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Zolmitriptan Intranasal: A Review of the Pharmacokinetics and Clinical Efficacy

Authors

  • Peter J. Goadsby MD, PhD, DSc,

  • Roger Yates PhD


  • Institute of Neurology, Headache Group, London, UK (Dr. Goadsby) and Raycandoc, Wilmslow, UK (Dr. Yates)

  • Dr. Goadsby wrote the first draft of the clinical section. There have been no ghost writers, nor other industry inputs into that section. Dr. Goadsby's interest stems from the formulation being possibly useful in cluster headache. Dr. Yates was responsible for the first draft of the pharmacokinetics sections. Dr. Yates' interest relates to his directing the pharmacokinetic work that went into this formulation, in his former capacity as an employee of AstraZeneca. Dr. Yates has previously received payment from AstraZeneca in a consultancy capacity. Dr. Yates acknowledges Marianne Wells from Adis Communications for editorial support, which was funded by AstraZeneca.

Address all correspondence to Dr. Peter J. Goadsby, Institute of Neurology, Headache Group, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.

Abstract

Migraine is a common disabling neurological disorder, associated with headache, nausea, and on occasions vomiting. Zolmitriptan is a widely available serotonin 5HT1B/1D receptor agonist with a long track record in clinical studies and in the treatment of acute migraine. A nasal formulation has been developed that has clear evidence for local absorption, resulting in plasma drug concentrations within 2 minutes of dosing, central nervous system penetration 3 minutes later, and a significant efficacy benefit versus placebo 10 to 15 minutes after dosing. Intranasal zolmitriptan offers advantages to migraineurs, particularly those seeking a more rapid onset of effect without wishing to self-inject, or those with gastrointestinal upset. The comparison of pharmacokinetic and clinical data available from different formulations of zolmitriptan contributes both to the understanding of its mode of action and the characteristics required of an acute migraine treatment if it is to meet patient needs.

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