Topical cream for migraine

May 5, 2015

A topical cream seems to be effective in treating migraine headaches. Achelios Therapeutics announced results from a Phase IIa placebo-controlled clinical trial in moderate and severe migraine sufferers treated with Topofen, the company’s proprietary topical anti-migraine therapy. This is a well-known non-steroidal anti-inflammatory drug (NSAID) ketoprofen, which is applied to the face and seems to provide relief for patients suffering from acute migraine.

The results of the clinical trial were presented at the American Academy of Neurology annual meeting in Washington, D.C. Surprisingly, this study showed that it may be possible to relieve severe migraine with a topical application to facial nerve endings. Topical application avoids potentially serious side effects of NSAIDs, such as stomach bleeding and ulcers. The randomized, crossover, double-blind, placebo-controlled study involved only 48 adults with a history of episodic migraine with and without aura. Of the severe migraine patients, 77 percent experienced relief of pain and migraine-associated symptoms and 45 percent had sustained pain relief from two to 24 hours compared to 15 percent on placebo. Also, 50 percent of patients who treated their severe pain with Topofen were pain free at 24 hours compared to 25 percent of placebo-treated patients. Some patients experienced application-site irritation, which was mild or moderate in severity. That was the only reported side effect, which resolved quickly.

Such a small study does not prove that this treatment is in fact effective. A typical drug trial required for an FDA approval usually involves hundreds of patients. However, you do not need to wait for this cream to appear on the market because there are creams containing an NSAID already available by prescription (Voltaren Gel) and over-the-counter (Aspercreme). It is possible that the cream tested in the study may be better because it is a different NSAID, but Voltaren Gel is already approved and you can ask your doctor for a prescription. It is possible that insurance companies will not pay for it since it is not approved for migraines. A tube of Voltaren Gel will cost you about $55 (go to GoodRx.com to get the lowest price).

Written by
Alexander Mauskop, MD
Continue reading
November 15, 2025
Cluster headaches
Cluster headaches and solar activity
It was an unusual week at the New York Headache Center. After months of relative calm, my schedule suddenly filled with cluster headache patients—one even consulting me virtually from Saudi Arabia. The influx came right after a G5-level geomagnetic storm, one of the strongest solar events in recent memory.
Read article
November 10, 2025
Alternative Therapies
A Week of Meditation Changes Brains and Bodies
A week-long meditation retreat produces dramatic changes in brain and metabolic functions
Read article
October 21, 2025
Alternative Therapies
Meditation is better than slow breathing exercise in reducing pain
A new study published in the journal PAIN by Dr. A. Amorim and her colleagues at the University of California San Diego examined how mindfulness meditation reduces pain. The findings help clarify whether mindfulness meditation is more effective than simple slow breathing for pain relief.
Read article