This New FDA-Approved Nasal Spray Could Help With Migraine

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Photo Illustration by Lara Antal for Verywell Health

Key Takeaways

  • A new FDA-approved migraine nasal spray might be available as early as July.
  • Pfizer's nasal spray Zavzpret offers an alternative for people who can't take oral medications due to nausea, or those who are at risk of heart disease.

A new FDA-approved nasal spray for migraines could offer relief to people who can’t tolerate other migraine medications because they’re prone to nausea or at risk for heart disease.

Pfizer’s Zavzpret (zavegepant) is the first nasal spray that targets the calcitonin gene-related peptide (CGRP), a protein that’s released during migraines. A phase 3 trial shows that one 10mg dose of Zavzpret could reduce migraine pain in as little as 15 minutes and last for up to 48 hours.

“A lot of other medications run out pretty quickly and the pain rebounds or returns. We’re not seeing that after using zavegepant,” said Kathleen Mullin, MD, a lead investigator of the phase 3 trial and associate medical director at New England Institute for Neurology & Headache.

CGRP-blocking medications are a relatively new type of migraine treatment and offer an alternative to triptans, another class of migraine medications that cause blood vessels to narrow and may not be safe for people with heart disease.

“The CGRPs have been huge because they’re effective, they’re very well tolerated and safe for all of those patients with cardiovascular risk factors,” Mullin said.

Before Zavzpret, the only migraine-specific nasal sprays available on the market were triptan nasal sprays, Mullin said. Oral CGRP-blocking migraine medications are also available, but this new nasal spray provides an alternative for people who can’t take pills due to migraine-induced nausea.

“Even for patients that don’t vomit, most headache patients have something called gastroparesis where their gut really slows down and doesn’t absorb medications well,” she said, adding that the nasal spray allows for the medication to be absorbed more effectively since it bypasses the stomach.

How Effective Is Zavzpret?

The new nasal spray provided pain relief two hours after dosage for 24% of the trial participants, compared to 15% of those who took placebos.

This means one in four patients will respond well, according to Robert P. Cowan, MD, a neurology professor and director of headache research at Stanford University School of Medicine. If it’s a group of 1,000 patients, he explained, 250 people will have found a new, effective treatment.

Although this medication might not work for everyone, it adds another treatment option for the millions of people who suffer from migraines.

What Are the Side Effects of Zavzpret?

One of the most common side effects from the trial was altered taste, but Mullin said this typically only lasts for 10–15 minutes and can be resolved by sucking a mint after using the nasal spray. Other limited side effects were nausea and nasal discomfort.

“Between the pain of their headache and the next fastest way to relieve their pain would be an injection, having a funny taste in a headache patient’s mouth is usually not as bad as the alternative,” she said.

When Will Zavzpret Be Available?

Patients can expect Zavzpret to be available as soon as July and a Pfizer spokesperson told Verywell that pricing “is expected to be comparable in price to other FDA-approved CGRP migraine medicines.”

Patients may be able to take Zavzpret with other migraine medications like an anti-inflammatory drug or triptan if these are safe for them, Mullin said.

“Giving patients the power to have multiple options is always going to help empower them to overcome their headache,” Mullin said.

What This Means For You

If you experience migraines, consider talking to a healthcare provider about your treatment options. The new nasal spray might not be right for everyone, but it may be a helpful management tool for people who can’t take other migraine medications.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Lipton RB, Croop R, Stock DA, et al. Safety, tolerability, and efficacy of zavegepant 10 mg nasal spray for the acute treatment of migraine in the USA: a phase 3, double-blind, randomised, placebo-controlled multicentre trialLancet Neurol. 2023;22(3):209-217. doi:10.1016/S1474-4422(22)00517-8

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