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Zavegepant

Phase 3

Migraine | Small molecule | Neurology |Pfizer, Inc.|Last Updated: Jul 20, 2026

Target and mechanism

Molecular targetCALCRL, RAMP1
Target classAntagonist
ModalitySmall molecule

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials3
Total Enrollment5,546

FDA Designations

No designations recorded

Clinical trial landscape

Zavegepant · 9 trials · 5 indications

Phase 3 2Phase 2 3Phase 1 4
NCT05989048A Study to Learn About Zavegepant as the Acute Treatment of Migraine in Asian AdultsMigraine
COMPLETED1,414 Analytics
NCT04571060Randomized Trial in Adult Participants With Acute MigrainesMigraine
COMPLETED1,978 Analytics
PHASE3COMPLETED
A Study to Learn About Zavegepant as the Acute Treatment of Migraine in Asian Adults
MigraineUnlock trial analytics
PHASE3COMPLETED
Randomized Trial in Adult Participants With Acute Migraines
MigraineUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants With Pain Freedom at 2 Hours Post-dose
At 2 hours post-dose

Pain freedom was defined as pain intensity being none at the specified time point. Participants recorded their headache pain intensity using 4-point numeric rating scale (0= none, 1= mild, 2= moderate, 3= severe).

Percentage of Participants With Freedom From Most Bothersome Symptom (MBS) at 2 Hours Post-dose
At 2 hours post-dose

MBS was selected from nausea, phonophobia or photophobia before dosing by the participants. In this outcome measure, percentage of participants who recorded an MBS (present) before dosing and did not have the MBS (absent) at the time of evaluation (i.e., 2 hours post-dose) were reported.

Percentage of Participants With Freedom From Pain at 2 Hours Post-dose
2 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the electronic clinical outcome assessment (eCOA) handheld device. Pain freedom was defined as pain level of none post-dose.

Percentage of participants who achieve minimal pain at 30 minutes following their first administration of zavegepant 20mg.
end of study (up to 70 days from baseline)

Minimal pain is defined as 0 or 1 on the 0-4 numerical rating scale.

Number Of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) and AEs Leading To Discontinuation
From study drug dosing up to the end of the study (up to 52 weeks)

An AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in participants or clinical investigation participants administered an investigational (medicinal) product that does not necessarily have a causal relationship with this treatment. An SAE was defined as any event that met any of the following criteria at any dose: death; life-threatening; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect in the offspring of a participant who received study drug; other important medical events that may not have resulted in death, be life-threatening, or required hospitalization, based upon appropriate medical judgment, they may have jeopardized the participant and may have required medical or surgical intervention to prevent one of the other serious outcomes.

Number Of Participants With Clinically Significant Laboratory Abnormalities
From study drug dosing up to the end of the study (up to 52 weeks)

Clinically significant laboratory abnormalities were defined as Grades 3 to 4 laboratory test results according to numeric laboratory test criteria found in Common Technical Criteria for Adverse Events Version 5.0 (2017) if available; otherwise, according to Division of Acquired Immune Deficiency Syndrome. Table for Grading the Severity of Adult and Pediatric Adverse Events Corrected Version 2.1 (2017) for glucose, low-density lipoprotein (LDL)-cholesterol, uric acid, and urinalysis. Laboratory test groups of clinical interest included hematology, serum chemistry, and urinalysis. Participants must have had a non-missing measurement in to be included for a given parameter. Laboratory results were presented in US units.

Maximum Observed Plasma Concentration (Cmax)
Day 1: 0 hour, 1.25 hours, 3.5 hours; Day 2: 18 hours

Cmax is defined as the maximum observed plasma concentration of zavegepant after administration of a single dose

Time to Reach Maximum Observed Plasma Concentration (Tmax)
Day 1: 0 hour, 1.25 hours, 3.5 hours; Day 2: 18 hours

Tmax is defined as the time to reach maximum observed plasma concentration

Area Under the Curve From Time Zero to infinity.
Day 1: 0 hour, 1.25 hours, 3.5 hours; Day 2: 18 hours

AUC (0 - inf) is defined as area under the concentration-time curve from time 0 to infinity.

Area Under the Breast Milk Concentration-time Profile from time 0 extrapolated to infinite time (AUCinf), if data permit
0 to 2, 2 to 4, 4 to 6, 6 to 8, 8 to 12, 12 to 16, 16 to 24 hours

AUCinf = Area under the breast milk concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf). It is obtained from AUC (0-t) plus AUC (t-inf).

