| Migraine Disorders
Onzetra Xsail vs Treximet
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Onzetra Xsail vs Treximet 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 signalsTreximet 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 Treximet but not Onzetra Xsail, including UnitedHealthcare
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Category
Onzetra Xsail
Treximet
At A Glance
Nasal powder
As needed
5-HT1B/1D agonist (triptan)
Oral
As needed (max 2 doses/24 hrs)
5-HT1 agonist + NSAID
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 - Adults 1 tablet of 85/500 mg orally; max 2 tablets per 24 hours separated by at least 2 hours.
Migraine Disorders - Pediatric Patients 12 to 17 Years 1 tablet of 10/60 mg orally; max 1 tablet of 85/500 mg per 24 hours.
Migraine Disorders - Mild to Moderate Hepatic Impairment 1 tablet of 10/60 mg orally per 24 hours.
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
- Coronary artery bypass graft (CABG) surgery setting
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke or transient ischemic attack (TIA), or history of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing medication, ergot-type medication (e.g., dihydroergotamine or methysergide), or another 5-HT1 agonist
- Concurrent or recent (within 2 weeks) use of a monoamine oxidase-A (MAO-A) inhibitor
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Known hypersensitivity to sumatriptan, naproxen, or any component of TREXIMET
- Severe hepatic impairment
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%) Dizziness, somnolence, paresthesia, nausea, dyspepsia, dry mouth, chest discomfort/chest pain, neck/throat/jaw pain/tightness/pressure
Serious Cardiovascular thrombotic events, GI bleeding/ulceration/perforation, arrhythmias, cerebrovascular events, other vasospasm reactions, hepatotoxicity, hypertension, heart failure and edema, medication overuse headache, serotonin syndrome, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, DRESS, hematological toxicity, exacerbation of aspirin-sensitive asthma, seizures
Postmarketing Exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), fixed drug eruption (FDE)
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.
Sumatriptan is a selective 5-HT1B/1D receptor agonist that causes cranial vessel constriction and inhibits trigeminal neuropeptide release to abort migraine; naproxen sodium is an NSAID that inhibits COX-1 and COX-2, reducing prostaglandin synthesis to provide analgesic and anti-inflammatory effects.
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)
Treximet
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Onzetra Xsail
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Treximet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Onzetra Xsail
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Treximet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Onzetra Xsail.
No savings programs available for Treximet.
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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.