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Why the Key to Stopping Your Migraine Attack May Be Right Under Your Nose - GymFitly - Health and Fitness

Why the Key to Stopping Your Migraine Attack May Be Right Under Your Nose

When a migraine hits, your life screeches to a halt. You want relief fast and consider taking your prescription pills, but you don’t think you can keep them down. Your nausea is overwhelming, and your stomach is too sensitive right now. What other options are there? Fortunately, the answer to your migraine may be in the upper nasal space.

According to the American Migraine Foundation, at least 39 million Americans are living with migraine, but due to lack of diagnosis, the actual number is probably higher. For those who are prescribed treatment, oral medications are a popular option, but can be problematic due to the nausea that often accompanies migraine and the side effects of those medications. Many people are looking to alternatives that help them feel better quickly, which is shifting attention to the upper nasal space.

Sick to your stomach from migraine?

The nausea that accompanies migraine strongly contributes to the burden and disability associated with migraines. The American Migraine Prevalence and Prevention study revealed that patients with migraine who experienced high-frequency nausea had significantly higher odds of occupational disability or taking medical leave, and increased headache pain severity and impact (Lipton RB).

What’s more, nausea is an extremely disabling symptom of migraine that may impact patients’ use of oral treatment in an evolving attack. In a survey of 500 patients with migraine, nausea and vomiting were reported to affect a patient’s willingness to take an oral medication in 30.5% and 42.2% of patients with migraine, respectively (Rapoport AM, Silberstein SD).

If you are unable to take an oral medication, nasal sprays are another option, but not all sprays work the same. Researchers are focusing on the upper nasal space because medication is absorbed more quickly through the blood vessels in this specific area. Delivering migraine medication to the [upper] nose bypasses the stomach (gut), which is ideal for people who experience nausea and migraine, but also for those needing faster relief.

Time to breathe a sigh of relief

The American Headache Society guidelines recommend a non-oral therapy for patients who have limited or no response to pills or tablets. However, another option are infusions which can be cumbersome and expensive for patients and providers, and traditional migraine nasal sprays are only able to reach the lower nasal space.

An alternative is Trudhesa® (dihydroergotamine mesylate), the first and only product to use a proprietary Precision Olfactory Delivery (POD®) technology to deliver a proven treatment for migraine (DHE) to the vascular-rich upper nasal space — reducing nausea, dysgeusia (taste disorder) and postnasal drip.

“This method of delivery bypasses the gut and potential absorption issues when you are nauseous and vomiting,” explained Sheena Aurora, M.D., Vice President, Medical Affairs at Impel Pharmaceuticals. “The medication offers rapid, sustained and consistent symptom relief without injection or infusion, which is how DHE has historically been administered. Trudhesa is shown to be effective even when taken hours after the onset of a migraine attack.”

To learn more about migraine medication delivery through the upper nasal space, visit

Important Safety Information

Serious or potentially life-threatening reductions in blood flow to the brain or extremities due to interactions between dihydroergotamine (the active ingredient in Trudhesa) and strong CYP3A4 inhibitors (such as protease inhibitors and macrolide antibiotics) have been reported rarely. As a result, these medications should not be taken together.


Trudhesa is used to treat an active migraine headache with or without aura in adults. Do not use Trudhesa to prevent migraine when you have no symptoms. It is not known if Trudhesa is safe and effective in children.

Do not use Trudhesa if you:

  • Have any disease affecting your heart, arteries, or blood circulation
  • Are taking certain anti-HIV medications known as protease inhibitors (such as ritonavir or nelfinavir)
  • Are taking a macrolide antibiotic such as clarithromycin or erythromycin
  • Are taking certain antifungals such as ketoconazole or itraconazole
  • Have taken certain medications such as triptans or ergot-type medications for the treatment or prevention of migraine within the last 24 hours
  • Have taken any medications that constrict your blood vessels or raise your blood pressure
  • Have severe liver or kidney disease
  • Are allergic to ergotamine or dihydroergotamine

Before taking Trudhesa, tell your doctor if:

You have high blood pressure, chest pain, shortness of breath, heart disease; or risk factors for heart disease (such as high blood pressure, high cholesterol, obesity, diabetes, smoking, strong family history of heart disease or you are postmenopausal, or male over 40); or problems with blood circulation in your arms, legs, fingers, or toes.

  • You have or had any disease of the liver or kidney.
  • You are taking any prescription or over-the-counter medications, including vitamins or herbal supplements.
  • You are pregnant, planning to become pregnant or are nursing, or have ever stopped medication due to an allergy or bad reaction.
  • This headache is different from your usual migraine attacks.

The use of Trudhesa should not exceed dosing guidelines and should not be used on a daily basis.

Serious cardiac (heart) events, including some that have been fatal, have occurred following the use of dihydroergotamine mesylate, particularly with dihydroergotamine for injection, but are extremely rare.

You may experience some nasal congestion or irritation, altered sense of taste, sore throat, nausea, vomiting, dizziness, and fatigue after using Trudhesa.

Contact your doctor immediately if you experience:

  • Numbness or tingling in your fingers and toes
  • Severe tightness, pain, pressure, heaviness, or discomfort in your chest
  • Muscle pain or cramps in your arms or legs
  • Cold feeling or color changes in 1 or both legs or feet
  • Sudden weakness
  • Slurred speech
  • Swelling or itching

The risk information provided here is not comprehensive. To learn more, talk about Trudhesa with your healthcare provider or pharmacist. The FDA-approved product labeling can be found at or 1-800-555-DRUG. You can also call 1-833-TRUDHESA (1-833-878-3437) for additional information.

Impel, POD and the Impel logo are trademarks of Impel Pharmaceuticals Inc.

© 2022 Impel Pharmaceuticals Inc. All Rights Reserved.

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