Onzetra Xsail (Sumatriptan)

What Members SayTop TipsSide EffectsCopay HelpFAQs

Onzetra Xsail (sumatriptan) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat acute migraine headaches with or without aura in adults.

What Members Say

MHT logo These insights are based on 333 comments about Onzetra Xsail from MyMigraineTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Onzetra Xsail can bring meaningful headache relief during a migraine attack.
Nasal delivery can feel useful when quick relief is needed.
Onzetra Xsail can help with breakthrough migraine despite preventive treatment.
Having a rescue option on hand can feel reassuring.

Considerations:

Abnormal taste, nasal discomfort, and a runny nose are common with Onzetra Xsail.
Relief can be incomplete or inconsistent from one attack to another.
Timing matters, and waiting too long can make treatment less helpful.
Using sumatriptan too often can worsen headaches over time.

How Onzetra Xsail Works and How It’s Taken

Onzetra Xsail is a type of migraine medicine called a triptan. It works by acting on serotonin receptors found on blood vessels and pain nerves in the head. This can help narrow blood vessels and reduce the release of chemicals that cause migraine pain.

Doctors prescribe Onzetra Xsail when an adult needs treatment for a migraine attack, with or without aura, after migraine has been clearly diagnosed.

Onzetra Xsail is given as a dry nasal powder with a breath-powered device, typically taken at the start of a migraine attack. A second dose may be taken at least two hours later if needed.

Typical Dosing for Migraine

The recommended dose of Onzetra Xsail for migraine is 22 milligrams of sumatriptan nasal powder, given using two nosepieces with the breath-powered delivery device.

If the migraine has not gone away two hours after the first dose, or comes back after getting better for a short time, a second 22-milligram dose may be taken at least two hours after the first dose. Do not take more than 44 milligrams in 24 hours.

Your doctor may advise not treating more than an average of four headaches in a 30-day period, because safety beyond that has not been established.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Onzetra Xsail

These insights are based on 333 comments about Onzetra Xsail from MyMigraineTeam members.

Members who use Onzetra Xsail often talk about keeping it available for sudden migraine attacks, paying close attention to when they take it, and noticing common nose-related side effects. Some members also emphasize tracking what works over time and speaking up when a treatment plan is not helping enough.

1

Keep Onzetra Xsail handy for breakthrough migraine.
“I always have sumatriptan spray with me. I get Botox injections, but for breakthrough migraines the spray usually will take care of them.”
2

Use it early and talk to your doctor about timing.
“I have sumatriptan to take at the onset, but I find I only have a small window to take them, and if I miss taking them at the right time they are useless.”
3

Be aware of taste and nose-related side effects.
“The medication tasted terrible and made my nose run.”
4

Keep a record of what works and what does not.
“I have literally tried EVERYTHING. It is the first thing I have used that my body does not get ‘used to.’”

Connect with others who understand life with migraine. Join MyMigraineTeam for free.

Onzetra Xsail Side Effects

In clinical trials of Onzetra Xsail for the acute treatment of migraine with or without aura in adults, the most common side effects occurred in about 2 percent to 20 percent of people. They include:

Unusual or bad taste in your mouth
Discomfort of your nose or throat
Runny nose
Stuffy nose
Postnasal drip

Serious Side Effects and Warnings

Onzetra Xsail can cause serious side effects that may require immediate medical attention. These include:

Heart problems — Heart attack and reduced blood flow to the heart, including myocardial ischemia or myocardial infarction, can occur.
Dangerous heart rhythm problems — Arrhythmias, such as ventricular tachycardia or ventricular fibrillation, can occur.
Chest, throat, neck, or jaw tightness, pain, pressure, or heaviness — These symptoms can be noncardiac, but they may be a sign of a heart problem in some people.
Raynaud’s syndrome — Changes in color or sensation in your fingers and toes can occur.
Gastrointestinal and colonic ischemic events — Stomach and intestinal problems can occur.
Peripheral vascular ischemia — Problems with blood circulation to your legs and feet can occur.
Cerebrovascular events — Stroke or other blood flow problems in the brain can occur.
Severe allergic reactions — Hypersensitivity, including angioedema and anaphylaxis, can cause swelling, trouble breathing, or a severe whole-body allergic reaction.
Medication overuse headache — Worsening headaches can occur from using acute migraine medicines too often.
Serotonin syndrome — This serious reaction can cause agitation, hallucinations, fever, tachycardia (fast heartbeat), blood pressure changes, muscle twitching, poor coordination, nausea, vomiting, or diarrhea.
Seizures — Seizures can occur.
Increased blood pressure — This can include rare hypertensive crisis, which is a dangerous spike in blood pressure.

