Nasal Spray

Nasal treatments deliver medication into the body by being absorbed into the blood vessels that line the nostrils. The drugs going into the nose are distributed to the rest of the body via the bloodstream. These types of medications send a pre-measured mist of medication into the nostrils when the user presses on a small hand-held pump.

Migraine nasal spray medications

People who suffer from severe migraine want fast-acting relief from the pain and other migraine symptoms. When the medication is delivered intranasally–through the nostrils–relief can come in 15 to 30 minutes, which is much faster than waiting for a pill to be dissolved, digested and distributed throughout the body. This is especially true in the case of migraine, which can often cause digestion to slow.1

Nasal sprays can also help people who experience nausea and vomiting during migraine attacks, since they do not need to take a medication by mouth. Many people who experience frequent migraine have oral medications for mild-to-moderate migraine without nausea and a nasal preparation for more severe attacks or those with nausea and vomiting.

Not all medications can be mixed, so it is important to be sure that oral and nasal medicines can be taken together when used in this fashion.2

How should I use nasal spray medications?

Migraine medications delivered by nasal spray are meant to disrupt a migraine already in progress rather than serving as migraine prevention. As with most migraine medications, nasal spray medications work best when taken soon after onset, although certain medicines, including nasal DHE, can work even after a migraine has progressed.1

Nasal medicines are meant to be sprayed into the nose with the head upright. It is important not to sniff or tip the head backward, which sends the medicine down the throat and into the stomach instead of into the bloodstream.2

What types of migraine medicines come as nasal sprays?

There are three classes of medications that are available as nasal sprays for treating ongoing migraine.

  • Nasal Triptans (cause blood vessel narrowing)
  • Nasal dihydroergotamine or DHE (a formulation of ergotamine, which also constricts blood vessels)
  • Nasal ketorolac (a non-steroidal anti-inflammatory to prevent pain)2

Nasal triptans and ergotamines are specifically approved to treat migraine. The ketorolac is U.S. Food and Drug Administration approved to fight pain, but not specifically for migraine.

What are some common nasal sprays for migraine?

The following is a partial list of medications that are available as nasal sprays:

  • Onzetra®
  • Zomig Nasal Spray®
  • Migranal®
  • Imitrex®
  • Stadol® N.S., a narcotic migraine medicine

What are some side effects of nasal sprays?

Some people who use migraine nasal spray medications experienced the following side effects:

  • Unusual taste
  • Dry mouth
  • Tingling sensation, numbness, skin sensitivity, especially around the nose
  • Pain, pressure, and tightness sensations (such as in the nose, throat, or chest)
  • Drowsiness, fatigue, or weakness
  • Nausea and/or vomiting
  • Stuffy or runny nose
  • Dizziness

These are not all the possible side effects of nasal sprays. Patients should check the specific class of nasal spray for an exhaustive list of side effects and talk to their doctor about what to expect with treatment with nasal sprays.

What else should I know about nasal spray migraine medications?

Most of these medications should not be taken if you are pregnant, may become pregnant or if you are nursing. They are also not safe to take if you have heart problems, high blood pressure, circulatory problems, or kidney problems.

Some of these medicines have been linked to life-threatening conditions when taken in combination with certain protease inhibitors, anti-fungal medications, and certain antibiotics.3

It’s always important to read the warnings on the drug label, to learn if you should avoid taking the drug as well as what you should discuss with your doctor.

Written by: Sara Finkelstein | Last reviewed: June 2018.
View References
  1. Zahid H Bajwa, Jonathan H Smith. Acute Treatment of Migraine in Adults. Up to Date. Published January 15, 2018. https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults?topicRef=720&source=see_link#H3489319 Accessed April 28, 2018.
  2. Deborah E. Tepper. Nasal Sprays for the Treatment of Migraine. American Migraine Foundation. March 5, 2013. https://americanmigrainefoundation.org/understanding-migraine/nasal-sprays-treatment-migraine/ Accessed April 28, 2018.
  3. Product Monograph MIGRANAL. May 27, 2010. Novartis Pharmaceuticals. http://sterimaxinc.com/wp-content/uploads/2014/12/migranal.pdf Accessed April 28, 2018.