Tolfenamic Acid and Caffeine: A Useful Combination in Migraine

Cephalalgia ◽  
1982 ◽  
Vol 2 (4) ◽  
pp. 173-177 ◽  
Author(s):  
H. Hakkarainen ◽  
J. Parantainen ◽  
G. Gothoni ◽  
H. Vapaatalo

Tolfenamic acid is a potent inhibitor of prostaglandin biosynthesis, which has been proved effective in the treatment of acute migraine attacks. The usefulness of caffeine, metoclopramide and pyridoxine as adjuncts to tolfenamic acid was tested in acute migraine attacks in ten patients. A combination of tolfenamic acid (200 mg) with either caffeine (100 mg), metoclopramide (10 mg) or pyridoxine (300 mg) was given twice to each patient in random order. Thus 60 attacks were treated. The tolfenamic acid-caffeine combination proved the most effective as judged by duration and intensity of attacks, working ability, vigilance, and overall evaluation of the drugs by the patients. Metoclopramide was somewhat better than pyridoxine as an additive.

Cephalalgia ◽  
1984 ◽  
Vol 4 (4) ◽  
pp. 253-263 ◽  
Author(s):  
Riitta A Tokola ◽  
Pentti Kangasniemi ◽  
Pertti J Neuvonen ◽  
Olavi Tokola

Tolfenamic acid is a fenamate which inhibits prostaglandin (PG) biosynthesis and may act as a PG antagonist as well. Caffeine and metoclopramide are used in combination with analgesics and ergotamine in the treatment of migraine attacks, but controlled clinical studies on fixed combinations with analgesics are rare. The effects of orally given tolfenamic acid (200 mg), caffeine (100 mg), metoclopramide (10 mg), tolfenamic acid + caffeine (200 mg + 100 mg), tolfenamic acid + metoclopramide (200 mg + 10 mg) and placebo were studied in 49 migraine patients (3 men, 46 women) in a double-blind randomized cross-over study comprising 482 migraine attacks. The patients were allowed to take either one or two capsules of each preparation for an attack. Additional drugs were allowed after 3 h. Parameters characterizing the effects and side-effects of the drugs were registered. Tolfenamic acid and its combinations were found to be effective in the treatment of acute migraine, but caffeine and metoclopramide alone did not differ from placebo. Combination with metoclopramide was better than tolfenamic acid alone as judged by the smaller dose needed and the intensity of attack. Between tolfenamic acid alone and its caffeine combination there were no statistically significant differences.


Cephalalgia ◽  
1986 ◽  
Vol 6 (4_suppl) ◽  
pp. 85-92 ◽  
Author(s):  
KMA Welch

Naproxen sodium, a potent inhibitor of prostaglandin biosynthesis and platelet aggregation, was studied for efficacy in migraine prophylaxis in a randomized, double-blind, placebo-controlled, cross-over trial. On naproxen treatment, 52% of the patients had no severe headaches whereas 19% had no severe headaches during placebo. Naproxen sodium was much better than placebo when patients' diaries were reviewed for severity of attacks, nausea, vomiting, activity reduction, duration of headache, and decreased use of therapeutic medication. Naproxen sodium can be recommended as a drug of first choice for migraine prevention.


Cephalalgia ◽  
1993 ◽  
Vol 13 (2) ◽  
pp. 117-123 ◽  
Author(s):  
C Dahlöf ◽  
R Björkman

The aim of the present study was to assess the efficacy and tolerability of single oral doses of 50 mg and 100 mg of diclofenac-K compared to placebo in migraine sufferers during three attacks. The study was conducted in a double-blind, randomized, placebo-controlled, three-period, within-patient comparative trial; 72 migraine patients were treated with diclofenac-K (50 mg or 100 mg) or placebo at six centres (1 in Sweden and 5 in Finland). The primary efficacy end-point was the change in pain intensity assessed on a 100 mm Visual Analogue Scale (VAS) at 120 min after taking the study medication. We found that 50 mg and 100 mg of diclofenac-K reduced the pain intensity significantly better than placebo ( p = 0.003 and p = 0.001, respectively), without difference between the doses; 100 mg diclofenac-K was significantly better than placebo in improving phonophobia, photophobia, working ability and need for rescue medication. Diclofenac-K 50 mg or 100 mg is an effective and well-tolerated acute treatment for migraine headache and its associated symptoms. The higher dose of diclofenac-K was only marginally more effective than the lower dose.


1997 ◽  
Vol 84 (3) ◽  
pp. 976-978 ◽  
Author(s):  
Michael P. Toglia ◽  
Philip J. Hinman ◽  
Bradley S. Dayton ◽  
John F. Catalano

Picture and word recall was examined in conjunction with list organization. 60 subjects studied a list of 30 items, either words or their pictorial equivalents. The 30 words/pictures, members of five conceptual categories, each represented by six exemplars, were presented either blocked by category or in a random order. While pictures were recalled better than words and a standard blocked-random effect was observed, the interaction indicated that the recall advantage of a blocked presentation was restricted to the word lists. A similar pattern emerged for clustering. These findings are discussed in terms of limitations upon the pictorial superiority effect.


