| Migraine Disorders
Onzetra Xsail vs Relpax
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Onzetra Xsail vs Relpax with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRelpax has a higher rate of injection site reactions vs Onzetra Xsail based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Relpax but not Onzetra Xsail, including UnitedHealthcare
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Category
Onzetra Xsail
Relpax
At A Glance
Nasal powder
As needed
5-HT1B/1D agonist (triptan)
Oral
As needed
5-HT1B/1D agonist (triptan)
Indications
- Migraine Disorders
- Migraine Disorders
Dosing
Migraine Disorders 22 mg (one 11 mg nosepiece per nostril) intranasally as a single dose; if migraine unresolved at 2 hours or returns, a second 22 mg dose may be administered at least 2 hours after the first; maximum 44 mg per 24 hours.
Migraine Disorders 20 mg or 40 mg orally for acute treatment; a second dose may be taken at least 2 hours after the first if migraine has not resolved or returns; maximum 80 mg/day.
Contraindications
- Ischemic coronary artery disease or coronary artery vasospasm, including Prinzmetal's angina, or other significant underlying cardiovascular disease
- Wolff-Parkinson-White Syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medications, or another 5-HT1 agonist
- Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor
- Hypersensitivity to sumatriptan
- Severe hepatic impairment
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or history or current evidence of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication such as dihydroergotamine (DHE) or methysergide
- Hypersensitivity to eletriptan or any excipient (angioedema and anaphylaxis seen)
- Recent use (within at least 72 hours) of potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir
Adverse Reactions
Most common (>=2%) Abnormal taste, nasal discomfort, rhinorrhea, rhinitis
Serious Myocardial ischemia, myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increased blood pressure, hypersensitivity reactions, seizures
Postmarketing Epistaxis
Most common (>=2%) Asthenia, nausea, dizziness, somnolence, headache, paresthesia, flushing/feeling of warmth, chest tightness/pain/pressure, abdominal pain/discomfort, dry mouth, dyspepsia, dysphagia
Serious Myocardial ischemia and myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increase in blood pressure, hypersensitivity reactions
Postmarketing Seizure, vomiting
Pharmacology
Sumatriptan is a selective 5-HT1B/1D receptor agonist that constricts intracranial blood vessels and inhibits pro-inflammatory neuropeptide release from the trigeminal system, relieving migraine headache.
Eletriptan is a selective 5-HT1B/1D receptor agonist (triptan) that acts on intracranial blood vessel receptors and trigeminal sensory nerves to produce cranial vessel constriction and inhibit pro-inflammatory neuropeptide release.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Onzetra Xsail
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Relpax
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Onzetra Xsail
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Relpax
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (7/8)
Humana
Onzetra Xsail
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Relpax
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Onzetra Xsail.
No savings programs available for Relpax.
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Onzetra XsailView full Onzetra Xsail profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.