The World Health Organization (WHO) ranks migraines as the 19th disability-causing disease worldwide. It is reported that 12% of the population suffers from migraines; however, many people self-medicate instead of seeing a healthcare professional. In a U.S. based study, 52% of respondents who met the criteria for migraines had not had their condition diagnosed by a doctor or healthcare professional.
Without a diagnosis and proper management, it is possible that you could get secondary headache syndrome and/or medication-overuse headaches, further exacerbating the problem. It is important to tell your doctor if you have migraines.
Migraines are characterized by unilateral pain (pain on one side of the head) that pulsates. The following symptoms are often experienced during a migraine:
Sensitivity to light, smells, sound, and touch
Stomach upset and vomiting
Stiffness in the neck and shoulders
Migraines with aura (focal neurological symptoms) account for about a quarter of all migraines. When aura occurs, it typically sets in slowly and acts as a warning before the pain starts. Aura can occur during a migraine as well. Aura most often causes you to see strange things like colored spots but can also include blind spots, flashes of light, sparkles and stars, tunnel vision, and zig zags.
Treatment differs for migraines with aura versus migraines without. Again, it is important to speak with your physician or healthcare professional to seek guidance in dealing with migraines.
During a migraine attack the pylorus (a section of your stomach) closes, limiting the absorption of oral medication. A study was done in 2011 to test the benefit of using sublingual piroxicam during acute migraine attacks without aura.
Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing substances in the body that cause pain and inflammation. Sublingual troches are small gelatin lozenges that dissolve under the tongue or between the cheek and gums. They have regained tremendous popularity for the absorption of medications because the lining of the mouth is thin and rich in blood supply.
In the study, 60 patients were given either the sublingual piroxicam or a placebo during a migraine attack. Patients treated with the piroxicam showed a significant decrease in pain intensity 15 minutes after ingestion and went to show a further reduction in the 24 hours after administration. Of those patients given the placebo only 10% reported an excellent to good response as compared to 83.3% of patients given the piroxicam troches.
As the area’s only PCAB Accredited compounding pharmacy, we can compound piroxicam troches in our lab with a prescription. If you would like information about this compounded solution to take with you to your physician, please stop by the pharmacy and ask.
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