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

Most common
paresthesia (≥2%)
warm/cold sensation (≥2%)

Nurtec

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

Sumatriptan vs. Nurtec 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

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

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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