Zavzpret is a brand-name nasal spray that’s prescribed for treating migraine. Zavzpret contains the active drug zavegepant and belongs to the calcitonin gene-related peptide (CGRP) receptor antagonist drug class.

Zavzpret is FDA-approved for the acute (immediate) treatment of migraine that occurs with or without aura in adults. It’s not approved to help prevent migraine.

FDA approval

The Food and Drug Administration (FDA) first approved Zavzpret for acute treatment of migraine in 2023. It’s the first nasal spray CGRP receptor antagonist to receive FDA approval for this use. Other CGRP receptor antagonists approved for the acute treatment of migraine are taken by mouth.

Effectiveness

For information about the effectiveness of Zavzpret, see the “Zavzpret use for migraine” section below.

Zavzpret is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

As with all medications, the cost of Zavzpret can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Zavzpret, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Zavzpret, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Zavzpret, or if you need help understanding your insurance coverage, help is available.

Financial assistance to help you pay for Zavzpret may be available. A program called Pfizer RxPathways is available for Zavzpret. For more information and to find out if you’re eligible for support, call 844-989-7284 or visit the program website.

These websites also offer tools to help you find low cost healthcare and certain educational resources. To learn more, visit their websites.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Zavzpret may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Zavzpret is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

The Food and Drug Administration (FDA) approves prescription drugs such as Zavzpret to treat certain conditions.

Zavzpret is FDA-approved for the acute (immediate) treatment of migraine that occurs with or without aura in adults. It’s not approved to prevent migraine.

Migraine explained

Migraine is a neurological condition, which means it affects the brain and nerves. With migraine headaches, you have a throbbing headache that’s usually accompanied by other symptoms. These may include sensitivity to light and sound, nausea, vomiting, and dizziness.

Some people also experience an aura before other symptoms of a migraine episode begin. Auras are sensory changes, such as changes in vision or sensations. Some people may also have trouble with speech or language.

After the symptoms of a migraine episode are managed, you may feel tired and irritable for a couple of days.

A migraine episode may last several hours or even several days. It can significantly affect your ability to carry on with your usual activities. Migraine episodes are recurrent. You may have them frequently or occasionally.

To learn more about migraine, visit our headache and migraine hub.

Effectiveness for migraine

Zavzpret has been found effective for quickly relieving the symptoms of a migraine episode. To find out how the drug performed in clinical trials, see Zavzpret’s prescribing information.

Zavzpret and children

Zavzpret is not FDA-approved for use in children. It’s not known if the medication is safe or effective in this age group. The drug hasn’t been studied in children.

The following information describes Zavzpret dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Zavzpret comes as a single-dose nasal spray. Each nasal spray contains one dose of 10 milligrams (mg).

Dosage for migraine

You should take Zavzpret when needed to treat a migraine episode. The recommended dosage is one 10-mg spray into one nostril. You should take this dose as soon as possible after your migraine symptoms start.

The maximum dosage of Zavzpret is one 10-mg spray in 24 hours. Do not take more than eight doses in any 30-day period.

Will I need to use this drug long term?

Zavzpret is prescribed to help relieve the symptoms of a migraine episode. If you and your doctor determine that Zavzpret is safe and effective for you, you can use it whenever you need to treat a migraine. However, it’s not known whether it’s safe to use Zavzpret to treat more than eight migraines in any 30-day period.

Zavzpret can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Zavzpret. These lists do not include all possible side effects.

For more information about the possible side effects of Zavzpret, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Zavzpret, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Zavzpret. To learn about other mild side effects, talk with your doctor or pharmacist, or view Zavzpret’s prescribing information.

Mild side effects of Zavzpret can include:

  • taste disturbances, such as a bitter or metallic taste in your mouth or loss of taste
  • nasal discomfort
  • nausea
  • vomiting
  • mild allergic reaction*

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Zavzpret, see “Allergic reaction” below.

Serious side effects

Serious side effects from Zavzpret aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or you think you’re having a medical emergency.

Serious side effects can include severe allergic reaction.*

* For details about allergic reaction and Zavzpret, see “Allergic reaction” below.

ALLERGIC REACTION

As with most drugs, some people can have an allergic reaction after taking Zavzpret. This was a rare side effect in clinical trials of this drug.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your face, tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Zavzpret, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Zavzpret can interact with some other medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Drug-condition interactions can also cause certain effects. For information about these interactions, see the “Zavzpret precautions” section below.

Zavzpret and other medications

Below is a list of medications that can interact with Zavzpret. This list does not contain all drugs that may interact with Zavzpret.

Before taking Zavzpret, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Types of drugs that can interact with Zavzpret include:

  • Decongestant nasal sprays or drops. These medications are prescribed to relieve a blocked or stuffy nose. Taking them with Zavzpret can make Zavzpret less effective. You should avoid using these drugs with Zavzpret. If you need to use a decongestant nasal spray or drops, do not use them for at least 1 hour after taking a dose of Zavzpret. Examples of these drugs include:
    • oxymetazoline (Afrin, Dristan, Vicks Sinex, others)
    • phenylephrine (Neo-Synephrine)
  • OATP1B3 inhibitors or inducers. OATP1B3 is a protein that’s involved in transporting certain drugs into the liver, where they’re broken down. Drugs that are OATP1B3 inducers or inhibitors can affect the action of this protein. Taking Zavzpret with one of these drugs may either raise the risk of Zavzpret side effects or make Zavzpret less effective. Examples of these drugs include rifampin (Rifadin, Rimactane).

Zavzpret and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Zavzpret. However, you should still check with your doctor or pharmacist before using any of these products while taking Zavzpret.

