Nurtec vs. Aimovig

See how Nurtec and Aimovig compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Nurtec is the only oral CGRP drug approved for both stopping a migraine attack and preventing episodic migraine, while Aimovig is approved only for prevention.

  • Nurtec is a dissolving tablet taken as needed or every other day, while Aimovig is a once-monthly self-injection.

  • Aimovig has a lower typical list price than Nurtec, but it requires self-injection and cannot treat a migraine once it has started.

Nurtec vs. Aimovig Drug Summary

Nurtec

Nurtec is a CGRP receptor antagonist that comes as an orally disintegrating tablet. It is FDA-approved both to stop a migraine attack once it starts and to prevent episodic migraine, using the same 75 mg dose for either purpose.

Aimovig

Aimovig is a monoclonal antibody that blocks the CGRP receptor, given as a once-monthly injection. It is FDA-approved only to prevent migraine attacks and is not used to treat an attack in progress.

Nurtec vs. Aimovig Side Effects

Nurtec

Most common
nausea (up to 2.7%)
abdominal pain/dyspepsia (up to 2.4%)

Aimovig

Most common
injection site reactions (5-6%)
constipation (up to 3%)

Nurtec vs. Aimovig Dosage

Nurtec

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 75 mg as needed At the start
Maximum dose 75 mg every other day If needed
Dose changes 1 increase As tolerated

Aimovig

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 70 mg once monthly At the start
Maximum dose 140 mg once monthly If needed
Dose changes 1 increase As tolerated

Nurtec vs. Aimovig Indications

Nurtec

Nurtec is FDA-approved to treat a migraine attack once it starts and to prevent episodic migraine, using the exact same 75 mg tablet for both. This dual approval means some patients can use one prescription for two different needs. It is not approved for chronic migraine or cluster headache.

  • Acute treatment of migraine with or without aura

  • Preventive treatment of episodic migraine

  • Same tablet strength used for both purposes

  • Not approved for chronic migraine or cluster headache

Aimovig

Aimovig is FDA-approved only to prevent migraine attacks before they happen, taken as a monthly injection. It is not approved to treat a migraine once symptoms begin, so it cannot replace an acute medication. It is intended for ongoing, long-term prevention rather than occasional use.

  • Preventive treatment of migraine in adults

  • Not indicated for treating an attack once it begins

  • Given as a once-monthly self-injection

  • Used continuously for ongoing prevention

Nurtec vs. Aimovig Pros and Cons

Nurtec

Nurtec is the only oral CGRP medication approved to both stop a migraine in progress and prevent future attacks, using the same tablet for both purposes. It dissolves without water, which appeals to people who have trouble swallowing pills during an attack. It generally costs more out of pocket than Aimovig.

Pros

  • Only oral CGRP drug approved for both acute and preventive use

  • Dissolves under the tongue, no water needed

  • Flexible as-needed dosing for acute attacks

  • No dose titration required, starts at full strength

Cons

  • Typically $1,000 to $1,376 per month without insurance, higher than Aimovig

  • Must avoid strong CYP3A4 inhibitors due to interaction risk

  • Daily decision-making needed on whether and when to dose

  • No generic version available

Aimovig

Aimovig is dosed once a month as a subcutaneous injection, aimed only at preventing migraine attacks over time. It does not treat migraines once they start, so many patients still need a separate acute medication on hand. It typically costs less out of pocket than Nurtec.

Pros

  • Only 12 doses needed per year

  • Typically $783 to $943 per month without insurance, lower than Nurtec

  • As an antibody, has no known CYP450 drug interactions

  • Prefilled autoinjector simplifies at-home dosing

Cons

  • Requires self-injection with a needle

  • Cannot treat a migraine attack that has already started

  • Constipation risk, including rare serious complications

  • Injection site reactions are common

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