Unique Migraine Nasal Spray: We’re still waiting

Back in 2008 we talked about some unique nasal sprays that were being tested for migraine treatment.  One of these was AZ-001, a nasal spray using the drug prochlorperazine.

Nasal Spray: Still Waiting.

Photo courtesy of robin_24

I’m not sure if that specific version is being actively developed by Alexza Pharmaceuticals or not, but the concept is still being researched.  Dr. Venkata Yellepeddi from Roseman University of Health Sciences has developed a nasal spray based on prochlorperazine.  Here’s what he had to say:

Prochloperazine is a dopamine receptor antagonist that is widely used as an anti-nausea medication.  Comparative clinical studies have shown that prochloperazine provides better pain relief than other anti-migraine drugs such as sumatriptan, metoclopramide, and ketorolac.  Currently, there are no marketed nasal spray formulations of prochlorperazine available for the treatment of migraine.  Prochlorperazine is only available in tablet form, which has delayed onset of action.

Prochlorperazine is already used for migraine, and is especially useful for migraine with nausea.  It’s also used for severe nausea from other causes, and in some cases as a antipsychotic.  It’s sold under brand names such as Compazine, , and Buccastem among others.

Nasal sprays are useful for a number of reasons.  For one thing, by bypassing the gut they are more useful for patients with nausea.  A more precise amount of medication will get into your system, and will be available faster.

Dr. Yellepeddi has also created a nasal spray with no preservatives, which may cause problems in some patients.  The formulation seems to be stable, but unfortunately testing is still in the early stages.  We may have to wait several more years before this one is available.

For more, read the press release from the American Association of Pharmaceutical Scientists:  First-in-class nasal spray demonstrates promise for migraine pain relief

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4 comments… add one
  • HH Nov 17, 2014

    Curious if you have ever tried a migraine drug in a self-administered nasal spray form. I did, about 11 years ago, and according to the doctor who prescribed it to me, I was not alone in finding it an iffy/hit or miss system. In my case, the drug was lidocaine. Perhaps much has changed since 2003, or that the issues were exclusive to the actions or properties of lidocaine nasal spray, but the drawbacks were: 1) you had to position yourself and the sprayer just right to get enough of the dose as far up in the nostril as possible, 2) once in, the drug irritated the tissues, and 3) if there was a slight “misfire,” you simply had to wait it out until you could dose again. But by that time, the migraine was intractable. (I assume intranasal drugs that are not self-administered might work better.) Before I started this comment, I read several user reviews of the nasal spray form of Zomax and some users experienced the same issues I had with the lidocaine spray. The web page on which I am posting this comment has an article/ad for OptiNose. After clicking on it reading it, I visited their website. They address the issues I have expressed. Perhaps they have designed a better nasal delivery system, but it appears it is not on the market yet. Pure speculation: could the delay in the nasal spray form of prochlorperazine have to do with the drawbacks of a foolproof delivery system?

  • Amazonite Nov 19, 2014

    Years ago I was prescribed Stadol nasal spray for severe headache / migraine / cluster headache / chronic daily headache / whatever the heck kind of headaches I get. To date, it’s the only thing I’ve ever taken that will stop a severe headache; however, the side effects are something to be reckoned with (visual hallucinations, for one thing; extreme dizziness; and respiratory depression). I used to have to wait until I was actually already lying in bed to use it. As bad as it made me feel otherwise, it would get rid of the headache; however, I used it only as a last resort.

    There are times I wish I had some more nowadays. My regular meds don’t work well anymore.

  • NS Dec 24, 2014

    I currently use the generic stadol.its difficult to gauge a correct dose and side effects are being stoned, slur words tiered but can’t sleep, groggy not steady on feet, extreame nausea . The side effects have to be carefully weighd against possible pain relief for a couple of hours but your too stoned to do anything productive.

  • Hanne Pinkava Mar 3, 2017

    I’m trying out Ausanil homeopathic nasal spray. It can sting in the beginning since it’s cayenne pepper in it. But it works!

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