Abstract
Sumatriptan (ST) is a commonly prescribed drug for treating migraine. The efficiency of several routes of ST administration has been investigated. Recently, the intranasal route with different delivery systems has gained interest owing to its fast-acting and effectiveness. The present study is aimed at reviewing the available studies on novel delivery systems for intranasal ST administration. The oral route of ST administration is common but complicated with some problems. Gastroparesis in patients with migraine may reduce the absorption and effectiveness of ST upon oral use. Furthermore, the gastrointestinal (GI) system and hepatic metabolism can alter the pharmacokinetics and clinical effects of ST. The bioavailability of conventional nasal liquids is low due to the deposition of a large fraction of the delivered dose of a drug in the nasal cavity. Several delivery systems have been utilized in a wide range of preclinical and clinical studies to enhance the bioavailability of ST. The beneficial effects of the dry nasal powder of ST (AVP-825) have been proven in clinical studies. Moreover, other delivery systems based on microemulsions, microspheres, and nanoparticles have been introduced, and their higher bioavailability and efficacy were demonstrated in preclinical studies. Based on the extant findings, harnessing novel delivery systems can improve the bioavailability of ST and enhance its effectiveness against migraine attacks. However, further clinical studies are needed to approve the safety and efficacy of employing such systems in humans.
Highlights
Migraine, one of the most common neurological disorders globally, has been ranked as the second cause of disability among young and middle-aged individuals [1, 2]
Migraine is a common cause of disability that is related to the increased sensitization of the trigeminovascular system
One FDA-approved system is a breathpowered exhalation delivery system (AVP-825) that was recommended as a promising therapy for migraine headache in clinical studies
Summary
One of the most common neurological disorders globally, has been ranked as the second cause of disability among young and middle-aged individuals [1, 2]. As a first-line treatment, triptans are used for moderate-to-severe migraine headaches Their application is usually limited due to adverse effects, time-and frequency-restricted use, and the risk of emerging drug overuse headache [11]. In this class, sumatriptan (ST), the most commonly prescribed drug, was approved by the US FDA for migraine attacks in 1992 [12]. To overcome oral route limitations, the intranasal route (nasal spray) has been introduced to improve the consistency and speed of absorption of the medication and prevent the complications related to self-administration injection [24]. This review highlights the current available intranasal delivery approaches for migraine treatment, including the dry nasal powder of ST (AVP-825), microemulsions, microspheres, and nanoparticles
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