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Non-oral delivery systems in headache therapy

Focus on intranasal delivery

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For many patients with migraine, and almost all patients with cluster headache, non-oral formulations of antimigraine drugs are required to achieve successful headache relief. Various non-oral options for drug delivery of antimigraine agents have been introduced — subcutaneous formulations, suppositories, inhaled formulations, and intranasal sprays.

Within the last decade, serotonin 5-HT1B/D receptor agonists (triptans) have become the drugs of first choice for the acute treatment of both migraine and cluster headache, and are available in various formulations. Despite this large variety, most patients still prefer oral medication over the available non-oral formulations, mainly because of the specific adverse events of non-oral formulations or their particular mode of administration.

The development of zolmitriptan intranasal spray, with a favourable pharmacokinetic and tolerability profile compared with existing oral formulations, may change patient preference towards intranasal administration. This article summarizes advantages and disadvantages of the available non-oral formulations used for the treatment of headache.

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No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Correspondence to Dr Volker Limmroth.

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Limmroth, V., Dowson, A.J., Diener, H. et al. Non-oral delivery systems in headache therapy. Am J Drug Deliv 2, 59–68 (2004). https://doi.org/10.2165/00137696-200402010-00004

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  • Migraine
  • Sumatriptan
  • Cluster Headache
  • Nasal Spray
  • Zolmitriptan