Get medical help right away if you think you are having a serious reaction.

How To Save on Onzetra Xsail

Currax Pharmaceuticals, the manufacturer of Onzetra Xsail, offers the CurAccess Program. Eligible people with commercial insurance may pay as little as $0 per month.

To learn more, visit the Onzetra Xsail savings page, or call 888-412-9325.

What To Know Before Taking Onzetra Xsail

Before starting Onzetra Xsail, your doctor may do a heart and blood vessel check (a cardiovascular evaluation), especially if you are new to triptan medicines and have multiple risk factors for heart disease.

Tell your doctor if you have any allergies to sumatriptan or any ingredients in Onzetra Xsail.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.

Do not use Onzetra Xsail if you have:

Heart problems or a history of heart problems
A history of stroke, transient ischemic attacks (TIAs), or problems with your blood circulation
Uncontrolled high blood pressure
Hemiplegic migraine or basilar migraine, or uncertainty about whether you have these types of migraine
Peripheral vascular disease (narrowing of blood vessels to the legs, arms, stomach, intestines, or kidneys)
Use of other migraine medications in the last 24 hours, including other triptans, ergots, or ergot-type medications
Use of a medicine called a monoamine oxidase inhibitor (MAOI), which cannot be taken within 14 days before or after taking Onzetra Xsail
Severe liver problems
An allergy to sumatriptan, the medicine in Onzetra Xsail, or any of the components in Onzetra Xsail

Onzetra Xsail can cause dizziness, weakness, or drowsiness. If you have these symptoms, do not drive a car, use machinery, or do anything where you need to be alert.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Onzetra Xsail, talk with your doctor about the risks and benefits. Onzetra Xsail passes into your breast milk. It is not known if this can harm your baby. If you are breastfeeding, you can lower the amount of medicine your baby is exposed to by avoiding breastfeeding for 12 hours after using Onzetra Xsail.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Onzetra Xsail?

In a clinical study, 68 percent of people who used Onzetra Xsail had relief from their headache two hours after treatment. This was compared to 45 percent of people who took a placebo (an inactive treatment).

At two hours, 34 percent of people had no headache at all, compared to 17 percent with placebo. After the same amount of time, 82 percent had no nausea, 52 percent had no sensitivity to light, and 68 percent had no sensitivity to sound. The results were similar whether or not people had aura at the start of the migraine attack.

How long does Onzetra Xsail take to work for migraine?

In a clinical study, headache relief was measured as early as 15 minutes after using the medicine and was followed for up to 48 hours. After a 22-milligram dose, the average time to reach peak levels in the blood is about 45 minutes. This can range from about 10 minutes to two hours.

Can Onzetra Xsail cause a bad taste or nose symptoms when used for migraine?

Yes. In clinical studies, 20 percent of people reported a bad or unusual taste. About 11 percent had nose discomfort, 5 percent had a runny nose, and 2 percent had a stuffy nose.

Nose and throat irritation can happen and usually goes away in less than two hours. Nosebleeds have also been reported after the medicine was approved.

Can Onzetra Xsail be used with other medicines for migraine?

Some medicines should not be used with Onzetra Xsail. Do not use it within 24 hours of another triptan or an ergot medicine. Do not use it if you are taking an MAO-A inhibitor or if you stopped one within the past two weeks.

Serotonin syndrome is a rare but serious condition that can happen if Onzetra Xsail is used with certain antidepressants, such as SSRIs, SNRIs, TCAs, or MAO inhibitors. Talk to your doctor before taking other medicines for migraine.