Imitrex vs. Ubrelvy
See how Imitrex and Ubrelvy compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Imitrex is a triptan taken at the first sign of a migraine, while Ubrelvy is a gepant that works through a different pathway with fewer cardiovascular restrictions.
Imitrex is available as a tablet, injection, or nasal spray, while Ubrelvy comes only as an oral tablet.
Ubrelvy typically costs more per month than Imitrex without insurance, and both usually need prior authorization from insurers.
Imitrex vs. Ubrelvy Drug Summary
Imitrex
Imitrex (sumatriptan) is a triptan that treats acute migraine attacks by narrowing blood vessels and blocking pain pathways in the brain. It comes as an oral tablet, subcutaneous injection, or nasal spray, and is taken at the first sign of a migraine with or without aura.
Ubrelvy
Ubrelvy (ubrogepant) is a CGRP receptor antagonist that treats acute migraine attacks by blocking a protein involved in migraine pain. It is taken as an oral tablet at the onset of a migraine, with a second dose allowed if symptoms return.
Imitrex vs. Ubrelvy Side Effects
Imitrex
Ubrelvy
Imitrex vs. Ubrelvy Dosage
Imitrex
Ubrelvy
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg, 50 mg, or 100 mg | At the start |
| Maximum dose | Repeat dose, max 200mg/day | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg or 100 mg orally | At the start |
| Maximum dose | 50 mg or 100 mg (2nd dose) | If needed |
| Dose changes | 1 increase | As tolerated |
Imitrex
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg, 50 mg, or 100 mg | At the start |
| Maximum dose | Repeat dose, max 200mg/day | If needed |
| Dose changes | 1 increase | As tolerated |
Ubrelvy
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg or 100 mg orally | At the start |
| Maximum dose | 50 mg or 100 mg (2nd dose) | If needed |
| Dose changes | 1 increase | As tolerated |
Imitrex vs. Ubrelvy Indications
Imitrex
Imitrex is FDA-approved for acute treatment of migraine with or without aura in adults; the injectable form also treats cluster headache. It is not approved for migraine prevention, hemiplegic or basilar migraine, or use in patients under 18.
Acute migraine attacks with or without aura
Cluster headache (injection form only)
Adults only for tablet form
Not for migraine prevention
Ubrelvy
Ubrelvy is FDA-approved for the acute treatment of migraine with or without aura in adults. It is not approved for preventive treatment of migraine, for hemiplegic or basilar migraine, or for use in children or teenagers under 18.
Acute migraine attacks with or without aura
Not approved for migraine prevention
Adults only
Not studied in pediatric patients
Imitrex vs. Ubrelvy Pros and Cons
Imitrex
Imitrex has decades of real-world use and multiple delivery options for people who need faster relief or cannot swallow pills during an attack. Its triptan mechanism means it is contraindicated in people with heart disease or uncontrolled blood pressure.
Pros
Available as tablet, injection, or nasal spray
Long track record since 1992 approval
Also approved for cluster headache (injection)
Roughly $650 to $850 per month without insurance, before savings programs
Cons
Contraindicated in coronary artery disease
Cannot combine with other triptans or ergots within 24 hours
Risk of serotonin syndrome with SSRIs/SNRIs
Not for people with uncontrolled hypertension
Ubrelvy
Ubrelvy works through a different pathway than triptans, so it can be an option for people who cannot take triptans due to cardiovascular risk. It requires dose adjustments with certain drug interactions and is only available as a tablet.
Pros
No cardiovascular contraindications like triptans
Option for patients who cannot use triptans
No restriction on combining with triptans same day
Simple two-dose regimen if needed
Cons
Only available as an oral tablet
Interacts with strong CYP3A4 inhibitors
Dose adjustment needed for severe kidney impairment
Roughly $1,085 to $1,140 per month without insurance, before savings programs
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