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Tosymra
Tosymra is a nasal spray formulation of sumatriptan, a serotonin receptor agonist (triptan) used for the acute treatment of migraine with or without aura in adults. It works by narrowing blood vessels around the brain, which helps relieve migraine symptoms such as headache, nausea, and sensitivity to light and sound. Tosymra provides an alternative for those who cannot tolerate oral medications or need fast-acting relief. It is not intended for the prevention of migraines or treatment of other types of headaches.
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Frequently Asked Questions
How quickly does Tosymra work?
Tosymra can start relieving migraine symptoms within 10 to 15 minutes after administration, providing fast relief for acute migraine attacks.
Can I use Tosymra if I have a cold or nasal congestion?
You should avoid using Tosymra if you have significant nasal congestion, as it may reduce the absorption of the medication and its effectiveness.
What should I do if I need more than one dose in 24 hours?
If your migraine returns, you can take a second dose after one hour. However, do not exceed three sprays (30 mg) in a 24-hour period.
Is Tosymra safe to use with other migraine medications?
You should not use Tosymra with other triptans or ergotamine-containing medications. Always consult your doctor before combining it with other medications.
What should I do if I miss a dose of Tosymra?
Tosymra is taken as needed for migraines, so there is no regular dosing schedule. Use it at the onset of a migraine attack, and follow the dosing instructions provided by your doctor.
Comprehensive Drug Guide
How Does Tosymra Work?
Tosymra works by stimulating serotonin (5-HT1) receptors in the brain, which causes the blood vessels around the brain to constrict. This reduces the dilation and pressure that cause migraine headaches. By narrowing these blood vessels and reducing inflammation, Tosymra helps to alleviate the pain and other associated symptoms of migraines.
Common Dosages
- Tosymra is available as a nasal spray in a strength of 10 mg per spray.
Typical Dosing
- The typical dose for adults is one spray (10 mg) in one nostril at the onset of a migraine attack.
- If the migraine persists or returns, a second spray may be taken after one hour, but the maximum dose is 30 mg in 24 hours (three sprays).
- Do not use more than two doses for the same migraine attack.
Typical Dosing
FDA Approved Indications
- The acute treatment of migraine attacks with or without aura in adults.
Who Shouldn't Take Tosymra?
- Coronary artery disease (CAD)
- Uncontrolled high blood pressure
- History of stroke or transient ischemic attack (TIA)
- Severe liver impairment
- Known hypersensitivity to sumatriptan or any other components of the spray
Advice From The Pharmacist
- Use Tosymra exactly as prescribed and administer it at the first sign of a migraine for the best effect. Spray it into one nostril and keep your head upright while using the spray.
- If you need a second dose, wait at least one hour after the first spray before administering another dose.
- Store Tosymra at room temperature and keep it out of reach of children.
- If you experience chest pain, shortness of breath, or any unusual symptoms after using the spray, seek immediate medical attention.
Side Effects of Tosymra
Common Side Effects
- Nasal discomfort or irritation
- Unusual taste in the mouth
- Dizziness
- Fatigue
- Nausea
Uncommon/Severe Side Effects
- Heart attack or stroke
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Serotonin syndrome (with symptoms like confusion, rapid heart rate, or hallucinations)
- Chest pain or pressure
Risks and Warnings of Tosymra
- Cardiovascular Risk: Like other triptans, Tosymra can cause blood vessel constriction, increasing the risk of heart attack or stroke, particularly in patients with heart disease or risk factors such as high blood pressure.
- Serotonin Syndrome: Tosymra can cause serotonin syndrome, especially when used with other serotonergic medications (like SSRIs or SNRIs). Symptoms include agitation, hallucinations, and rapid heart rate.
- Not for Use in Hemiplegic or Basilar Migraine: Tosymra should not be used in patients with hemiplegic or basilar migraine due to the increased risk of stroke.
Interactions with Tosymra
Common Drug Interactions
- SSRIs/SNRIs: Using Tosymra with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) can increase the risk of serotonin syndrome.
- Ergotamine medications: Combining Tosymra with ergotamine-containing medications (used to treat migraines) can increase the risk of prolonged blood vessel constriction.
- Monoamine oxidase inhibitors (MAOIs): Tosymra should not be used with MAOIs or within two weeks of stopping an MAOI.
Alternatives to Tosymra
- Imitrex (Sumatriptan): Available in oral, injectable, and nasal spray forms, used for the acute treatment of migraines.
- Zomig (Zolmitriptan): Another triptan available in nasal spray form for acute migraine treatment.
- Rizatriptan (Maxalt): A triptan available in oral forms for migraines.
- Dihydroergotamine (Migranal): A nasal spray used for the treatment of migraines that do not respond to triptans.
