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Published online: 18 July 2014
^ Springer International Publishing Switzerland 2014
Abstract Diclofenac potassium powder for oral solution (Voltfast®, Catafast®, Cambia®; hereafter referred to as diclofenac potassium powder) is a non-steroidal anti-inflammatory drug (NSAID), and is indicated for the acute treatment of migraine. This article reviews the pharmacological properties of diclofenac potassium powder and its efficacy and tolerability in patients with acute migraine. Diclofenac potassium powder was clinically efficacious and generally well tolerated in placebo-controlled trials in patients with this indication; it was more effective than diclofenac potassium tablets with regard to the primary endpoint of 2-h pain relief as well as in several important secondary endpoints, such as time to onset of analgesic action. The oral powder-for-solution formulation of diclofenac potassium is a useful option in the acute treatment of migraine with or without aura.
1 Introduction
Migraine, one of the top 10 causes of disability worldwide [1], is a disorder which can persist for 40-50 years, and consists of attacks of moderate to severe throbbing, uni- lateral headache, often associated with accompanying symptoms such as nausea, vomiting, photophobia and phonophobia, and occasionally auras [2]. It affects 15 % of the global population [1], and is regularly associated with an inability to function normally in routine daily activities; more than half of patients with migraine report impairment or the need for bed rest [3]. This often has a negative effect on both work/school and social/family activities [3]. The global number of years lived with disability caused by migraine was 325 per 100,000 population in 2010, up 8 % from 1990 [1]. Almost twice as many women as men experience migraine (19 vs. 11 % globally) [1].
First-line treatment for acute migraine generally includes oral triptans, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin or paracetamol, either as mono- therapy or combination therapy [4-6]. Ideally, treatment for acute migraine should be able to treat attacks rapidly and consistently without recurrence of headache, restore functioning ability, minimize rescue medication use, opti- mize self-care, be cost effective, and have few or no adverse events [6].
Novel formulations or delivery methods of migraine drugs have been developed to try to improve onset of relief and other treatment factors. These include, for example, sumatriptan iontophoretic patch, dihydroergotamine mes- ylate by oral...