Zavegepant nasal spray in the acute treatment of migraine: a profile of its use

Zavegepant nasal spray (ZAVZPRET (R)) is the first intranasal calcitonin gene-related peptide (CGRP) receptor antagonist approved in the USA for the acute treatment of migraine with or without aura in adults. It is a valuable option for these patients, particularly for those who prefer nonoral medications, are unable to take oral treatments due to nausea, vomiting or other gastrointestinal comorbidities, or need rapid relief from migraine symptoms. In clinical trials, a single zavegepant nasal spray resulted in significantly more patients achieving freedom from pain and freedom from the most bothersome symptom (light sensitivity, sound sensitivity or nausea) at 2 h postdose compared with placebo. The nasal spray offers pain relief within 15 min of administration, return to normal function in 30 min, and sustained relief for up to 48 h. It is generally well tolerated, with taste disorders being the most common adverse reaction. Zavegepant nasal spray remains well-tolerated in the long term (when used up to eight times per month for 1 year) with no safety signals.