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Atzumi

Pronunciation: at-zu-mi
Generic name: dihydroergotamine
Brand name: Atzumi
Dosage form: nasal powder (5.2 mg per device)
Drug class: Antimigraine agents

Medically reviewed by Carmen Pope, BPharm. Last updated on May 5, 2025.

What is Atzumi?

Atzumi is used to treat migraine with or without aura in adults. It is a nasal powder, and one dose is administered into one nostril as soon as possible after migraine symptoms start. 

Atzumi (dihydroergotamine nasal powder) gained FDA approval on April 30, 2025. There is no generic.

Mechanism

Atzumi (dihydroergotamine) works via multiple mechanisms to treat migraines. It binds to and activates serotonin receptors (5-HT1Dα and 5-HT1Dβ) to constrict cranial blood vessels, inhibit inflammation, block pain transmission in the trigeminal nerve pathway, and disrupt the neurological cascade that causes migraine symptoms.

Atzumi belongs to the drug class called ergotamines.

Side effects

The most common side effects of Atzumi are:

Serious side effects and warnings

Atzumi may cause an allergic reaction. Get emergency medical help if you have signs of an allergic reaction, such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.

Atzumi may cause the following serious side effects:

Tell your healthcare provider or seek emergency help if you have:

Atzumi nasal powder should not be used to treat any headaches that are different from your usual migraine headaches.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before using this medicine

You should not use dihydroergotamine if you are allergic to it or similar medicines (ergotamine, ergonovine, methylergonovine, and others), or if you have or have ever had:

Some drugs should not be used with dihydroergotamine. Your treatment plan may change if you also use:

Before taking, tell your doctor about all your medical conditions, including if you:

Pregnancy

May cause harm to an unborn baby. There is a risk of preterm labor if women use Atzumi during pregnancy. Do not use Atzumi if you are pregnant.

Breastfeeding

Do not breastfeed while using this medicine, and for at least 3 days after your last dose.

How should I use Atzumi?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Each Atzumi nasal powder device contains one dose.

Atzumi nasal powder is absorbed quickly through your nasal passages and is for use only in the nose.

Your first dose may be given in a medical setting where any serious side effects can be quickly treated.

Dosing information

Onset of migraine: Atzumi 5.2 mg (contents of one device in 1 nostril).

At least 1 hour after the first dose: 5.2 mg (one device) if needed.

Maximum dosage in 24 hours: 10.4 mg (2 devices).

The safety of taking more than 4 doses within 7 days or 12 doses within a 30-day period has not been established.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow breathing, blood pressure changes, confusion, hallucinations, agitation, convulsions, coma, nausea, vomiting, stomach pain, and pain, numbness, cold feeling, or pale appearance of your fingers or toes.

What should I avoid while using Atzumi?

Do not use Atzumi within 24 hours before or after using another migraine headache medicine, including:

Grapefruit may interact with Atzumi and cause side effects. Avoid consuming grapefruit products.

What other drugs will affect Atzumi?

Tell your doctor about all your current medicines. Many drugs can affect dihydroergotamine, especially:

This list is not complete, and many other drugs may affect Atzumi. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Storage

Store Atzumi at room temperature in its protective foil pouch until ready to use.

Ingredients

Active ingredient: dihydroergotamine 5.2 mg (equivalent to 6.0 mg dihydroergotamine mesylate)

Inactive ingredients: hypromellose, mannitol, and microcrystalline cellulose.

Atzumi nasal powder is a drug-device combination product consisting of a powder prefilled in a single-dose delivery device for nasal administration into one nostril. It does not need to be assembled or primed before use.

Available in a carton of 8 nasal devices, each individually packaged in a protective foil pouch.

Manufacturer

Atzumi (dihydroergotamine nasal powder) is made by Satsuma Pharmaceuticals, Inc., based in Durham, NC.

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.