| Migraine Disorders
Depakote vs Treximet
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Depakote vs Treximet with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsTreximet has a higher rate of injection site reactions vs Depakote based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Treximet but not Depakote, including UnitedHealthcare
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Category
Depakote
Treximet
At A Glance
Oral
Daily in divided doses
Valproate anticonvulsant
Oral
As needed (max 2 doses/24 hrs)
5-HT1 agonist + NSAID
Indications
- Bipolar Disorder
- Complex partial seizures
- Absence Epilepsy
- Migraine Disorders
- Migraine Disorders
Dosing
Bipolar Disorder 750 mg/day initially in divided doses, titrated rapidly to clinical response; max 60 mg/kg/day; oral.
Complex partial seizures 10-15 mg/kg/day initially, increased by 5-10 mg/kg/week to optimal response; max 60 mg/kg/day; divide doses if total daily dose exceeds 250 mg; oral.
Absence Epilepsy 15 mg/kg/day initially, increased at one-week intervals by 5-10 mg/kg/day until seizures are controlled; max 60 mg/kg/day; divide doses if total daily dose exceeds 250 mg; oral.
Migraine Disorders 250 mg twice daily; some patients may benefit from doses up to 1,000 mg/day; oral.
Migraine Disorders - Adults 1 tablet of 85/500 mg orally; max 2 tablets per 24 hours separated by at least 2 hours.
Migraine Disorders - Pediatric Patients 12 to 17 Years 1 tablet of 10/60 mg orally; max 1 tablet of 85/500 mg per 24 hours.
Migraine Disorders - Mild to Moderate Hepatic Impairment 1 tablet of 10/60 mg orally per 24 hours.
Contraindications
- Hepatic disease or significant hepatic dysfunction
- Mitochondrial disorders caused by mutations in mitochondrial DNA polymerase gamma (POLG; e.g., Alpers-Huttenlocher Syndrome) and children under two years of age suspected of having a POLG-related disorder
- Known hypersensitivity to divalproex sodium, sodium valproate, or valproic acid
- Known urea cycle disorders
- Migraine prophylaxis in pregnant women or in women of childbearing potential not using effective contraception
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Coronary artery bypass graft (CABG) surgery setting
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke or transient ischemic attack (TIA), or history of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing medication, ergot-type medication (e.g., dihydroergotamine or methysergide), or another 5-HT1 agonist
- Concurrent or recent (within 2 weeks) use of a monoamine oxidase-A (MAO-A) inhibitor
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Known hypersensitivity to sumatriptan, naproxen, or any component of TREXIMET
- Severe hepatic impairment
Adverse Reactions
Most common (>=5%) Nausea, vomiting, somnolence, dizziness, tremor, asthenia, alopecia, headache, abdominal pain, dyspepsia, diarrhea, weight gain
Serious Hepatic failure, birth defects, pancreatitis, hyperammonemic encephalopathy, suicidal behavior and ideation, bleeding and hematopoietic disorders, hypothermia, DRESS/multiorgan hypersensitivity, serious dermatologic reactions, angioedema
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, parkinsonism, aplastic anemia, pancytopenia, fractures, decreased bone mineral density, polycystic ovary disease, male infertility, angioedema
Most common (>=2%) Dizziness, somnolence, paresthesia, nausea, dyspepsia, dry mouth, chest discomfort/chest pain, neck/throat/jaw pain/tightness/pressure
Serious Cardiovascular thrombotic events, GI bleeding/ulceration/perforation, arrhythmias, cerebrovascular events, other vasospasm reactions, hepatotoxicity, hypertension, heart failure and edema, medication overuse headache, serotonin syndrome, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, DRESS, hematological toxicity, exacerbation of aspirin-sensitive asthma, seizures
Postmarketing Exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), fixed drug eruption (FDE)
Pharmacology
Divalproex sodium dissociates to the valproate ion in the gastrointestinal tract; its therapeutic mechanisms have not been fully established, but its anticonvulsant activity is thought to relate to increased brain concentrations of gamma-aminobutyric acid (GABA).
Sumatriptan is a selective 5-HT1B/1D receptor agonist that causes cranial vessel constriction and inhibits trigeminal neuropeptide release to abort migraine; naproxen sodium is an NSAID that inhibits COX-1 and COX-2, reducing prostaglandin synthesis to provide analgesic and anti-inflammatory effects.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Depakote
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (9/12)
Treximet
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Depakote
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Treximet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Depakote
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Treximet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Depakote.
No savings programs available for Treximet.
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DepakoteView full Depakote profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.