Nasal sprays can be an effective medication option to manage migraine symptoms. Often, nasal sprays can provide faster relief than oral medication.

You may have heard of nasal sprays as a potential treatment option for migraine. But what exactly are they, and how do they work?

Below, we’ll answer these questions about migraine nasal sprays and discuss which ones are currently available. Continue reading to learn more.

Nasal sprays for migraine can offer more rapid relief than oral medications. In fact, research from 2021 suggests that nasal sprays can start easing symptoms of a migraine attack in as little as 15 minutes.

Generally speaking, medications that are given intranasally can be absorbed more rapidly and effectively than oral medications. What’s the reason for this?

Your nasal cavity contains many blood vessels, which provide a more direct route for the drug into your bloodstream.

When a drug is directly absorbed into your bloodstream, it avoids being broken down by your digestive system or by your liver during first-pass metabolism. This means that more of the drug is readily available to ease your migraine symptoms.

Now, let’s explore the general mechanisms behind the drugs that are used in migraine nasal sprays.

Triptans

Triptans are one of the first-line treatments for migraine episodes that are moderate to severe in intensity. Your doctor may recommend a triptan if nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen haven’t been effective in easing short-term (acute) migraine symptoms.

These drugs bind to certain subtypes of receptors in your brain that are linked with serotonin, a neurotransmitter whose levels are important in migraine.

When a triptan binds to these receptors, it causes blood vessels in your brain to tighten (vasoconstriction). This has the effect of lowering pain signaling and inflammation.

Ergotamines

Generally speaking, triptans have replaced ergotamines as one of the primary treatments for acute migraine attacks. Your doctor may prescribe an ergotamine if other medications haven’t been effective at relieving your symptoms.

Ergotamines also bind to serotonin receptors in your brain. This causes blood vessels to constrict and lowers pain signaling. However, they’re also less specific than triptans, which means that they can also cause more side effects.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs block enzymes called cyclooxygenase (COX) 1 and 2, which stop the production of prostaglandins. Prostaglandins are chemicals that contribute to pain and inflammation.

A doctor may prescribe ketorolac (Toradol), an NSAID available as a nasal spray, to help manage migraine attacks that cause severe pain. They may also recommend ketorolac as a rescue medication if your primary abortive medication isn’t effective.

To manage migraine episodes, you typically use nasal sprays by spraying into your nostrils. Whether you’ll need to spray it into one nostril or both nostrils will depend on the product, so be sure to read the product information carefully beforehand.

Plus, it’s important to spray the medication into your nostril (or nostrils) with your head upright. Tilting your head or sniffing forcibly can cause the medication to go down your throat instead, which can affect how well your medication works.

Several migraine nasal sprays approved by the Food and Drug Administration (FDA) are available. These include:

  • Imitrex: Imitrex is a nasal spray of the triptan drug sumatriptan. It received FDA approval in 1997 and is prescribed for the acute treatment of migraine attacks with or without aura in adults.
  • Tosymra: Tosymra is also a nasal spray of the triptan drug sumatriptan. It received FDA approval in 2019 and, like Imitrex, is prescribed for the treatment of an acute migraine attack with or without aura in adults.
  • Zomig: Zomig is a nasal spray of the triptan drug zolmitriptan. It received FDA approval in 2003 and is prescribed for the treatment of acute migraine attacks with or without aura in adults.
  • Migranal: Migranal is a nasal spray of the ergotamine dihydroergotamine. It received FDA approval in 1997 and is prescribed for acute migraine attacks with or without aura in adults.
  • Sprix: Sprix is a nasal spray of the NSAID ketorolac. It received FDA approval in 1989 and is prescribed for the treatment of moderate to severe pain in adults.
  • Trudhesa: Trudhesa is a nasal spray of dihydroergotamine mesylate (DHE). It received FDA approval in 2021 and is prescribed to treat migraine episodes with or without aura in adults.

Questions for your doctor

If you’re interested in a nasal spray for migraine, there are several questions that you may want to ask your doctor first. These include:

  • Are nasal spray medications appropriate for managing my acute migraine attack symptoms?
  • If so, which type of nasal spray medication do you recommend?
  • How would using a nasal spray medication compare to using an oral medication?
  • How and when should I take my nasal spray medication?
  • How long will it take for the medication to work?
  • What side effects can I expect?
  • Are there any drug or supplement interactions that I should be aware of?
  • When should I contact you if my migraine nasal spray isn’t effective in easing my symptoms?

Nasal sprays can help ease the symptoms of an acute migraine attack. They can also often work to ease your symptoms faster than oral abortive medications.

Several types of migraine medications are available in nasal spray forms. Some examples include triptans (Imitrex, Zomig), dihydroergotamine (Migranal), and ketorolac (Sprix).

If you’d like to try a nasal spray for migraine, talk with your doctor. They can help you find out if a nasal spray may be beneficial for your acute migraine symptoms. They can also inform you of any side effects or interactions to watch out for.