2005 ◽  
Vol 17 (2) ◽  
pp. 160
Author(s):  
G. Mataveia ◽  
S.J. Terblanche ◽  
J.O. Nöthling ◽  
D. Gerber

Frozen-thawed ram semen crosses the cervix poorly, necessitating laparoscopic insemination. Acceptable fertility can be achieved with frozen-thawed ram semen deposited at the external cervical opening if ram semen plasma (SP) is added (McPhie et al. 2000 14th ICAR 2, 78 abst). Homologous SP improves the fertility of frozen-thawed sperm of boars and dogs. Heterologous SP may have effects as well; the addition of bovine SP increased the ability of buffalo sperm (Syncerus caffer) to fertilize bovine oocytes in vitro (de Haas et al. 2003 Theriogenology 59, 392). The aim of the current study was to compare the effects of SP of rams (SPR), bulls (SPB), and dogs (SPD), protein-free TALP, Triladyl (Minitüb, Tiefenbach, Germany), and skim milk upon longevity and percentage of progressively motile frozen-thawed ram sperm. Three ejaculates from each of six rams (2 Dorpers, 2 Döhne merinos, and 2 merinos), aged 2–4 years, were extended in Triladyl, pooled and frozen as a single batch per ram at 200 × 106/mL in 0.25-mL straws. SPR was obtained from the same rams and SPB from 5 bulls by centrifugation, while the post-sperm fractions were collected from 5 dogs (SPD). Within a species, the SP from different donors was pooled and frozen in aliquots at −18°C. The 108 straws (6 rams, 6 diluents, 3 replicates) were thawed in random order. Once thawed, a straw was emptied into a tube with 0.85 mL of the appropriate fluid at 37°C and kept for 6 h. Percentage of progressively motile sperm was estimated at ×200 magnification immediately and 2, 4 and 6 h after thawing. One person thawed the semen and prepared motility specimens, while another performed all motility evaluations. Data were evaluated by means of repeated-measures ANOVA, with rams as subjects and time and fluid as fixed effects. Non-significant interactions were removed from the model. Means were compared by means of Bonferroni's test (P < 0.05). The model included ram, time, fluid, and ram × fluid, and time × fluid interactions, which were all significant (P < 0.01). Mean motility decreased from each time to the next and were 39.0% (0 h), 26.0% (2 h), 19.6% (4 h) and 12.6% (6 h), SEM 1.38%, n = 108. Mean motility was higher for skim milk (39.9%) than for all other fluids except Triladyl (27.7%), which was better than SPB (13.0%), whereas TALP (20.5%) and SPR (21.9%) were similar to Triladyl and SPB (n = 72, SEM 2.85%). The interactions (ram × fluid or time × fluid) were mainly due to SPD, SPR, Triladyl, and TALP, while milk resulted in the best and SPB in the lowest motility. This study shows that heat-treated skim milk maintains progressive motility of frozen-thawed ram sperm better than the SP of various species and protein-free TALP. In contrast to SPR, skim milk is known to result in poor fertility of frozen-thawed ram semen after cervical insemination. It would thus appear that maintenance of progressive motility in vitro may be a poor indicator of fertility after cervical insemination.


1982 ◽  
Vol 24 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Ushio Sankawa ◽  
Masaaki Shibuya ◽  
Yutaka Ebizuka ◽  
Hiroshi Noguchi ◽  
Yoichi Iitaka ◽  
...  

Cephalalgia ◽  
1983 ◽  
Vol 3 (1) ◽  
pp. 31-36 ◽  
Author(s):  
S. Kaivola ◽  
J. Parantainen ◽  
T. Österman ◽  
H. Timonen

Tolfenamic acid (TA), a potent inhibitor of prostaglandin (PG) biosynthesis and action, was tested prophylactically against hangover symptoms in 30 healthy volunteers in a double–blind cross-over study. One capsule of TA (200 mg) or placebo was taken before starting to drink alcohol and another before going to bed. The hangover symptoms were evaluated in the morning. TA was found significantly better than placebo in the subjective evaluation of drug efficacy ( p<0.001) and in reducing the reported hangover symptoms in general (p < 0.01). In the TA group, significantly lower symptom scores were obtained for headache (p<0.01), and for nausea, vomiting, irritation, tremor, thirst and dryness of mouth (all p < 0.05). In a separate study with eight participants, plasma levels of PGs were followed during ingestion of alcohol with or without TA. The plasma concentrations of PGE2 and TXB2 (a metabolite of thromboxane A2) were lower in the TA group during alcohol ingestion, while PGF2a and 6-keto-PGF1a (a metabolite of prostacyclin) were unaffected. TXB2 correlated with blood alcohol levels in a U-shaped manner.


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