| Migraine Disorders
Treximet vs Trokendi XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Treximet vs Trokendi Xr 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 signalsTrokendi Xr has a higher rate of injection site reactions vs Treximet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trokendi Xr but not Treximet, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Treximet
Trokendi Xr
At A Glance
Oral
As needed (max 2 doses/24 hrs)
5-HT1 agonist + NSAID
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Indications
- Migraine Disorders
- Lennox-Gastaut Syndrome
- Migraine Disorders
Dosing
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.
Lennox-Gastaut Syndrome Adjunctive therapy: adults (>=17 years) 200-400 mg orally once daily, initiated at 25-50 mg once daily and titrated in 25-50 mg/week increments; pediatric patients 6-16 years approximately 5-9 mg/kg/day orally once daily, initiated at 25 mg/day and titrated at 1-3 mg/kg/day every 1-2 weeks, not to exceed 400 mg/day.
Migraine Disorders Preventive treatment for patients 12 years and older: 100 mg orally once daily, titrated over 4 weeks starting at 25 mg/day (Week 1: 25 mg, Week 2: 50 mg, Week 3: 75 mg, Week 4: 100 mg).
Contraindications
- 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
- Recent alcohol use within 6 hours prior to or 6 hours after TROKENDI XR administration
- History of hypersensitivity reaction to topiramate, TROKENDI XR, or any inactive ingredient (anaphylaxis and angioedema have occurred)
Adverse Reactions
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)
Most common (>=10%) Paresthesia, weight loss, anorexia, dizziness, somnolence, nervousness, psychomotor slowing, speech disorders, vision abnormal
Serious Acute myopia and secondary angle closure glaucoma, metabolic acidosis, oligohydrosis and hyperthermia, suicidal behavior and ideation, fetal toxicity, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema, hyperammonemia and encephalopathy, decrease of bone mineral density, kidney stones
Postmarketing Hepatic failure, hepatitis, pancreatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pemphigus, nephrocalcinosis, maculopathy, decreased INR with vitamin K antagonists
Pharmacology
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.
Topiramate is a sulfamate-substituted monosaccharide anticonvulsant whose precise mechanism is unknown but is believed to involve blockade of voltage-dependent sodium channels, augmentation of GABA-A receptor activity, antagonism of AMPA/kainate glutamate receptors, and inhibition of carbonic anhydrase isozymes II and IV.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Treximet
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Trokendi Xr
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Treximet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Treximet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Trokendi Xr
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Treximet.
No savings programs available for Trokendi Xr.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
TreximetView full Treximet profile
Trokendi XrView full Trokendi Xr profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.