Onzetra Xsail (sumatriptan nasal powder)

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Onzetra® Xsail® (sumatriptan nasal powder) is a prescription medicine used to treat acute migraine with or without aura in adults with a clear migraine diagnosis. Onzetra Xsail comes in capsules for use in a disposable nosepiece.1

Onzetra Xsail is designed to only treat a migraine that has already begun. It should also not be used to treat other types of headaches, including hemiplegic migraine or basilar migraine.

Overuse of acute migraine drugs like Onzetra Xsail can cause medication overuse headaches. If your migraine attacks worsen, your doctor may decide to stop your treatment with Onzetra Xsail.1

What are the ingredients in Onzetra Xsail?

The active ingredient in Onzetra is sumatriptan.1

How does Onzetra Xsail work?

Onzetra Xsail is a type of drug known as a serotonin 5-HT1B/1D receptor agonist (triptan). It works by binding to 5-HT1B/1D receptors on blood vessels in the brain. This process helps narrow the blood vessels around the brain. In turn, this reduces inflammation in the body that can trigger head pain, nausea, sensitivity to light and sound, and other migraine symptoms.1

What are the possible side effects?

The most common side effects of Onzetra Xsail include:1

  • Unusual or bad taste in your mouth
  • Discomfort, burning, or irritation of the throat or nose
  • Runny nose, stuffy nose, and/or post-nasal drip

These are not all the possible side effects of Onzetra Xsail. Talk to your doctor about what to expect when taking Onzetra Xsail. You also should call your doctor if you have any changes that concern you when taking Onzetra Xsail.

Other things to know

Onzetra Xsail comes in capsules for use in a disposable nosepiece. The medicine should only be used with the Xsail breath-powered delivery device. Your doctor will show you how to use Onzetra Xsail.1

You should not use Onzetra Xsail if you have:1

  • An allergy to sumatriptan
  • Heart problems or a history of heart problems
  • Narrowing of blood vessels to your legs, arms, stomach, or kidney
  • Uncontrolled high blood pressure
  • Severe liver problems
  • Hemiplegic migraines or basilar migraines
  • Had a stroke, transient ischemic attacks (TIAs), or problems with your blood circulation
  • Have taken other migraine medicine within the last 24 hours

Before starting treatment with Onzetra Xsail, tell your doctor if you:1

  • Have high blood pressure
  • Have high cholesterol
  • Have diabetes
  • Smoke
  • Are overweight
  • Have heart problems or a family history of heart problems or stroke
  • Have kidney problems
  • Have liver problems
  • Have epilepsy or seizures

There is not enough data to know if Onzetra Xsail is safe to take while pregnant or breastfeeding. Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding before taking Onzetra Xsail. They can help you decide if Onzetra Xsail is right for you.1

Onzetra Xsail can interact with other medicines and cause serious side effects. Before starting treatment with Onzetra Xsail, tell your doctor if you take antidepressant drugs called:1

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)

Before beginning treatment for migraine tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

For more information, read the full prescribing information of Onzetra Xsail.

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