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Medicines > generic: None & routes : Intranasal or Intravenous (continuous infusion in a REMS-certified facility)

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generic: (Click arrow to add another value)
brand:
Zavzpret (zavegepant) (1) · Zulresso (1)
classes:
CGRP receptor antagonist (1) · GABA-A positive allosteric modulator (1) · Gepant (1) · Neuroactive steroid (1)
mechanism:
None (1) · Small-molecule CGRP receptor antagonist; intranasal formulation (1)
uses:
Acute treatment of migraine with or without aura in adults (1) · Postpartum depression (PPD) in adults (1)
starting dose:
10 mg (one spray) intranasally in one nostril (1) · Single 60-hour continuous IV infusion: 30 mcg/kg/h × 4h → 60 mcg/kg/h × 20h → 90 mcg/kg/h × 28h → 60 mcg/kg/h × 4h → 30 mcg/kg/h × 4h (1)
preparations:
10 mg/spray nasal solution (1) · 100 mg/20 mL vial, single-use (1)
fda max:
10 mg per 24 h (1) · Single 60-hour course (1)
routes: (Click arrow to add another value)
onset:
Antidepressant effect within hours of infusion start; sustained at 30 days (1) · Pain relief reported within 15 min in trials (1)
duration:
Single infusion course (1) · ~48 h sustained pain freedom in responders (1)
halflife:
~6.6 h (1) · ~9 hours (terminal) (1)
bioavailability:
100% (IV) (1) · ~5% intranasal (1)
pregnancy:
Limited data; avoid (1) · Medicine is structurally identical to endogenous allopregnanolone; pregnancy considerations relate to breastfeeding during/after infusion. Limited data; brief interruption of breastfeeding considered (1)
legal:
Rx (1) · Rx; REMS program required (excessive sedation/loss of consciousness during infusion) (1)

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