evaluation and the first dose should take place in a physician's office setting. Sensations of pain, tightness, pressure and heaviness in the chest, throat, neck, and jaw have been reported with AXERT® and other triptans. This is generally not associated with myocardial ischemia, but patients with signs or symptoms suggestive of angina should be evaluated for the presence of CAD. Patients who experience symptoms or signs suggestive of decreased arterial flow following the use of any triptan, such as ischemic bowel syndrome or Raynaud's syndrome, are candidates for further evaluation.

The development of a potentially life-threatening serotonin syndrome may occur with triptans, including AXERT® treatment, particularly when combined with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). If combined treatment with AXERT® and an antidepressant is clinically warranted, patients should be closely observed for signs and symptoms of the serotonin syndrome such as mental status changes, hyperthermia, diaphoresis, labile blood pressure, tachycardia, hyperreflexia, incoordination and/or gastrointestinal symptoms, especially during treatment initiation and dosage escalation. Patients with the serotonin syndrome require immediate medical attention.

Do not use AXERT® within 24 hours of ergotamine-containing or ergot-type medications, or another 5-HT1 agonist (e.g. triptan). Patients taking ketoconazole need a lower dose of AXERT®. Do not use if known hypersensitivity exists to AXERT®. Use with caution in patients with known hypersensitivity to sulfonamides.

The most common side effects in adults are nausea, somnolence, paresthesia, headache and dry mouth.

The most common side effects in adolescents are dizziness, somnolence, headache, paresthesia, nausea and vomiting.

For more detailed information, please see full Prescribing Information.

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This page was last updated on Oct 14 2010 at 01:19:47 EDT.