Talk To Your Doctor About Migraine Prevention
North American Precis Syndicate
Doctors have new ways to prevent migraine headaches. (NAPS)
(NAPSI)—A migraine headache can be debilitating and sometimes hit like a
runaway freight train, but did you know that in some cases it’s preventable?
Unfortunately, migraine preventive therapy is severely underutilized. Nearly
40 percent of people who suffer from migraine could benefit from preventive
treatment, but only a small percentage receive this type of therapy.1
Migraine prevention is just a conversation away. Here’s some information
about migraine and preventive treatment options to help you start a dialogue
with your doctor.
What causes migraine and can it be
Just about everyone has headaches, but contrary to popular belief,
migraine is not just a bad headache.2 In fact, the World Health
Organization places migraine as one of the 10 most disabling illnesses on the
planet.3 Doctors aren’t exactly sure what causes migraine
headaches, but they think imbalances in certain brain chemicals may play a
role, along with genetics and other factors including:4
• Physical and environmental
elements. Emotional stress (one of the most common migraine triggers);
consuming salty, processed foods and alcohol and caffeine; skipping meals;
sensory overload; changes in sleep pattern; physical strain; and changes in
• Genes. A family history of
migraine increases the likelihood of having migraines.
• Age. Migraine headaches can
occur at any point in life, but the first one usually happens during the
teenage years. Migraines tend to peak in the thirties and are less severe
later in life.
• Gender. Women experience
migraine more than men.
• Hormonal changes. Birth
control pills and hormone replacement therapy can make migraine symptoms
worse for some women but better for others.
Knowing your pattern of getting a migraine headache, and learning what
triggers to avoid, are helpful prevention techniques. For those with frequent
migraines who aren’t able to avoid or effectively treat a migraine headache
after it has started, migraine prevention therapy may be an answer.
What are some migraine prevention
For patients with frequent migraine attacks (1-2 per week or more),
doctors recommend preventive therapy.5 Topiramate
is the most commonly prescribed migraine preventive due to a sizable body of
evidence demonstrating its ability to improve outcomes in migraine patients
in terms of reduced disability and improved quality of life.6 The
American Academy of Neurology and the American Headache Society have given topiramate a “top tier” rating for migraine prevention.7
The Food & Drug Administration (FDA) has approved Qudexy®
XR (topiramate) extended-release capsules, for use
in the prevention of migraine headaches in adults and adolescents 12 years of
age and older. Qudexy XR is taken once daily by
In addition, three injectable anti-calcitonin gene-related peptide (CGRP) therapies,
indicated for the preventive treatment of migraine in adults, were recently
approved by the FDA.
With all of the treatments available for the prevention of migraine, it’s
important to talk to your doctor and discuss options that can be tailored to
your individual needs.
For more information about migraine prevention and Qudexy®
XR, talk to your doctor or visit www.QudexyXR.com.
IMPORTANT SAFETY INFORMATION SHOULD I KNOW?
Qudexy® XR should not be used in patients with metabolic
acidosis who are also taking a medicine called metformin
Qudexy XR can cause serious side effects,
• Serious eye problems,
which may include blurred or sudden decrease in vision, eye pain and redness
or a blockage of fluid that may cause increased pressure in the eye (secondary angle closure glaucoma). If
left untreated, this can lead to permanent vision loss.
• Decreased sweating and fever. People,
especially children, should be watched for signs of decreased sweating and
fever, especially in hot temperatures. Some people may need to be
hospitalized for this condition.
• Increased acid level in the blood
(metabolic acidosis). This may or may not cause symptoms. Symptoms may
include feeling tired, decreased appetite, change in heartbeat, or trouble
thinking clearly. If left untreated, metabolic acidosis can cause brittle or
soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth
in children, and may possibly harm the unborn child of pregnant patients.
• High blood ammonia levels. High ammonia
in the blood can affect mental activities, slow alertness and cause tiredness
or vomiting. This can also happen when Qudexy XR is
taken with a medicine called valproic acid (e.g., Depakene® and Depakote®).
• Kidney stones. Drink plenty of fluids
when taking Qudexy XR to decrease your chances of
getting kidney stones.
• Low body temperature. Taking Qudexy XR when you are also taking valproic
acid may cause a drop in body temperature to less than 95°F, tiredness,
confusion, or coma.
• Effects on thinking and alertness. Qudexy XR may affect how you think, and can cause
confusion, problems with concentration, attention, memory, or speech. Qudexy XR may cause depression or mood problems,
tiredness, and sleepiness.
