Migraine is a genetic/familial neurological problem affecting 25% of women and 6% of men. Prevalence of migraine is a female to male ratio of 3:1. Migraine is the sixth cause of disability worldwide. It causes unexpected visits to the emergency department. Although recent developments have brought a number of effective new medications for treatment, sadly, 70% of persons with migraine do not receive proper treatment.
Fifty percent of persons affected do not go or no longer go to the doctor, preferring to self-medicate with over-the-counter oils, compresses, or medication.
There is a need for a quick, safe treatment for migraine that can be taken anytime during an attack.
Read my article, “What is migraine?” on my website, www.doctormigraine.com.
This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, Migraine textbook author, Podcaster, YouTube video producer, and Blogger.
Read my mini book on Migraine here.
Elyxyb (celecoxib) is an NSAID for acute migraine treatment that is delivered in an oral solution. The drug works within 1 hour, even for moderate to severe migraine and it works to treat migraine regardless of when you take it.
Sustained relief occurred for up to 24 hours after taking Elyxyb. The treatment was well-tolerated with no serious adverse events reported in clinical trials.
Further questions
What is the indication for Elyxyb use? It is indicated by the FDA for acute treatment of migraine with or without aura.
How is Elyxyb given? It is supplied as an oral solution containing 25mg of celecoxib per mL (120mg/4.8mL) in disposable glass bottles. It comes as a self-microemulsifying drug delivery system that improves solubility and bioavailability for faster absorption. The maximum dosage in a 24-hour period is 120mg.
How quickly does Elyxyb work? Following administration of 120mg under fasting conditions, the median time to peak concentration (Tmax) was observed to be 1 hour (range, 0.67-3.00).
What did drug studies of Elyxyb show? FDA approval came after analysis of data from 2 double-blind, placebo-controlled trials of patients with episodic migraine (2 to 8 migraine attacks per month, with no more than 14 headache days per month, and with 48 hours of headache-free time between migraine attacks).
Results from both studies showed a significantly greater proportion of patients treated with Elyxyb achieved pain freedom and symptom freedom at 2 hours post-dose compared with those treated with placebo.
What were the adverse reactions of Elyxyb?
The most common adverse reaction reported was dysgeusia. Like other NSAIDs, Elyxyb carries a Boxed Warning related to the risk of serious cardiovascular and gastrointestinal adverse events.
What are possible drug interactions? CYP2C9 substrate, CYP2D6 inhibitor-weak antiplatelet effects, decreases renal perfusion; GI mucosal injury/bleeding risk, hyperkalemia, hypertensive effects.
What are the possible effects on pregnancy and breastfeeding? Weigh risk/benefit in 1st trimester, consider avoiding use at 20-29 wk gestation, and avoid use starting at 30 wk gestation.
For individuals desiring pregnancy, NSAIDs may delay ovulation.
Pregnancy and Migraine
Elyxyb may be used during breastfeeding.
Is there a risk of causing medication overuse headache? Elyxyb is an NSAID and can cause medication overuse headache if taken more than 15 days a week in susceptible persons. It should not be taken more than 2 days a week.
Read my article “What is medication overuse headache?’ on my website, www.doctormigraine.com.
Read my big book on migraine here.
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Although this site provides information about various medical conditions, the reader is directed to his own treating physician for medical treatment.
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All the best.
Britt Talley Daniel MD