Migraine represents an area of significant unmet medical need. According to the Centers for Disease Control and Prevention, over 37 million Americans suffer from migraine headaches. The triptan class of medications is generally considered a standard of care with over 14 million prescriptions written annually. Sumatriptan has a market share of over 50 percent, making it the most commonly prescribed migraine drug in the United States. 100 mg tablets are the most commonly prescribed form and strength of sumatriptan.
ONZETRA® Xsail® is the first intranasal medication delivery system consisting of 22mg sumatriptan powder. It is indicated for the acute treatment of migraine in adults with or without aura. The fast-acting dry-powder sumatriptan is delivered intranasally utilizing the novel Xsail Breath Powered® Delivery Device. All formulations of sumatriptan, including ONZETRA Xsail, are contraindicated for certain patients, including those with a history of coronary artery disease (CAD) or coronary vasospasm.
The Breath Powered delivery technology relies on the user's breath to propel medication into the nasal cavity where absorption is efficient and consistent. The user exhales into the device, automatically closing the soft palate and sealing off the nasal cavity. Through a sealing nosepiece placed into the nostril, the exhaled breath carries medication from the device directly into one side of the nose. Narrow nasal passages are gently expanded and medication is dispersed into the nasal cavity reaching areas where it can be rapidly absorbed. As the medication is delivered, the air flows around to the opposite side of the nasal cavity and exits through the other nostril. Closure of the soft palate helps reduce swallowing and GI absorption.
Important Safety Information for Patients and Doctors
What is ONZETRA® Xsail® (sumatriptan nasal powder) used for?
ONZETRA Xsail is a prescription medication approved for the acute treatment of migraine, with or without aura in adults. ONZETRA Xsail is used for people who have been told by a healthcare provider that they have migraine headaches. ONZETRA Xsail is not for the prevention of migraines or for other types of headaches, including cluster headache.
What important information should I know about ONZETRA Xsail?
ONZETRA Xsail may cause serious side effects, including:
- Heart attack and other heart problems, which may lead to death. Stop using ONZETRA Xsail and get emergency medical help right away if you have any symptoms of a heart attack like shortness of breath or tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw that is severe or does not go away
- Changes in color or sensation in your fingers and toes (Raynaud’s syndrome)
- Stomach and intestinal problems (gastrointestinal and colonic ischemic events)
- Problems with blood circulation to your legs and feet (peripheral vascular ischemia)
- Serious allergic reactions (symptoms include hives; tongue, mouth, lip, or throat swelling; problems breathing)
- Medication overuse headaches. Some people who use ONZETRA Xsail too many times may have worse headaches. If your headaches get worse your doctor may decide to stop your treatment with ONZETRA Xsail
- Serotonin syndrome, a rare but serious problem that can happen in people using ONZETRA Xsail, especially if ONZETRA Xsail is used with antidepressant medicines called SSRIs, SNRIs, or TCAs. Call your doctor right away if you have any of the following symptoms of serotonin syndrome: mental changes such as seeing things that are not there (hallucinations), agitation, or coma; fast heartbeat; changes in blood pressure; high body temperature; tight muscles; trouble walking; or nausea, vomiting, or diarrhea
- Seizures. Seizures have happened in people taking sumatriptan who have never had seizures before
The most common side effects of ONZETRA Xsail are abnormal taste, discomfort of your nose or throat, runny nose, and stuffy nose. This is not a complete list of side effects. Tell your doctor about any side effect that bothers you or does not go away.
Who should not take ONZETRA Xsail?
Do not take ONZETRA Xsail or stop using ONZETRA Xsail if you:
- Have heart problems or a history of heart problems
- Have had a stroke, transient ischemic attacks (TIAs), or problems with your blood circulation
- Have uncontrolled high blood pressure
- Have hemiplegic migraines or basilar migraines. If you are not sure if you have these, ask your doctor
- Have peripheral vascular disease (narrowing of blood vessels to the legs, arms, stomach, intestines, or kidneys)
- Have taken other migraine medications in the last 24 hours, including other triptans, ergots, or ergot-type medications. Ask your doctor for a list of these medicines if you are not sure
- Are taking a medicine called a monoamine oxidase inhibitor (MAOI). MAOIs cannot be taken within 14 days before or after taking ONZETRA Xsail
- Have severe liver problems
- Have an allergy to sumatriptan, the medicine in ONZETRA Xsail, or any of the components in ONZETRA Xsail
What should I tell my healthcare provider before taking ONZETRA Xsail?
Before you take ONZETRA Xsail, tell your doctor about all your medical conditions and all the medicines you take, including prescription medicines, especially antidepressants, and all over-the-counter medicines, vitamins, and herbal supplements.
What should I avoid while taking ONZETRA Xsail?
ONZETRA Xsail can cause dizziness, weakness, or drowsiness. If you have these symptoms, do not drive a car, use machinery, or do anything where you need to be alert.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 800-FDA-1088.
For more information please visit the ONZETRA Xsail website.