Sumatriptan vs. Aimovig

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

Key Takeaways

  • Sumatriptan is a fast-acting triptan taken at the first sign of a migraine attack, while Aimovig is a once-monthly injection used to prevent migraines before they start.

  • Sumatriptan stops pain that has already begun but is not meant for daily prevention and carries cardiovascular warnings that rule it out for some people.

  • Aimovig targets the CGRP receptor to reduce how often migraines happen, but it does nothing once an attack is already underway.

Sumatriptan vs. Aimovig Drug Summary

Sumatriptan

Sumatriptan is a triptan, a serotonin receptor agonist that treats a migraine attack once it starts. It comes as a tablet, injection, or nasal spray and is taken as needed, not on a daily schedule.

Aimovig

Aimovig is a monoclonal antibody that blocks the CGRP receptor, a pathway linked to migraine attacks. It is given as a once-monthly injection to prevent migraines, not to treat one already underway.

Sumatriptan vs. Aimovig Side Effects

Sumatriptan

Most common
Paresthesia (up to 6%)
Flushing (up to 3%)
Vertigo (up to 2%)
Malaise or fatigue (up to 2%)

Aimovig

Most common
Injection site reactions (5-6%)
Constipation (up to 3%)
Cramps or muscle spasms (up to 2%)
Pruritus (up to 1%)

Sumatriptan vs. Aimovig Dosage

Sumatriptan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg once per attack At the start
Maximum dose 100 mg once per attack If needed
Dose changes 2 increases 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

Sumatriptan vs. Aimovig Indications

Sumatriptan

Sumatriptan is FDA-approved for the acute treatment of migraine with or without aura in adults. It is meant to stop a migraine attack that has already begun, not to prevent future attacks.

  • Stops a migraine attack already in progress

  • Works for migraine with or without aura

  • Taken as needed, not on a fixed schedule

  • Available as tablet, injection, or nasal spray

  • Not approved to prevent migraines

Aimovig

Aimovig is FDA-approved for the preventive treatment of migraine in adults. It is meant to reduce how often migraines occur, not to relieve pain during an attack already underway.

  • Reduces how often migraine attacks occur

  • Given as one injection per month

  • Not effective for stopping an active attack

  • First CGRP receptor monoclonal antibody approved

  • Used long-term for ongoing prevention

Sumatriptan vs. Aimovig Pros and Cons

Sumatriptan

Sumatriptan has decades of clinical use and a well-established safety profile for stopping migraine pain quickly. It costs far less than newer preventive options but is not suitable for people with cardiovascular disease and cannot prevent attacks from happening.

Pros

  • Fast-acting relief once a migraine attack starts

  • Available as tablet, injection, or nasal spray

  • Decades of real-world clinical use

  • Roughly $12 to $185 per month for 9 tablets, much less than Aimovig

Cons

  • Contraindicated with heart disease, stroke history, or Prinzmetal's angina

  • Risk of serotonin syndrome with other serotonergic medications

  • Cannot be used to prevent migraines from occurring

  • Frequent use raises risk of medication overuse headache

Aimovig

Aimovig offers a simple once-monthly dosing schedule aimed at reducing migraine frequency rather than treating attacks in progress. It avoids the cardiovascular contraindications of triptans but carries a much higher price tag and a shorter track record than older medications.

Pros

  • Only needs one injection per month

  • Reduces how often migraine attacks happen over time

  • No cardiovascular contraindications like triptans carry

  • Targets the CGRP pathway directly involved in migraine

Cons

  • Does not relieve pain once an attack has started

  • Roughly $783 to $943 per month before insurance, much more than sumatriptan

  • Constipation risk, including rare serious complications

  • Less long-term safety data than older migraine medications

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