*Eligibility Criteria/Terms and Conditions: By using the MIGRANAL coupon, you confirm that you understand and agree to comply with the following terms and conditions of this offer:
  • This offer is only valid for patients with commercial insurance.
  • This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan or any other federal or state health care programs.
  • You agree not to seek reimbursement for all or any part of the benefit received through this offer and are responsible for making any required reports of your use of this offer to any insurer or other third party who pays any part of the prescription filled.
  • This offer is good only in the United States of America (including the District of Columbia, Puerto Rico and the U.S. Virgin Islands) at participating retail pharmacies.
  • You must be 18 years of age or older to redeem this offer.
  • You must present the coupon along with your prescription to participate in this program. You must activate the coupon before using by calling 1-855-330-3269 or by visiting www.migranal.com.
  • The coupon is good for use only with the products identified herein. No other purchase is necessary.
  • This offer cannot be redeemed at government-subsidized clinics.
  • The coupon is good for a maximum of 12 30-day prescription fills.
  • Patient is responsible for paying the first $5 for their MIGRANAL Generic prescription or the first $35 for their MIGRANAL prescription. Valeant Pharmaceuticals will be responsible to pay any remaining co-payment for each eligible prescription fill using the coupon up to a maximum amount of $250 per fill. Patient is responsible for all additional costs and expenses after maximum limits are reached.
  • The coupon and offer are not health insurance.
  • The selling, purchasing, trading, or counterfeiting of the coupon is prohibited by law. Void if reproduced.
  • This offer is not valid with other offers. The coupon has no cash value. No cash back.
  • Valeant Pharmaceuticals reserves the right to rescind, revoke, terminate, or amend this offer at any time, without notice.
  • You understand and agree to comply with the terms and conditions of this offer as set forth above.
  • This offer and coupon expire on 12/31/16.
  • For questions call: 1-844-247-3986.

Helpful Resources

Patient Education Materials

How to use MIGRANAL

 

My Migraine Medication Checklist

Patients complete this checklist to help determine how their medication is working.

 

American Headache Society® (AHS) Guidelines

MIGRANAL is DHE Nasal Spray, a Group 1 treatment option for migraines (the same category as triptans) according to AHS US Headache Consortium Guidelines. Group 1 treatments provide "proven, pronounced statistical and clinical benefit."2

Group 1
“Proven, pronounced statistical and clinical benefit”a
DHE Nasal Spray
Triptans PO, SC, or IN
Dihydroergotamine SC, IM, or IV
Some analgesics
Groupings do not imply superiority to other treatment options.
PO=per oral; SC=subcutaneous; IN=intranasal; IM=intramuscular; IV=intravenous.
aAt least 2 double-blind placebo-controlled studies and clinical impression of effect.

 

INDICATIONS AND USAGE

Migranal® (dihydroergotamine mesylate, USP) Nasal Spray is indicated for the acute treatment of migraine headaches with or without aura. Migranal Nasal Spray is not intended for the prophylactic therapy of migraine or for the management of hemiplegic or basilar migraine.

IMPORTANT SAFETY INFORMATION

WARNING

Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of DIHYDROERGOTAMINE with potent CYP3A4 inhibitors including protease inhibitors and macrolide antibiotics. Because CYP3A4 inhibition elevates the serum levels of DIHYDROERGOTAMINE, the risk for vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased. Hence, concomitant use of these medications is contraindicated.

  • Migranal Nasal Spray should not be given to patients with ischemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or to patients who have clinical symptoms or findings consistent with coronary artery vasospasm, including Prinzmetal's variant angina.
  • Migranal Nasal Spray also should not be given to patients with uncontrolled hypertension, patients who have used 5-HT1 agonists, ergotamine-containing or ergot-type medications, or methysergide within the last 24 hours.
  • Migranal Nasal Spray should not be administered to patients with hemiplegic or basilar migraine.
  • Migranal Nasal Spray is also contraindicated in patients with known peripheral arterial disease, sepsis, following vascular surgery, and severely impaired hepatic or renal function.
  • Migranal Nasal Spray may cause fetal harm and possesses oxytocic properties and therefore, should not be administered to pregnant women and should not be used by nursing mothers.
  • Migranal Nasal Spray is contraindicated in patients who have previously shown hypersensitivity to ergot alkaloids.
  • Migranal Nasal Spray should not be used with peripheral and central vasoconstrictors because the combination may result in additive or synergistic elevation of blood pressure.
  • Migranal Nasal Spray should only be used where a clear diagnosis of migraine headache has been established.
  • Migranal should not be used by patients with documented ischemic or vasospastic coronary artery disease. Migranal should not be administered unless a cardiovascular evaluation provides satisfactory clinical evidence that a patient with risk factors (e.g., hypertension, hypercholesterolemia, smoker, obesity, diabetes, strong family history of CAD, females who are surgically or physiologically postmenopausal, or males who are over 40 years of age) is reasonably free of unrecognized coronary artery disease (CAD). Even for patients with a satisfactory cardiovascular evaluation, it is strongly recommended that administration of the first dose of Migranal take place in the setting of a medically staffed facility.
  • During clinical studies and the foreign postmarketing experience with Migranal Nasal Spray, there have been no fatalities due to cardiac events. Serious cardiac events, including some that have been fatal, have occurred following use of dihydroergotamine mesylate injection, but are extremely rare.
  • The most commonly reported adverse events in clinical trials for Migranal Nasal Spray were rhinitis, altered sense of taste, application site reactions, dizziness, nausea, and vomiting. Adverse events associated with discontinuation were rhinitis, dizziness, facial edema, cold sweats, accidental trauma, depression, elective surgery, somnolence, allergy, vomiting, hypotension, and paresthesia.
Please click here for full Prescribing Information for Migranal Nasal Spray, including Boxed Warning and Patient Information.
 
