Migraine Therapy


Well Care Compounding Pharmacy is the only compounding pharmacy in the state of Nevada to offer a patented Topical Regional Neuro-Affective (TRNA) therapy for the treatment of migraine headaches.  Migraderm is covered by many insurance companies, including some of the Medicare Part D.

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What is Migraderm or TRNA Therapy?

Migraderm is a patented topical formulation that was developed and studied by Dr. Ronald Aung-Din MD, a neurologist in Florida. Migraderm is a topical transdermal cream that is applied to the back of the neck at the hairline allowing rapid absorption for quicker relief time in treating the painful effects of migraines.

The custom formulation can provide a therapeutic dose of Sumatriptan directly to the trigeminal nerve. The therapy is unique in providing a therapeutic benefit while avoiding both systemic and cerebral blood (1). Migraderm is a revolutionary leap forward in the treatment of migraine therapy and relief.

Topical Regional Neuro-Affective (TRNA) Therapy is (1):

  • A non-systemic drug
  • Formulated as a topical cream
  • Compounded in a dermal penetration enhancing medium
  • Applied to the BONATH (Back of the Neck at the Hairline)

How does Migraderm work?

Sumatriptan essentially stops the migraine process in midstride, reversing the neurological process that triggers your symptoms. However, with commercial medications, the delivery system is systemic and can cause other issues (stomach upset, drowsiness, etc.).  Migraderm goes directly to the cause of the issue, the central nervous system (primarily the trigeminal nerve), while not affecting your systemic system.  In studies performed, a majority of patients felt relief of migraine symptoms within 10 minutes of application and headache relief within 30 minutes.  Approximately 99% of individuals reported total relief 60 minutes after applying the cream.

What is the difference between TRNA Therapy and Other Therapies?

TRNA Therapy

  • Goes directly to the central nervous system through free nerve-endings and peripheral nerve connections.
  • Does not rely on dermal, systemic, or cerebral blood flow for effect.
  • Rapid and prolonged drug effect as regional administration allows high tissue saturation of drug.
  • Side-effects minimized
  • Drug – drug interactions and metabolism/excretion negligible: may be considered green.

Systemic Therapy (oral, transdermal patch, injection)

  • Relies on therapeutic drug blood levels at the central nervous system target sites.
  • Drug enters systemic blood for effect after delivery by injection, patch, or pill.
  • Therapeutic effect dependent on GI absorption, hepatic first pass, cardiac output, and cerebral blood flow.
  • Prone to systemic and CNS side effects
  • Interactions with concomitant drugs and issues of metabolism and excretion.

How can I learn more?

Pharmacists at Well Care Compounding Pharmacy are always available to assist with any questions you may have regarding Migraderm therapy.

Dr. Aung-Din’s youtube research video can be viewed at http://youtu.be/urg7CoN0rKk

Reference: 1. Aung-Din R. Topical Regional Neuro-Affective (TRNA) Therapy: Novel Ground-Breaking Triptan Drug Delivery for Treating Migraines. Drug Delivery Technology. 2009; 9(9): 44-51.