Sumatriptan vs. Nurtec
See how Sumatriptan and Nurtec compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Sumatriptan is a fast-acting triptan used only to stop an active migraine attack, while Nurtec (rimegepant) can both treat an attack and prevent future episodic migraines.
Sumatriptan comes in tablet, injection, and nasal spray forms and is one of the most affordable migraine medications, especially as a generic.
Nurtec dissolves on the tongue without water and avoids the cardiovascular restrictions of triptans, but it costs far more out of pocket with no generic option.
Sumatriptan vs. Nurtec Drug Summary
Sumatriptan
Sumatriptan is a triptan that works by narrowing swollen blood vessels in the brain to relieve migraine pain. It is FDA-approved only for the acute treatment of migraine attacks, not for prevention. Most people take a tablet as soon as symptoms start, with a second dose allowed later if the migraine returns.
Nurtec
Nurtec (rimegepant) is a CGRP receptor antagonist that blocks a protein involved in migraine pain signaling. It is FDA-approved both to stop an active migraine and to prevent episodic migraines, using the same dissolving tablet either way. Most people take one tablet as needed or every other day for prevention, dissolved on the tongue.
Sumatriptan vs. Nurtec Side Effects
Sumatriptan
Nurtec
Sumatriptan vs. Nurtec Dosage
Sumatriptan
Nurtec
| 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 |
| 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 |
Sumatriptan
| 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 |
Nurtec
| 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 |
Sumatriptan vs. Nurtec Indications
Sumatriptan
Sumatriptan is FDA-approved only for the acute treatment of migraine attacks with or without aura in adults. It is not approved to prevent migraines or to treat cluster headaches in tablet form. It works best when taken right as migraine symptoms begin.
Treats acute migraine attacks with or without aura
Available as tablet, injection, or nasal spray
Not approved for migraine prevention
Not approved for cluster headache in tablet form
Nurtec
Nurtec is FDA-approved for both the acute treatment of migraine attacks and the prevention of episodic migraine in adults, using the same tablet for either purpose. It is not approved for chronic migraine prevention or cluster headache.
Treats acute migraine attacks with or without aura
Prevents episodic migraine attacks
Same tablet used for acute and preventive dosing
Not approved for chronic migraine prevention
Sumatriptan vs. Nurtec Pros and Cons
Sumatriptan
Sumatriptan has decades of real-world use and is one of the most affordable migraine medications available, especially as a generic. It is not suitable for people with heart disease or a history of stroke, and it only treats attacks that have already started.
Pros
Available as tablet, injection, or nasal spray for faster options
Generic pricing, roughly $12 to $185 per 9 tablets
Long track record with decades of clinical use
Works within the same day it's taken for an active attack
Cons
Contraindicated with heart disease, stroke history, or Prinzmetal's angina
Not approved to prevent migraines from happening
Cannot be combined with ergotamines or other triptans within 24 hours
Nurtec
Nurtec offers the flexibility of treating an active migraine and preventing future episodic migraines with one medication. It carries a much higher price tag than sumatriptan with no generic option, and it is not suitable for people who need to avoid strong CYP3A4 inhibitor interactions.
Pros
Can both treat attacks and prevent episodic migraines
Dissolves on the tongue without water for easy dosing
No cardiovascular contraindications like triptans have
Fewer reported common side effects in clinical trials
Cons
Costs roughly $1,000 to $1,376 per month with no generic
Can cause serious hypersensitivity reactions, sometimes days later
May raise blood pressure or worsen Raynaud's phenomenon
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