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Sprix

The Battle of the Nasal Sprays

Occasional but Terrible Migraine Attack? You might want to try Sprix.

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New research is confirming the benefits of a medication that can fight episodic migraine. It might be just the thing to try if you haven’t had success with the medications your doctor has prescribed up to this point.

Many migraine patients are familiar with Toradol, or ketorolac tromethamine. Ketorolac is actually one of the top recommended drugs to give a migraine patient in emergency. It’s low on side effects and high on effectiveness.

Today, ketorolac is available as a nasal spray – perfect for those trying to avoid injections but who still want something that’s fast-acting. The nasal spray is commonly sold under the brand name Sprix.

The Battle of the Nasal SpraysBut how does this medication compare to migraine-specific medications, such as the ever-popular sumatriptan?

A study in the journal Headache this past February attempted to answer the question, pitting ketorolac nasal spray against sumatriptan nasal spray.

In a double-blind study of 72 randomized participants were treated for 152 migraine attacks.

The results? Ketorolac was every bit as good as sumatriptan – in fact, in some ways it had the edge. The pain relief seemed to last longer, and ketorolac was better at fighting nausea. It also helped fight photophobia, that painful sensitivity to light that many migraine patients experience.

More good news – none of the patients, taking either of the two medications, withdrew from the study due to side effects.

These things make a nasal spray such as Sprix very attractive for those with episodic migraine.

However, ketorolac is not recommended for chronic migraine. It is intended for very occasional use. There are cardiovascular and gostrointestinal risks if the medication is taken frequently, or if it’s taken constantly for more than a few days (read more here). For migraine patients who already may be at increased risk in these areas, frequent use of ketorolac should be avoided.

But those with episodic, or more occasional, migraine still face another hurdle. This medication can be very expensive. However, Dr. Alexander Mauskop from the New York Headache Clinic has an excellent suggestion to save money. He writes:

The main problem with intranasal ketorolac is its cost. On GoodRx.com the price of 5 vials of Sprix (with a coupon) is about $1,000. Each vial is good for one day of use; it contains 8 sprays (15 mg each) and the usual dose is one spray into each nostril, repeated every 6 hours as needed. However, there is a way around the cost of this medication. Ten 30 mg vials of generic ketorolac for injections cost $15. You just need to buy a nasal spray bottle, empty the contents of the vial into it and use it as needed.

Check with your doctor and your insurance company to confirm which option is best for you.

To read the ketorolac vs. sumatriptan study results, visit A Randomized Trial of Ketorolac vs Sumatripan vs Placebo Nasal Spray (KSPN) for Acute Migraine

Toradol for Migraine

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In certain cases, Toradol for migraine is a good option. But there are some risks and side effects that should be considered.

Toradol is actually a brand name, one of many, for ketorolac tromethamine. There are many other brand names, although Toradol may be the most familiar.Toradol for Migraine

Ketorolac belongs to a group of drugs known as NSAIDs – nonsteroidal anti-inflammatory drugs. Other drugs in this category include ibuprofen and fenoprofen.

Toradol for migraine is probably most useful as an emergency treatment at the hospital. Ketorolac, along with diclofenac, are both recommended in the emergency department, although they are not necessarily the first option to try (see Sequence of Treatments in Emergency – what works?).

In the journal Neurology‘s evidence-based guidelines, ketoprofen is one of the higher rated NSAIDs, considered to be “probably effective” according to clinical trials. There are, however, better treatments that should be tried first.

Common side effects with Toradol for migraine include swelling (in feet, ankles, face) and weight gain. As with most NSAIDs, there may be stomach issues such as diarrhea, nausea and stomach pain. Older adults seem to be more sensitive to side effects of ketorolac. It is not recommended for use during pregnancy.

There are some serious side effects, and your risk increases if you take the medication for a longer period of time. Usually ketorolac is recommended for one-time use in the emergency room, or for a brief time (a day or two) to stop a migraine attack at home.

To avoid some stomach related issues, a nasal spray may be prescribed (SPRIX).

If prescribed by your doctor, temporary use of ketorolac may help stop a migraine attack, and is often combined with other medications. However, it’s only a temporary solution.

For more information, see:

A New way to take Toradol

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Toradol is actually a brand name, but I mentioned it in the title because people are more familiar with that name.  It’s also sold as Acular, Glicima, Supradol, Apo-Ketorolac, Ketanov and Ketorol.

The actual name of the drug is ketorolac tromethamine, or simply ketorolac.  Most commonly it’s given as an oral tablet or injection.

Sprix

But there’s a new way to take ketorolac, and it has a new name – Sprix.  Sprix comes from ROXRO PHARMA, Inc.

What makes Sprix special?  It’s a nasal spray.  Nasal sprays may be an easier alternative particularly for those who are tired of taking injections.

Ketorolac is non-narcotic, a non-steroidal anti-inflammatory drug (NSAID).  It’s often used for fever and moderate to severe pain relief.  Obviously as an anti-inflammatory it’s helpful for reducing swelling and inflammation.

It’s not usually recommended for chronic conditions, however is an option for short term pain relief (usually up to 5 days).

Sprix is not yet available, but was just approved on the 17th of May (2010) by the FDA in the United States, so it should be available soon and will probably be a well accepted alternative to other forms of ketorolac.

For more on Sprix, including the official press release, visit the Sprix website.

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The articles on Headache and Migraine News are © 2004-2026 J. Cottrill.
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