Sumatriptan vs. Zomig

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

Key Takeaways

  • Sumatriptan and Zomig are both triptans used to stop a migraine attack once it starts, not to prevent future attacks.

  • Sumatriptan is generally the more affordable option and also comes as a self-injection, while Zomig offers an orally disintegrating tablet for people too nauseated to swallow pills.

  • Zomig's label reports higher rates of fatigue, dizziness, and drowsiness than sumatriptan's, so people sensitive to sedating side effects may tolerate sumatriptan better.

Sumatriptan vs. Zomig Drug Summary

Sumatriptan

Sumatriptan is a triptan, or serotonin 5-HT1B/1D receptor agonist, used for the acute treatment of migraine with or without aura in adults. It is taken as a tablet at the first sign of migraine, in doses of 25, 50, or 100 mg per attack, and is also available as an injection or nasal spray.

Zomig

Zomig (zolmitriptan) is also a triptan used for the acute treatment of migraine with or without aura in adults. It comes as a regular tablet, an orally disintegrating tablet, or a nasal spray, with a typical single dose of 2.5 mg or 5 mg per attack.

Sumatriptan vs. Zomig Side Effects

Sumatriptan

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

Zomig

Most common
asthenia (up to 14%)
nausea (up to 12%)
paresthesia (up to 11%)
dizziness (up to 11%)

Sumatriptan vs. Zomig 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

Zomig

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1.25 mg or 2.5 mg At the start
Maximum dose 5 mg as single dose If needed
Dose changes 2 increases As tolerated

Sumatriptan vs. Zomig Indications

Sumatriptan

Sumatriptan is FDA-approved for the acute treatment of migraine with or without aura in adults. It is not intended to prevent migraine attacks and the tablet form is not approved for cluster headache. It works best when taken right when migraine symptoms begin.

  • Acute treatment of migraine attacks in adults

  • Not approved for migraine prevention

  • Tablet form not approved for cluster headache

  • Best taken at the first sign of a migraine

Zomig

Zomig is also FDA-approved for the acute treatment of migraine with or without aura in adults. Like sumatriptan, it is not approved to prevent migraine or treat cluster headache. It is not approved for children under 12 years old in tablet or ODT form.

  • Acute treatment of migraine attacks in adults

  • Not approved for migraine prevention

  • Not approved for cluster headache

  • Not approved for children under 12 (tablet/ODT)

Sumatriptan vs. Zomig Pros and Cons

Sumatriptan

Sumatriptan is the original triptan and remains one of the most affordable options for acute migraine treatment, especially as a generic tablet. It comes in three delivery forms, including a self-injection for people who need the fastest possible relief. Its long history on the market means extensive real-world safety data.

Pros

  • One of the most affordable triptans, roughly $12 to $185 per month without insurance, before savings programs

  • Available as a subcutaneous injection for faster relief during severe attacks

  • Longest-established triptan, approved in 1992 with decades of safety data

  • Generally lower reported rates of fatigue and dizziness than zolmitriptan

Cons

  • No orally disintegrating tablet option for patients with nausea or trouble swallowing

  • Only offers fixed 25, 50, and 100 mg doses, less flexible than Zomig's titration option

  • Tablet form is not approved for cluster headache

Zomig

Zomig offers similar migraine relief with the added convenience of an orally disintegrating tablet, useful for people who feel too nauseated to swallow. It also allows a lower starting dose for people sensitive to triptans. Its side effect rates for fatigue and dizziness run higher than sumatriptan's, and brand pricing can be substantially higher without insurance.

Pros

  • Available as an orally disintegrating tablet, helpful during nausea or vomiting

  • Offers a low 1.25 mg starting dose for more gradual titration

  • Nasal spray option for rapid absorption when swallowing pills is difficult

  • Short elimination half-life of about 3 hours

Cons

  • Higher reported rates of fatigue, dizziness, and drowsiness than sumatriptan

  • Requires a lower maximum dose when combined with cimetidine

  • Brand-name pricing can range from roughly $13 to $1,332 per month without insurance, before savings programs

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