The Connection Between Gastroparesis and Migraine - GP Migraine
Oral migraine medications may not work or be effective due to gastroparesis. Zembrace SymTouch (3 mg auto-injector) and Tosymra (10 mg nasal spray) provide an alternative to an oral medication for migraine relief.
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What’s the connection between Gastroparesis (GP) and Migraine?

Is it possible GP may be affecting how well your migraine pills work?

Gastroparesis (GP) is a condition where the stomach empties food into the small intestine slower than normal. This can cause symptoms of nausea, vomiting and stomach pain. Many studies over the past 40 years show a connection between GP and migraine. GP is common before, during, and sometimes in between migraine attacks.

For people with  migraine, GP can slow and even block the absorption of oral medication (pills), causing delayed, incomplete, or no migraine symptom relief.

Do you have GP?

Symptoms for GP can include:

Nausea and vomiting
Delayed or inconsistent pain relief after taking your medication
Inadequate relief from your (most bothersome symptom) after taking migraine medication
No pain relief after taking your migraine medication
Oral drug delivery is blocked by gastroparesis

These symptoms during a migraine attack can be signs that you are experiencing GP.

 

* Most bothersome symptoms (like nausea, photophobia [light sensitivity], and phonophobia [sound sensitivity])

Learn more about GP and migraine with these short videos

Gottschalk discusses migraine and gastroparesis

Dr. Christopher Gottschalk

Professor of Neurology, Director of Headache and Facial Pain Center —
Yale School of Medicine.

Video provided by Migraine Meanderings. All rights reserved. September 2024.

Take the “M”. The Migraine Treatment Optimization Quiz (03:25)

Why is it Important to Optimize Your Acute Treatment? (03:04)

Find Out More About Gastroparesis and Migraine (02:13)

Did you know?

Oral medications can only work if your stomach is functioning properly. If you are not completely satisfied with your oral medication, consider adding a non-oral option to your migraine treatment plan.

Non-oral migraine medications, such as nasal sprays and injections bypass the digestive system entirely. This means they can DELIVER medication for more reliable and faster relief from migraine symptoms, regardless of how your stomach is functioning.

Non-oral drug delivery bypasses gatroparesis
Zembrace SymTouch Gastroparesis

DISCUSSION GUIDE

Talk with your healthcare provider about GP & Migraine

An important step to understanding how to better manage your migraine pain and associated symptoms is to have a conversation with your healthcare provider. Use this printable guide to help start the conversation with your healthcare team to see if gastroparesis (GP) and migraine is affecting you.

Download and share with your healthcare provider

Choosing the right non-oral migraine medication should be based on the speed of onset, ease-of-use/convenience, and safety/tolerability.

Zembrace SymTouch Logo

Zembrace® SymTouch® is a prescription medicine used to treat acute migraine with or without aura in adults.

  • A thin, small hidden needle
  • Compact design
  • A simple two-step injection process

Please see:
Important Safety Information
Instructions for Use
Prescribing Information

Tosymra Logo

Tosymra® is a prescription medicine used to treat acute migraine with or without aura in adults.

  • Fine, mist-like spray
  • Discreet size
  • Single use device, no priming required

Please see:
Important Safety Information
Instructions for Use
Prescribing Information

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Do not take Zembrace® SymTouch® or Tosymra® if you have hemiplegic migraines or basilar migraines or to treat cluster headache.

IMPORTANT SAFETY INFORMATION
Zembrace SymTouch or Tosymra can cause serious side effects, including heart attack and other heart problems, which may lead to death. Stop Zembrace Symtouch or Tosymra and get emergency medical help if you have any signs of heart attack:

  • discomfort in the center of your chest that lasts for more than a few minutes or goes away and comes back
  • severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
  • pain or discomfort in your arms, back, neck, jaw or stomach
  • shortness of breath with or without chest discomfort
  • breaking out in a cold sweat
  • nausea or vomiting
  • feeling lightheaded

Zembrace and Tosymra are not for people with risk factors for heart disease (high blood pressure or cholesterol, smoking, overweight, diabetes, family history of heart disease) unless a heart exam shows no problem.

Do not use Zembrace or Tosymra if you have:

  • history of heart problems
  • narrowing of blood vessels to your legs, arms, stomach, or kidney (peripheral vascular disease)
  • uncontrolled high blood pressure
  • hemiplegic or basilar migraines. If you are not sure if you have these, ask your provider.
  • had a stroke, transient ischemic attacks (TIAs), or problems with blood circulation
  • severe liver problems
  • taken any of the following medicines in the last 24 hours: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, ergotamines, or dihydroergotamine. Ask your provider for a list of these medicines if you are not sure.
  • are taking certain antidepressants, known as monoamine oxidase (MAO)-A inhibitors or it has been 2 weeks or less since you stopped taking a MAO-A inhibitor. Ask your provider for a list of these medicines if you are not sure.
  • an allergy to sumatriptan or any of the components of Zembrace or Tosymra

Tell your provider about all of your medical conditions and medicines you take, including vitamins and supplements.

Zembrace and Tosymra can cause dizziness, weakness, or drowsiness. If so, do not drive a car, use machinery, or do anything where you need to be alert.

Zembrace and Tosymra may cause serious side effects including:

  • changes in color or sensation in your fingers and toes
  • sudden or severe stomach pain, stomach pain after meals, weight loss, nausea or vomiting, constipation or diarrhea, bloody diarrhea, fever
  • cramping and pain in your legs or hips; feeling of heaviness or tightness in your leg muscles; burning or aching pain in your feet or toes while resting; numbness, tingling, or weakness in your legs; cold feeling or color changes in one or both legs or feet
  • increased blood pressure including a sudden severe increase even if you have no history of high blood pressure
  • medication overuse headaches from using migraine medicine for 10 or more days each month. If your headaches get worse, call your provider.
  • serotonin syndrome, a rare but serious problem that can happen in people using Zembrace or Tosymra, especially when used with anti-depressant medicines called SSRIs or SNRIs. Call your provider right away if you have: mental changes such as seeing things that are not there (hallucinations), agitation, or coma; fast heartbeat; changes in blood pressure; high body temperature; tight muscles; or trouble walking.
  • hives (itchy bumps); swelling of your tongue, mouth, or throat
  • seizures even in people who have never had seizures before

The most common side effects of Zembrace and Tosymra include: pain and redness at injection site (Zembrance only); tingling or numbness in your fingers or toes; dizziness; warm, hot, burning feeling to your face (flushing); discomfort or stiffness in your neck; feeling weak, drowsy, or tired; application site (nasal) reactions (Tosymra only) and throat irritation (Tosymra only).

Tell your provider if you have any side effect that bothers you or does not go away. These are not all the possible side effects of Zembrace and Tosymra. For more information, ask your provider.

This is the most important information to know about Zembrace and Tosymra but is not comprehensive. For more information, talk to your provider and read the Patient Information and Instructions for Use. You can also visit https://www.tonixpharma.com or call 1-888-869-7633.

You are encouraged to report adverse effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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