Onzetra Xsail (oral/nasal)
Medically reviewed on February 28, 2018
What is Onzetra Xsail?
Onzetra Xsail is a headache medicine that narrows blood vessels around the brain. This medicine also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.
Onzetra Xsail is used to treat migraine headaches in adults. This medicine will only treat a headache. Onzetra Xsail will not prevent headaches or reduce the number of attacks.
Onzetra Xsail should not be used to treat a common tension headache or a headache that causes loss of movement on one side of your body. Use this medicine only if your condition has been confirmed by a doctor as migraine headaches.
Onzetra Xsail may also be used for purposes not listed in this medication guide.
You should not use this medicine if you have uncontrolled high blood pressure, heart problems, certain heart rhythm disorders, a history of heart attack or stroke, or circulation problems that cause a lack of blood supply within the body.
Do not use Onzetra Xsail within 24 hours before or after using any other migraine headache medicine.
Before taking this medicine
You should not use Onzetra Xsail if you are allergic to it, or if you have ever had:
heart problems, or a stroke (including "mini-stroke");
circulation problems affecting your legs, arms, stomach, intestines, or kidneys;
a heart disorder called Wolff-Parkinson-White syndrome;
uncontrolled high blood pressure;
severe liver disease; or
a headache that seems different from your usual migraine headaches.
Do not use Onzetra Xsail if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor if you have ever had:
liver or kidney disease;
epilepsy or other seizure disorder;
high blood pressure, a heart rhythm disorder; or
risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, or being older than 40 and a man).
It is not known whether Onzetra Xsail will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Sumatriptan can pass into breast milk. Do not breast-feed within 12 hours after using sumatriptan. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.
Onzetra Xsail is not approved for use by anyone younger than 18 years old.
How should I use Onzetra Xsail?
Use Onzetra Xsail as soon as you notice headache symptoms. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
You may receive your first dose in a hospital or clinic setting to quickly treat any serious side effects.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Take a Onzetra Xsail tablet whole with a full glass of water. Do not split the tablet.
Do not take a Onzetra Xsail nosepiece capsule by mouth. It is for use only in the nasal inhaler device provided with this medicine.
After using Onzetra Xsail: If your headache does not completely go away, or goes away and comes back, use a second dose if it has been at least 2 hours since your first dose.
Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks.
Do not take more than 200 milligrams of oral Onzetra Xsail within 24 hours.
Do not use more than 40 milligrams of sumatriptan nasal spray or 44 milligrams of sumatriptan nosepiece capsules within 24 hours.
Call your doctor if your symptoms do not improve, or if you have more than 4 headaches in one month (30 days).
Store Onzetra Xsail at room temperature away from moisture, heat, and light.
What happens if I miss a dose?
Since Onzetra Xsail is used when needed, it does not have a daily dosing schedule. Call your doctor if your symptoms do not improve after using Onzetra Xsail.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include tremors, skin redness in your arms or legs, weakness, loss of coordination, breathing problems, blue-colored lips or fingernails, vision problems, or a seizure (convulsions).
What should I avoid while using Onzetra Xsail?
Do not use Onzetra Xsail within 24 hours before or after using another migraine headache medicine, including:
Avoid driving or hazardous activity until you know how Onzetra Xsail will affect you. Your reactions could be impaired.
Onzetra Xsail side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using Onzetra Xsail and call your doctor at once if you have:
sudden and severe stomach pain and bloody diarrhea;
severe chest pain, shortness of breath, irregular heartbeats;
a seizure (convulsions);
heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
increased blood pressure--severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed; or
signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.
Common side effects may include:
pain or tight feeling in your chest, throat, or jaw;
pressure or heavy feeling in any part of your body;
numbness or tingling, feeling hot or cold;
dizziness, drowsiness, weakness;
unusual or unpleasant taste in your mouth after using the nasal medicine;
pain, burning, numbness, or tingling in your nose or throat after using the nasal medicine; or
runny or stuffy nose after using the nasal medicine.
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 FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Onzetra Xsail?
Using Onzetra Xsail while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:
medicine to treat depression or a psychiatric disorder;
medicine for Parkinson's disease;
medicine for serious infections;
opioid medicine; or
medicine to prevent nausea and vomiting.
This list is not complete. Other drugs may affect Onzetra Xsail, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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