• Dizziness or loss of muscle coordination.
your healthcare provider right away if you have any of the above symptoms.
other antiepileptic drugs, Qudexy XR may cause
suicidal thoughts or actions in a very small number of people, about 1 in
500. Before taking Qudexy XR, tell your healthcare provider if you have or
have had depression, mood problems, or suicidal thoughts or behavior. Call a
healthcare provider right away if you have thoughts about suicide or dying;
attempt to commit suicide; have new or worsening depression or anxiety; feel
agitated or restless; experience panic attacks, have trouble sleeping
(insomnia), new or worsening irritability; feel or act aggressive, angry, or
violent; act on dangerous impulses; experience an extreme increase in
activity and talking (mania); or other unusual changes in your behavior or
Qudexy XR can harm your unborn baby. All women of
childbearing age should talk to their healthcare provider about possible
alternative treatments. If you take Qudexy XR
during pregnancy, your baby has a higher risk for birth defects called cleft
lip and cleft palate. These defects can begin early in pregnancy, even before
you know you are pregnant. Also, if you take Qudexy
XR during pregnancy, your baby may be smaller than expected at birth; the
long-term effects of this are not known. If the decision is made to use Qudexy XR, you should use effective birth control
(contraception). Tell your healthcare
provider right away if you become, or plan to become pregnant while taking Qudexy XR.
most common side effects of Qudexy XR include: tingling of the arms and legs (paresthesia),
not feeling hungry, weight loss, nervousness, nausea, speech problems,
tiredness, dizziness, sleepiness/drowsiness, a change in the way foods taste,
upper respiratory tract infection, slow reactions, difficulty with memory,
fever, abnormal vision, diarrhea, and pain in the abdomen. These are not all
the possible side effects of Qudexy XR. For more
information, ask your healthcare provider or pharmacist.
taking Qudexy XR, tell your healthcare provider
about all of your medical conditions,
including if you: have had depression, mood problems, or suicidal thoughts or
behavior; have kidney problems, kidney stones, or are getting kidney
dialysis; have a history of metabolic acidosis (too much acid in the blood);
have liver problems; have weak, brittle or soft bones (osteomalacia,
osteoporosis, osteopenia, or decreased bone
density); have lung or breathing problems; have eye problems, especially
glaucoma; have diarrhea; have a growth problem; are on a diet high in fat and
low in carbohydrates, which is called a ketogenic
diet; are having surgery; are pregnant or planning to become pregnant; or if
you are breastfeeding. The medicine in Qudexy XR (topiramate) passes into your breast milk. It is not known
if the medicine, topiramate, that passes into
breast milk can harm your baby. Talk with your healthcare provider about the
best way to feed your baby if you take Qudexy XR.
your healthcare provider about all the medicines you take, including prescription and over-the-counter
medicines, vitamins, and herbal supplements. Especially tell your healthcare
provider if you take metformin (e.g., Glucophage); valproic acid
(e.g., Depakene or Depakote);
any medicines that impair or decrease your thinking, concentration, or muscle
coordination; birth control pills (Qudexy XR may
make birth control pills less effective); medicines used to prevent seizures;
or any other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide, or dichlorphenamide).
not stop Qudexy XR without first talking to a
healthcare provider. If you have
epilepsy and you stop taking Qudexy XR suddenly,
you may have seizures that do not stop. Your healthcare provider will tell
you how to stop taking Qudexy XR slowly.
not drink alcohol while taking Qudexy XR. Qudexy XR and alcohol can
cause serious side effects such as severe sleepiness and dizziness and an
increase in seizures.
not drive a car, swim, climb, or operate heavy machinery until you know how Qudexy XR affects you. Qudexy XR can slow your thinking and motor
skills, and may affect vision. Even when taking Qudexy
XR, some patients with epilepsy will continue to have unpredictable seizures.
IS QUDEXY XR?
Qudexy® XR (topiramate) Extended-Release Capsules is a prescription
• To prevent migraine headaches in adults
and adolescents 12 years and older.
• To treat certain types of seizures
(partial-onset seizures and primary generalized tonic-clonic
seizures) in adults and children 2 years and older.
• With other medicines to treat certain
types of seizures (partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome) in adults and children 2 years and
is the most important information to know about Qudexy
XR, but is not comprehensive. For more information, talk to your healthcare
provider and read the Medication Guide for Qudexy
XR. You can also visit www.upsher-smith.com
or call 1-888-650-3789.
You are encouraged to report negative side
effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call
Qudexy is a registered trademark of Upsher-Smith
All other marks are the property of their
1. National Headache Foundation. Migraine
Prevention Therapy: What’s in the Pipeline? Available at https://headaches.org/2017/03/13/migraine-preventive-therapy-whats-pipeline/.
Accessed September 20, 2018.
2. Migraine Research Foundation. Available
Accessed September 12, 2018.
3. American Migraine Foundation. Available
Accessed September 12, 2018.
4. WebMD. Available at https://www.webmd.com/migraines-headaches/migraines-causes#1.
Accessed September 12, 2018.
5. American Headache Society. Available at https://americanheadachesociety.org/wp-content/uploads/2018/05/Alan_Rapoport_-_Migraine_Prevention_Medications.pdf.
Accessed September 12, 2018.
6. Silberstein SD. Topiramate
in Migraine Prevention: A 2016 Perspective. Headache. 2017 Jan;57(1):165-178.
7. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E.
Evidence-based guideline update: pharmacologic treatment for episodic
migraine prevention in adults: report of the Quality Standards Subcommittee
of the American Academy of Neurology and the American Headache Society.
Neurology. 2012;78(17): 1337-1345.
On the Net:North American Precis Syndicate, Inc.(NAPSI)