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sumatriptan succinate

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Overview

What is ONZETRA?

ONZETRA Xsail (sumatriptan nasal powder) uses a disposable, single use nosepiece which is attached by the patient to a delivery device body which has a mouthpiece and a piercing mechanism.  The nosepiece contains a hypromellose capsule filled with 11 mg sumatriptan base (as 15.4 mg of sumatriptan succinate) in a dry powder form.  Two nosepieces comprise a single 22 mg dose.  ONZETRA is for nasal administration with the Xsail device only. 

The active component of ONZETRA Xsail is sumatriptan, a selective 5-hydroxy-tryptamine receptor subtype 1 (5-HT) agonist (triptan), as the succinate salt. Sumatriptan succinate is chemically designated as 3-[2-(dimethylamino)ethyl]-N-methyl-indole-5-methanesulfonamide succinate (1:1), and it has the following structure:

The empirical formula is CHNOS • CHO, representing a molecular weight of 413.5.

Sumatriptan succinate is a white to off-white powder that is readily soluble in water and in saline.

The ONZETRA Xsail breath-powered delivery device is used to deliver the dry powder contained in the disposable nosepiece (in a capsule) into the nostril using breath exhaled into the device. The Xsail delivery device has a flexible mouthpiece to adjust to individual anatomic variations.  Under standardized testing, the Xsail device delivers a mean of 10 mg sumatriptan per nosepiece when tested at a flow rate of 30 L/min for 4 seconds (2 L total).  The amount of sumatriptan delivered to the nasal cavity will depend on patient factors such as expiratory flow.  Delivered dose was measured in patients with migraine headache treated in clinical trials to evaluate the efficacy of the product.  In these trials, each nosepiece delivered an average dose of 7.5-8.1 mg, providing a total dose of 15-16.2 mg per treatment episode from two nosepieces.



What does ONZETRA look like?



What are the available doses of ONZETRA?

ONZETRA Xsail is supplied as a disposable nosepiece containing a capsule and a reusable delivery device body. Each capsule contains 11 mg sumatriptan base (equivalent to 15.4 mg of sumatriptan succinate nasal powder) in a clear, hypromellose capsule with 825 printed on one side.

What should I talk to my health care provider before I take ONZETRA?

Pregnancy: Based on animal data, may cause fetal harm. ()

    

How should I use ONZETRA?

ONZETRA Xsail is indicated for the acute treatment of migraine with or without aura in adults.

Limitations

of Use

The recommended dosage of ONZETRA is 22 mg of sumatriptan nasal powder (2 nosepieces), administered using the Xsail breath-powered delivery device. If the migraine has not resolved by 2 hours after taking ONZETRA Xsail, or returns after a transient improvement, a second dose of 22 mg may be administered at least 2 hours after the first dose. The maximum recommended dose that may be given in 24 hours is two doses of ONZETRA Xsail (44 mg/4 nosepieces) or one dose of ONZETRA Xsail and one dose of another sumatriptan product, separated by at least 2 hours. The safety of treating an average of more than 4 headaches in a 30 day period has not been established.


What interacts with ONZETRA?

Sorry No Records found


What are the warnings of ONZETRA?

Sorry No Records found


What are the precautions of ONZETRA?

Sorry No Records found


What are the side effects of ONZETRA?

Sorry No records found


What should I look out for while using ONZETRA?

ONZETRA Xsail is contraindicated in patients with:


What might happen if I take too much ONZETRA?

In clinical trials, the highest single doses of sumatriptan nasal spray administered without significant reactions were 40 mg to 12 volunteers and 40 mg to 85 subjects with migraine, which is twice the highest single recommended dose. In addition, 12 volunteers were administered a total daily dose of 60 mg (20 mg 3 times daily) for 3.5 days without significant adverse reactions.

Overdose in animals has been fatal and has been heralded by convulsions, tremor, paralysis, inactivity, ptosis, erythema of the extremities, abnormal respiration, cyanosis, ataxia, mydriasis, salivation, and lacrimation.

The elimination half-life of ONZETRA Xsail is about 3 hours   , and therefore monitoring of patients after overdose with ONZETRA Xsail should continue for at least 15 hours or while symptoms persist.

It is unknown what effect hemodialysis or peritoneal dialysis has on the serum concentrations of sumatriptan.


How should I store and handle ONZETRA?

Store at room temperature between 20C to 25C (68F to 77F), with excursions permitted between 15C to 30C (59F to 86F). Do not store in the refrigerator or freezer.  Use nosepiece immediately after removing from foil pouch.This product is supplied in the following size(s):    30 g bottles, 44523-607-01    60 g bottles, 44523-607-02 To reportManufactured for: BIOCOMP PHARMA , INC. San Antonio, TX 78230 1355 This product is supplied in the following size(s):    30 g bottles, 44523-607-01    60 g bottles, 44523-607-02 To reportManufactured for: BIOCOMP PHARMA , INC. San Antonio, TX 78230 1355 This product is supplied in the following size(s):    30 g bottles, 44523-607-01    60 g bottles, 44523-607-02 To reportManufactured for: BIOCOMP PHARMA , INC. San Antonio, TX 78230 1355


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Clinical Information

Chemical Structure

No Image found
Clinical Pharmacology

Sumatriptan binds with high affinity to human cloned 5-HT receptors.  Sumatriptan presumably exerts its therapeutic effects in the treatment of migraine headache through agonist effects at the 5-HT receptors on intracranial blood vessels and sensory nerves of the trigeminal system, which result in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.

Non-Clinical Toxicology
ONZETRA Xsail is contraindicated in patients with:

Systemic clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents.

The use of ONZETRA Xsail is contraindicated in patients with ischemic or vasospastic CAD. There have been rare reports of serious cardiac adverse reactions, including acute myocardial infarction, occurring within a few hours following administration of sumatriptan. Some of these reactions occurred in patients without known CAD. 5-HT agonists, including ONZETRA Xsail, may cause coronary artery vasospasm (Prinzmetal’s angina), even in patients without a history of CAD.

Perform a cardiovascular evaluation in triptan-naïve patients who have multiple cardiovascular risk factors (e.g., increased age, diabetes, hypertension, smoking, obesity, strong family history of CAD) prior to receiving ONZETRA Xsail. If there is evidence of CAD or coronary artery vasospasm, ONZETRA Xsail is contraindicatedFor patients with multiple cardiovascular risk factors who have a negative cardiovascular evaluation, consider administering the first dose of ONZETRA Xsail in a medically supervised setting and performing an electrocardiogram (ECG) immediately following administration of ONZETRA Xsail. For such patients, consider periodic cardiovascular evaluation in intermittent long-term users of ONZETRA Xsail.  

The following serious adverse reactions are discussed in more detail in other sections of the prescribing information:

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Interactions

Interactions

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