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How do you use Onzetra Xsail?

Medically reviewed by Judith Stewart, BPharm. Last updated on May 3, 2023.

Official answer


Onzetra Xsail (sumatriptan nasal powder) is an intranasal migraine treatment that is used by exhaling into a device which has a sealing nosepiece.

Onzetra Xsail contains sumatriptan, is a fast-acting, serotonin 5-HT1B/1D receptor agonist (triptan) used for the acute treatment of migraine with or without aura in adults. It comes as a low-dose (22 mg) intranasal powder administered by use of one nosepiece (11 mg) in each nostril, with a maximum of two doses in any 24-hour period.

  • A dose is delivered when the user exhales into the device.
  • When the user exhales, this causes the soft palate to automatically close and seals off the nasal cavity which helps to prevent swallowing and reduces absorption through the stomach.
  • A sealing nosepiece is placed into the nostril, and the exhaled breath carries medication from the device directly into one side of the nose and deep into the nasal cavity.

Side effects include abnormal taste, nasal discomfort, and runny nose.

How to Use Onzetra Xsail

  1. Open the pouch and remove the first nosepiece. Remove the device cover. Insert the first nosepiece into the device until you hear it click into place.
  2. Fully PRESS and RELEASE white button to pierce the medication capsule. If you skip this step, you will not get any medication.
  3. INSERT the nosepiece deeply into your nose. Keep the nosepiece in your nose while you rotate the device to place the mouthpiece into your mouth.
  4. BLOW WITH YOUR MOUTH into the device for 2-3 seconds, like you're blowing up a balloon, to deliver medication into your nose. (You may hear a rattling sound or feel a vibration.) DO NOT press the white button while blowing.
  5. Press the clear tab to remove the first nosepiece. CHECK the capsule to see if the medication has gone.
    DISCARD the used nosepiece in the trash.
    Insert the second nosepiece into the device.
  6. Don't forget to pierce the capsule in the second nosepiece. If you skip this step, you will not get any medication.
  7. Repeat steps 3-4 with second nosepiece in second nostril.

When you have finished, check the nosepieces. It is normal to see a thin white residue after use. If one of both of the capsules appear unused, repeat steps 2-4 with the same nosepiece.

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