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Rofecoxib in the Prevention of
Perimenstrual Migraine: An Open-Label
Pilot Trial
Von Seggern RL, PharmD; Mannix L, MD; Adelman J, MD
Posted: March 2004  
Headache 2004;44:160-165

Objective:   To investigate the effectiveness of rofecoxib in the prevention of perimenstrual migraine.

Background:   Nonsteroidal anti-inflammatory drugs have demonstrated benefit in reducing the frequency and intensity of menstrual migraine when administered perimenstrually. Anti-inflammatory drugs, however, may not be well tolerated and can produce gastrointestinal irritation. Rofecoxib has anti-inflammatory and analgesic properties, and a significantly improved gastrointestinal tolerability profile.

Results:   Fourteen patients completed baseline and rofecoxib dosing for 2 menstrual cycles. Mean migraine frequency decreased from 5.6 to 2.6 migraines per menstrual cycle. Eight (57%) of 14 patients had a reduction in headache frequency. No significant improvement in headache intensity, duration, and functional impairment were observed. Both doses of rofecoxib were well tolerated with no statistical difference in patient response between the doses.

Conclusion:   Rofecoxib at a perimenstrual daily dose of 25 or 50 mg. demonstrated a significant reduction in frequency of perimenstrual migraine. A double-blind, placebo-controlled trial of rofecoxib in the prevention of perimenstrual migraine is warranted.