Area Under the Breast Milk Concentration-time Profile From Time Zero to the Time of Last Quantifiable Concentration (AUClast)
0 to 2, 2 to 4, 4 to 6, 6 to 8, 8 to 12, 12 to 16, 16 to 24 hours

Area under the breast milk concentration time-curve from zero to the last measured concentration (AUClast)

Area Under the Breast Milk Concentration-time Profile From Time Zero to the Time of 24 hr post dose (AUC24)
0 to 2, 2 to 4, 4 to 6, 6 to 8, 8 to 12, 12 to 16, 16 to 24 hours

AUC24= Area under the breast milk concentration versus time curve from time zero (pre-dose) to time 24 hours

Maximum observed breast milk concentration (Cmax)
0 to 24 hours post dose
Time for Cmax in Breast Milk (Tmax)
0 to 24 hours post dose
Terminal half-life for breast milk (t 1/2), if data permit
0 to 24 hours post dose
Cmax of Zavegepant in Plasma Following Single Dose of Zavegepant 10 mg IN
0 (pre-dose), 5 min, 10 min, 20 min, 30 min, 40 min, 50 min, 1 hour, 1.5 hours, 2 hours, 3 hours, 4 hours, 8 hours, 12 hours, 16 hours, 24 hours post dose on Day 1

Maximum plasma concentration (Cmax) was measured.

AUClast of Zavegepant in Plasma Following Single Dose of Zavegepant 10 mg IN
0 (pre-dose), 5 min, 10 min, 20 min, 30 min, 40 min, 50 min, 1 hour, 1.5 hours, 2 hours, 3 hours, 4 hours, 8 hours, 12 hours, 16 hours, 24 hours post dose on Day 1

AUClast, area under the plasma concentration-time profile from time 0 to the time of the last quantifiable concentration (Clast), was measured.

AUCinf of Zavegepant in Plasma Following Single Dose of Zavegepant 10 mg IN
0 (pre-dose), 5 min, 10 min, 20 min, 30 min, 40 min, 50 min, 1 hour, 1.5 hours, 2 hours, 3 hours, 4 hours, 8 hours, 12 hours, 16 hours, 24 hours post dose on Day 1

AUCinf, area under the plasma concentration-time curve from time 0 extrapolated to infinite time, was measured.

Plasma Concentration of Zavegepant at 30 Minutes Post-dose on Day 1 of Period 1- Tasso Device Versus (vs.) Standard Venous Phlebotomy
30 minutes post-dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants pharmacokinetic (PK) samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Plasma Concentration of Zavegepant at 1 Hour Post-dose on Day 1 of Period 1- Tasso Device vs. Standard Venous Phlebotomy
1-hour post-dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Plasma Concentration of Zavegepant at 2 Hours Post-dose on Day 1 of Period 1- Tasso Device vs. Standard Venous Phlebotomy
2-hours post-dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Plasma Concentration of Zavegepant at 4 Hours Post-dose on Day 1 of Period 1- Tasso Device vs. Standard Venous Phlebotomy
4-hours post-dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Plasma Concentration of Zavegepant at 8 Hours Post-dose on Day 1 of Period 1- Tasso Device vs. Standard Venous Phlebotomy
8-hours post-dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Plasma Concentration of Zavegepant at 12 Hours Post-dose on Day 1 of Period 1- Tasso Device vs. Standard Venous Phlebotomy
12-hours post-dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Area Under the Plasma Concentration-Time Profile From Time Zero (0) Extrapolated to Infinite Time (AUCinf) of Zavegepant: - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Area Under the Plasma Concentration-Time Profile From Time 0 to the Time of Last Quantifiable Concentration (AUClast) of Zavegepant - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Maximum Plasma Concentration (Cmax) of Zavegepant - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Time for Cmax (Tmax) of Zavegepant - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Terminal Half-Life (t1/2) of Zavegepant - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

t1/2 was calculated as loge (2) per kel, where kel is the terminal phase rate constant calculated by a linear regression of the log-linear concentration-time curve. Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Apparent Clearance (CL/F) of Zavegepant - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Apparent Volume of Distribution (Vz/F) of Zavegepant - Tasso Device vs. Standard Venous Phlebotomy
Tasso: 0.5, 1, 2, 4, 8 and 12 hours post dose on Day 1 of Period 1; Venous: 0 (pre-dose), 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours post dose on Day 1 of Period 1

Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Vz/F is influenced by the fraction absorbed. Tasso device used was Tasso-Plus (for liquid blood sample collection). In Period 1, for the treated participants PK samples were collected using Tasso-Plus and simultaneously standard venous phlebotomy. Data was to be reported for Tasso-Plus vs. venous phlebotomy concentrations (same participants).

