Sumatriptan comes as a spray (Imitrex, Tosymra) to inhale through the nose. It also comes as a powder (Onzetra Xsail) to inhale through the nose with a breath-powered delivery device. It is usually used at the first sign of a migraine headache. If your symptoms improve after you use sumatriptan but come back, you may use a second dose of sumatriptan (Imitrex, Onzetra Xsail) at least 2 hours later, or a second or third dose of sumatriptan (Tosymra) at least 1 hour after each other, if needed. However, if your symptoms do not improve after you use sumatriptan, do not use a second dose without talking to your doctor. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use sumatriptan exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

You may use your first dose of sumatriptan nasal in a doctor's office or other medical facility where you can be monitored for serious reactions.

Call your doctor if your headaches do not get better or occur more frequently after using sumatriptan nasal.

If you use sumatriptan more often or for longer than the recommended period of time, your headaches may get worse or may occur more frequently. You should not use sumatriptan nasal or take any other headache medication for more than 10 days per month. Call your doctor if you need to use sumatriptan nasal to treat more than four headaches in 1-month period.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

To use the nasal spray, follow these steps:

1. Read all of the manufacturer's instructions for using the nasal spray before you use your first dose.
2. Blow your nose gently.
3. Remove the device from the blister pack.
4. Hold the sprayer between your fingers and thumb, but be careful not to press the plunger.
5. Use your other hand to block one nostril by pressing firmly on the side of your nose.
6. Put the tip of the sprayer into your other nostril as far as feels comfortable (about one half inch). Keep your head upright and close your mouth. If you are using Tosymra, tilt your head slightly back, and point the tip of the inserted sprayer toward the outside of your nose. Be careful not to press the plunger or spray the medication in your eyes.
7. Breathe in gently through your nose. At the same time, press the plunger firmly with your thumb.
8. Keep your head level and remove the tip from your nose.
9. Breathe gently in through your nose and out through your mouth for 10 to 20 seconds. Do not breathe in deeply. It is normal to feel liquid in your nose or the back of your throat.
10. The sprayer only contains one dose of medication. After you have used it, dispose of it safely, so that is out of the reach of children and pets.

To inhale the nasal powder using an inhaler, follow these steps:

1. Read all of the manufacturer's instructions for using the nasal device before you use your first dose.
2. Remove the nosepiece from the pouch. The nosepiece contains a capsule filled with sumatriptan powder.
3. Click the nosepiece into the device body.
4. Fully press and release the white piercing button on the device body one time to pierce the capsule inside the nosepiece. It should only be pressed once.
5. Insert the first nosepiece deeply into the nostril. Keep it in the nostril as you rotate the device to put the mouthpiece into the mouth.
6. Blow forcefully with your mouth into the device for 2 to 3 seconds to deliver the medication into the nose. You may hear a vibration or rattling noise as you do this. Do not hold or press the white button while blowing.
7. Press the clear tab to remove the first nosepiece. Check the capsule in the nosepiece to ensure that the medication was given.
8. Remove and discard the nosepiece safely, so that is out of the reach of children and pets.
9. Repeat steps 2 to 8 using a second nosepiece in the other nostril to give the total dose.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

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