Zaveg

Indications

Zavegepant nasal spray is used in adults for the acute treatment of migraine attacks, with or without aura (warning signs such as flashing lights before the headache). It is taken when a migraine starts to relieve the headache and related symptoms such as nausea and sensitivity to light and sound. It is not used to prevent migraines.

How It Works

During a migraine, a protein called calcitonin gene-related peptide (CGRP) is released around nerves and blood vessels in the head, causing pain and inflammation. Zavegepant is a CGRP receptor antagonist (a gepant): it blocks the receptor that CGRP acts on, which helps stop the migraine process. Given as a nasal spray, it is absorbed quickly, so relief can start within about 15 minutes in some people.

Dosage and Administration

Adults: one spray (10 mg) into one nostril as a single dose when the migraine starts. Do not take more than 1 spray (10 mg) in 24 hours. The safety of treating more than 8 migraines in 30 days is not well known; talk to your doctor if you need it often. Follow the instructions on the label: blow your nose first, keep your head upright, close the other nostril, spray while breathing in gently, and do not sniff hard afterwards. Each device contains one dose only; do not prime or test it.

Interactions

• Rifampicin and other medicines that strongly affect liver transporters (OATP1B3 or NTCP): avoid using together.
• Nasal decongestant sprays: if needed, use them at least 1 hour after Zavegepant.

Tell your doctor or pharmacist about all medicines you take, including other migraine medicines.

Contraindications

Do not use Zavegepant if you have had a serious allergic reaction to it or any ingredient in the spray.

Side Effects

Common side effects include a changed or bad taste in the mouth, nasal discomfort or irritation, nausea and vomiting. Allergic reactions, including swelling of the face and hives, have been reported.

Get urgent medical help if you develop swelling of the face, lips, tongue or throat, difficulty breathing, a widespread itchy rash, or if your headache is sudden and severe, different from your usual migraines, or comes with weakness, confusion, trouble speaking or loss of vision.

Pregnancy and Lactation

There is limited information on use in pregnancy, so it should be used only if your doctor feels the benefit outweighs any risk. It is not known whether it passes into breast milk; ask your doctor before using it while breastfeeding.

Precautions and Warnings

It is not recommended for people with severe liver impairment or end-stage kidney disease. Using any acute migraine medicine on many days each month can lead to medication-overuse headache; keep a headache diary and see your doctor if migraines are frequent. Make sure your headaches have been diagnosed as migraine by a doctor.

Overdose

There is limited experience of overdose. If more than the recommended dose is used, contact a doctor or pharmacist for advice and watch for side effects.

Therapeutic Class

Antimigraine agent, CGRP receptor antagonist (gepant).

Storage

Store below 30°C, away from light and out of the reach of children. Keep the device in its blister until use and do not freeze.