Non-Oral Delivery Systems in Headache Therapy: Focus on Intranasal Delivery

Authors: Limmroth V.¹; Dowson A.J.²; Diener H-C.¹; Dahlöf C.³

Source: American Journal of Drug Delivery, Volume 2, Number 1, 2004 , pp. 59-68(10)

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Abstract:

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-HT_1B/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.

Keywords: Headache, treatment; Migraine, treatment; Drug delivery systems; Intranasal

Document Type: Review article

Affiliations: 1: 1 Department of Neurology, University Hospital Essen, Essen, Germany 2: 2 King’s Headache Service, King’s College Hospital, London, UK 3: 3 Gothenburg Migraine Clinic, Gothenburg, Sweden

Publication date: 2004-01-01