Secondary Endpoints

Percentage of Participants With Pain Relief at 15 Minutes Post-dose
At 15 minutes post-dose
Percentage of Participants With Pain Relief at 30 Minutes Post-dose
At 30 minutes post-dose
Percentage of Participants With Pain Relief at 2 Hours Post-dose
At 2 hours post-dose
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
ZavegepantEXPERIMENTALZavegepant intranasal 10 mg
PlaceboPLACEBO_COMPARATORPlacebo
Zavegepant (BHV-3500)EXPERIMENTAL10 mg intranasal (IN) up to 8 times per month, up to 1 year
Zavegepant 5 mgEXPERIMENTALParticipants administered a single intranasal dose of zavegepant 5 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar Unidose System (UDS) liquid spray device.
Zavegepant 10 mgEXPERIMENTALParticipants administered a single intranasal dose of zavegepant 10 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
Zavegepant 20 mgEXPERIMENTALParticipants administered a single intranasal dose of zavegepant 20 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
Zavegepant 10mgEXPERIMENTALIntranasal (IN) 10mg spray on Day 1
Zavegepant 10 mg Intranasal (IN)EXPERIMENTALAll participants will receive zavegepant 10 mg IN spray in period 1 and a butterscotch candy + zavegepant 10 mg IN spray in period 2

Interventions

NameTypeDescription
ZavegepantDRUGThe participants will receive single active dose sufficient to treat 1 migraine headache of moderate or severe intensity within Treatment Phase.
PlaceboDRUGSingle dose of matching placebo taken within Treatment Phase.
Zavegepant 20 mgDRUGParticipants will administer zavegepant 10 mg twice in quick succession (once into the left nostril, once into the right nostril, for a total of 20mg) to treat up to 3 separate cluster headache attacks maintaining a minimum interval of 48 hours between administrations.
Zavegepant (BHV-3500)DRUG10 mg IN up to 8 times per month, up to 1 year
Zavegepant matching placeboDRUGA single dose of placebo matched to zavegepant
Intranasal Aptar Pharma Unit Dose SystemDEVICEA single-dose intranasal device
Zavegepant 10mgDRUGintransal spray 10mg
Zavegepant 10 mg INDRUGAll participants will receive zavegepant 10 mg IN spray in period 1 and a butterscotch candy + zavegepant 10 mg IN spray in period 2
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites61

Inclusion Criteria: * Asian participants aged 18 years or older at screening. * Participants with minimum 1 year history of migraine (with or without aura) prior to the Screening Visit, consistent with a diagnosis according to the International Classification of Headache Disorders, 3rd Edition, inc...

Countries:ChinaSouth KoreaTaiwanUnited States
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Competitive Landscape -Migraine 30 trials

Recent Changes (Last 90 Days)

MEDIUMJun 22, 2026NCT05989048TRIAL_REMOVED: changed
MEDIUMJun 22, 2026NCT05989048TRIAL_REMOVED: changed
MEDIUMJun 22, 2026NCT05989048TRIAL_REMOVED: changed

Frequently asked questions about Zavegepant

What is Zavegepant used for?

Zavegepant is an investigational small molecule being studied for cluster headache, acute migraine, and acute treatment of migraine. It is also used in healthy volunteer studies to assess pharmacokinetics and breast milk transfer. The drug is in Phase 2 development for these neurology indications.

Who makes Zavegepant?

Zavegepant is being developed by Pfizer, Inc., which trades under the ticker PFE. The company is conducting clinical trials of the drug across multiple countries, including the United States and China.

What phase is Zavegepant in?

Zavegepant is in Phase 2 clinical development. It remains investigational and has not been approved by regulatory authorities. The drug is being evaluated for cluster headache and acute migraine, with ongoing trials in pediatric migraine patients.

What clinical trials is Zavegepant in?

Zavegepant has completed three Phase 1 trials: NCT05948085 comparing venous versus microsampling concentrations, NCT05960032 in healthy Chinese adults, and NCT06453356 in breastfeeding women. An active Phase 1 trial, NCT06995729, is recruiting children aged 6 years and older with a history of migraine.

Is Zavegepant the same as Zavegepant 20 mg?

Yes, Zavegepant 20 mg refers to the same drug, Zavegepant. The 20 mg designation specifies the dosage strength used in certain studies or formulations. Both names refer to the identical investigational compound being developed by Pfizer.

How does Zavegepant work?

Zavegepant is a small molecule designed to target pathways involved in migraine and cluster headache. As a neurology therapeutic, it is being studied for its ability to treat acute migraine episodes and cluster headache attacks, though its precise molecular target has not been disclosed in available trial information.