 
 

REFERENCES

  • 1. MIGRANAL [package insert]. Aliso Viejo, CA: Valeant Pharmaceuticals North America; 2014.
  • 2.Silberstein SD; US Headache Consortium. Practice Parameter: evidence-based guidelines for migraine headache (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55(6):754-762.
  • 3.Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: the American Headache Society Evidence Assessment of migraine pharmacotherapies. Headache. 2015;55:3-20.

MIG.0065.USA.18

INDICATION AND USAGE

Migranal® (dihydroergotamine mesylate, USP) Nasal Spray is indicated for the acute treatment of migraine headaches with or without aura. Migranal Nasal Spray is not intended for the prophylactic therapy of migraine or for the management of hemiplegic or basilar migraine.

IMPORTANT SAFETY INFORMATION

WARNING

Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of DIHYDROERGOTAMINE with potent CYP3A4 inhibitors including protease inhibitors and macrolide antibiotics. Because CYP3A4 inhibition elevates the serum levels of DIHYDROERGOTAMINE, the risk for vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased. Hence, concomitant use of these medications is contraindicated.

  • Migranal Nasal Spray should not be given to patients with ischemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or to patients who have clinical symptoms or findings consistent with coronary artery vasospasm, including Prinzmetal's variant angina.
  • Migranal Nasal Spray also should not be given to patients with uncontrolled hypertension, patients who have used 5-HT1 agonists, ergotamine-containing or ergot-type medications, or methysergide within the last 24 hours.
  • Migranal Nasal Spray should not be administered to patients with hemiplegic or basilar migraine.
  • Migranal Nasal Spray is also contraindicated in patients with known peripheral arterial disease, sepsis, following vascular surgery, and severely impaired hepatic or renal function.
  • Migranal Nasal Spray may cause fetal harm and possesses oxytocic properties and therefore, should not be administered to pregnant women and should not be used by nursing mothers.
  • Migranal Nasal Spray is contraindicated in patients who have previously shown hypersensitivity to ergot alkaloids.
  • Migranal Nasal Spray should not be used with peripheral and central vasoconstrictors because the combination may result in additive or synergistic elevation of blood pressure.
  • Migranal Nasal Spray should only be used where a clear diagnosis of migraine headache has been established.
  • Migranal should not be used by patients with documented ischemic or vasospastic coronary artery disease. Migranal should not be administered unless a cardiovascular evaluation provides satisfactory clinical evidence that a patient with risk factors (e.g., hypertension, hypercholesterolemia, smoker, obesity, diabetes, strong family history of CAD, females who are surgically or physiologically postmenopausal, or males who are over 40 years of age) is reasonably free of unrecognized coronary artery disease (CAD). Even for patients with a satisfactory cardiovascular evaluation, it is strongly recommended that administration of the first dose of Migranal take place in the setting of a medically staffed facility.
  • During clinical studies and the foreign postmarketing experience with Migranal Nasal Spray, there have been no fatalities due to cardiac events. Serious cardiac events, including some that have been fatal, have occurred following use of dihydroergotamine mesylate injection, but are extremely rare.
  • The most commonly reported adverse events in clinical trials for Migranal Nasal Spray were rhinitis, altered sense of taste, application site reactions, dizziness, nausea, and vomiting. Adverse events associated with discontinuation were rhinitis, dizziness, facial edema, cold sweats, accidental trauma, depression, elective surgery, somnolence, allergy, vomiting, hypotension, and paresthesia.
Please click here for full Prescribing Information for Migranal Nasal Spray, including Boxed Warning and Patient Information.