The Medical Letter on Drugs and Therapeutics
Onzetra Xsail - Sumatriptan Nasal Powder
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The FDA has approved Onzetra Xsail (Avanir), a nasal powder formulation of sumatriptan, for acute treatment of migraine in adults. Nasal spray formulations of sumatriptan (Imitrex) and zolmitriptan (Zomig) have been available for many years.

SUMATRIPTAN FORMULATIONS — Subcutaneously administered sumatriptan relieves pain faster (in about 10 minutes) and more effectively than other triptan formulations, but it causes more adverse effects.1,2 With oral sumatriptan, onset of pain relief generally occurs 45-60 minutes after administration, but patients with migraine who have nausea, vomiting, or gastroparesis may not be able to take or absorb an oral triptan.3 Sumatriptan nasal spray formulations have a more rapid onset of action than oral tablets, but their efficacy also depends on GI absorption (of the significant ... more      

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Title: Onzetra Xsail - Sumatriptan Nasal Powder
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