Dr. Richard Hoffmann, Ask the Pharmacist, 02/12/13

Q: I heard about a skin patch for treating migraine headaches. What can you tell me about it?

A: The FDA recently (2013) approved Zecuity (sumatriptan iontophoretic transdermal system (TDS)) for the acute treatment of migraine with or without aura in adults. It is the first “migraine patch” approved for the acute treatment of migraine headache pain.

The active ingredient in Zecuity is sumatriptan, which has been available for many years in oral tablets, injection, and as a nasal spray.

Sumatriptan works by constricting (narrowing) specific arteries in the brain, which leads to relief of migraine headache. Zecuity is a single-use, battery-powered skin patch applied to the upper arm or thigh that delivers sumatriptan through the skin and provides relief of both migraine headache pain and migraine-related nausea.

The most common side effects of Zecuity are application site pain, tingling, itching, warmth, and discomfort. However, it also comes with several contraindications, warnings and precautions, which are outlined in its Patient Labeling Information.

Approximately 31 million Americans have migraine headaches that can be debilitating or disabling. These headaches occur more frequently on one side of the head, are pulsating or throbbing and are accompanied by nausea or vomiting in most people.

Migraines may also be associated with sensitivity to light or sound and can be aggravated by routine physical activity, such as climbing stairs. Certain foods and beverages may also bring on or “trigger” a migraine attack in certain people. Some of these dietary triggers are:

+ Alcoholic drinks.

+ Coffee, tea, cola.

+ Aged cheese.

+ Chocolate.

+ Monosodium glutamate (MSG).

+ Smoked fish.

+ Nuts.

+ Pickled foods.

The exact cause of migraine headaches is not known, but research shows that a chemical known as serotonin is the main culprit.

This chemical, which is found in the brain, can cause blood vessels to narrow or constrict and stimulate pain receptors.

Levels of serotonin are unusually high just before a migraine and unusually low during the migraine attack. Many people who suffer from migraine have a family history of this problem and it is three times more common in women than in men.

Migraine usually begins when a person is in their late teens or early adulthood and attacks can increase or decrease during menstruation, pregnancy and menopause. Some people can even feel when a migraine is coming (aura).

If untreated, most migraine headaches can last at least four hours and up to 72 hours.

Richard P. Hoffmann, Pharm.D., has been a pharmacist for more than 40 years. Send questions to him at 2960 E. Coventry Court, Hernando, FL 34442.