Zavegepant
ZAVZPRET
What it isIntranasal CGRP receptor antagonist; acute migraine.
Why this oneThe only nasal gepant, so it works when vomiting prevents oral dosing and it acts within fifteen minutes.
What limits itDysgeusia is common and distinctive. Nasal discomfort; cost and access.
FDA-approved for
- acute migraine (nasal) (2023)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acute treatment of migraine (with or without aura) | adult | 10 mg PRN | 10 mg PRN | 10 mg/24h |
Renal No adjustment if CLcr ≥30 mL/min; avoid if CLcr <30 mL/min
Hepatic No adjustment mild-moderate (Child-Pugh A/B); avoid in severe (Child-Pugh C)
Max 10 mg (one spray) per 24 h; safety of treating >8 migraines per 30 days not established
Instructions
- Single spray in one nostril
Cautions
- Hypersensitivity reactions including anaphylaxis, facial swelling, urticaria
- Hypertension (new-onset or worsening)
- Raynaud's phenomenon
Adverse reactions
- Taste disorders (dysgeusia, ageusia)
- Nausea
- Nasal discomfort
- Vomiting
Pregnancy No adequate human data; no adverse developmental effects in animals
Lactation No human milk data; weigh benefits against clinical need
NO BOXED WARNINGS
Principal riskDysgeusia; nasal discomfort
Cost, est. cash$500–$1,200/month
Generic entry2031 est.
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityAgent-specific vascular, serotonergic or hepatic risks; acute overdose is usually limited outside ergot or cardiovascular agents.
Mechanism of action: Zavegepant ballicule
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