| Migraine Disorders

Onzetra Xsail vs Zavzpret

Side-by-side clinical, coverage, and cost comparison for migraine disorders.
Deep comparison between: Onzetra Xsail vs Zavzpret with Prescriber.AI
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Safety signalsZavzpret 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 Zavzpret but not Onzetra Xsail, including UnitedHealthcare
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Onzetra Xsail
Zavzpret
At A Glance
Nasal powder
As needed
5-HT1B/1D agonist (triptan)
Intranasal
As needed
CGRP receptor antagonist
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 10 mg as a single spray in one nostril as needed; maximum 10 mg (one spray) per 24-hour period; safety of treating more than 8 migraines in a 30-day period has not been established.
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
  • History of hypersensitivity reaction to zavegepant or any component of ZAVZPRET, including anaphylaxis
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%) Taste disorders (dysgeusia, ageusia), nausea, nasal discomfort, vomiting
Serious Hypersensitivity including facial swelling and urticaria (less than 1%)
Postmarketing Hypersensitivity (anaphylaxis), hypertension, Raynaud's phenomenon
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.
Zavegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; it blocks CGRP receptor signaling implicated in migraine pathophysiology.
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Most Common Insurance
Anthem BCBS
Onzetra Xsail
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
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Zavzpret
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
View full coverage details ›
UnitedHealthcare
Onzetra Xsail
  • Covered on 4 commercial plans
  • PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
View full coverage details ›
Zavzpret
  • Covered on 4 commercial plans
  • PA (5/8) · Step Therapy (4/8) · Qty limit (4/8)
View full coverage details ›
Humana
Onzetra Xsail
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
View full coverage details ›
Zavzpret
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Onzetra Xsail.
Cost estimate not availablePAF Co-Pay Relief: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Onzetra XsailView full Onzetra Xsail profile
ZavzpretView full Zavzpret profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.