Zavzpret and foods

There aren’t any foods that have been specifically reported to interact with Zavzpret. If you have any questions about eating certain foods with Zavzpret, talk with your doctor.

There are no known interactions between Zavzpret and alcohol.

If you have questions about drinking alcohol while using Zavzpret, talk with your doctor or pharmacist.

You should use Zavzpret according to the instructions your doctor gives you.

Zavzpret comes as a single-dose nasal spray. It’s used as a single dose in one nostril. You can find instructions for using the nasal spray on the manufacturer’s website. These are also printed in the medication guide that comes with your medication.

Note that you should not test or prime Zavzpret nasal spray before using it. If you press the plunger before taking the dose, the dose will be lost, and the spray will no longer work.

When to use

You should use Zavzpret to treat a migraine episode. Take it as soon as possible after your migraine symptoms start.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

Zavzpret is used for the acute (immediate) treatment of migraine that occurs with or without aura. An aura refers to sensory changes, such as changes in vision, that you may have before the migraine headache starts.

What happens with migraine

With a migraine episode, certain changes occur in your brain. A protein called calcitonin gene-related peptide (CGRP) plays a key role in causing these changes. Increased levels of CGRP are released in your brain during a migraine.

CGRP attaches to receptors on blood vessels and nerves in your brain, and it causes a widening and swelling of those blood vessels. This can lead to the throbbing headache you have with a migraine. CGRP also increases pain signaling in your brain. This can worsen the headache and cause other symptoms you may have with a migraine. These include increased sensitivity to light and sound, and nausea.

What Zavzpret does

Zavzpret is a type of drug called a CGRP receptor antagonist. It works by attaching to CGRP receptors in your brain and blocking them. This stops CGRP from producing its effects.

Zavzpret helps relieve the headache, light and sound sensitivity, and nausea you may have with a migraine episode.

How long does it take to work?

Zavzpret starts working right after you take a dose and can relieve migraine symptoms within 2 hours.

It’s not known whether Zavzpret is safe to use during pregnancy. It hasn’t been studied in people who are pregnant.

In animal studies, zavegepant (the active drug in Zavzpret) didn’t cause harmful effects when given to pregnant females. However, animal studies don’t always predict what happens in humans.

If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of using Zavzpret.

It’s not known whether Zavzpret is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Zavzpret.

For more information about taking Zavzpret during pregnancy, see the “Zavzpret and pregnancy” section above.

It isn’t known whether Zavzpret can pass into breast milk or whether the drug could lead to side effects in a child who is breastfed.

If you’re breastfeeding or planning to do so, talk with your doctor about whether Zavzpret is right for you. They can recommend the best way to feed your child after taking a dose of Zavzpret.

Here are answers to some frequently asked questions about Zavzpret.

Can Zavzpret cause long-term side effects?

No, it’s unlikely. In clinical trials, no long-term side effects were reported with Zavzpret. In one of these trials, Zavzpret was used to treat occasional migraines for up to 1 year. No additional or long-term side effects were reported in this trial.

If you have questions about the long-term safety of using Zavzpret to treat your migraine episodes, talk with your doctor.

Is Zavzpret safe for older adults?

It’s likely. In clinical trials, Zavzpret didn’t cause any specific side effects that might make it unsafe for older adults. Because these trials didn’t involve enough people ages 65 years and older, it’s unknown whether older adults respond differently to Zavzpret than younger adults. However, the manufacturer doesn’t recommend any dosage adjustments for Zavzpret based on age.

Note that Zavzpret is cleared from your body by your liver and kidneys. No dosage adjustments are needed if you have mild to moderate kidney or liver problems. However, the medication hasn’t been studied in people with severe liver or kidney problems. It’s not recommended for people with these problems. Older adults are more likely to have severe kidney or liver problems.

If you have questions about Zavzpret’s safety based on your age, talk with your doctor.

Will Zavzpret cure my migraine?

No, there is currently no cure for migraine.

For many people, Zavzpret can completely relieve the symptoms of a migraine episode. However, it might not work for everyone. To find out how the medication performed in clinical trials, see the drug’s prescribing information or talk with your doctor. They can tell you more about what to expect from Zavzpret.

Zavzpret isn’t approved for preventing migraine. At this time, it hasn’t been studied for migraine prevention. Some other medications in the same class as Zavzpret are approved for preventing migraine. These drugs can help reduce the number of migraine episodes you have. However, they won’t completely cure migraine so that you never have another episode.

To find out more about medications prescribed to help treat or prevent migraine, talk with your doctor.

This drug comes with several precautions. These are considered drug-condition interactions.

Before taking Zavzpret, talk with your doctor about your health history. Zavzpret may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Severe liver or kidney problems. Zavzpret hasn’t been studied in people with severe liver and kidney problems. It’s not recommended for people with these conditions. If you have a problem with your liver or kidneys, talk with your doctor about whether Zavzpret is safe for you.
  • Allergic reaction. If you’ve had an allergic reaction to Zavzpret or any of its ingredients, your doctor will likely not prescribe Zavzpret. Ask your doctor what other medications may be better options for you.
  • Pregnancy. It’s not known if Zavzpret is safe to use during pregnancy. For more information, see the “Zavzpret and pregnancy” section above.
  • Breastfeeding. It’s not known if Zavzpret is safe to use during breastfeeding. For more information, see the “Zavzpret and breastfeeding” section above.

Note: For more information about the potential negative effects of Zavzpret, see the “Zavzpret side effects” section above.

Do not use more Zavzpret than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Zavzpret

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Zavzpret from the pharmacy, the pharmacist will add an expiration date to the label on the carton. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, ask your pharmacist how to properly dispose of it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

Zavzpret nasal spray should be stored at room temperature.

Disposal

If you no longer need to take Zavzpret and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.