Ubrelvy vs. Emgality
See how Ubrelvy and Emgality compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Ubrelvy is an oral tablet taken during a migraine attack, while Emgality is a once-monthly injection used to prevent migraines before they start.
Ubrelvy works within hours to treat a migraine already underway; Emgality takes weeks to build up its preventive effect and isn't for active attacks.
Emgality is also approved for episodic cluster headache, a use Ubrelvy does not have.
Ubrelvy vs. Emgality Drug Summary
Ubrelvy
Ubrelvy (ubrogepant) is an oral CGRP receptor antagonist used for the acute treatment of migraine, with or without aura, in adults. It's taken as a single tablet at the first sign of a migraine, with a second dose allowed at least 2 hours later if needed. It does not prevent migraines from occurring.
Emgality
Emgality (galcanezumab-gnlm) is a monoclonal antibody that blocks CGRP, given as a once-monthly injection to prevent migraines in adults. It's also FDA-approved to treat episodic cluster headache, using a higher monthly dose during a cluster period. It does not treat a migraine that has already started.
Ubrelvy vs. Emgality Side Effects
Ubrelvy
Emgality
Ubrelvy vs. Emgality Dosage
Ubrelvy
Emgality
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg or 100 mg orally | At the start |
| Maximum dose | 50 mg or 100 mg (2nd dose) | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 240 mg | Day 1 |
| Maximum dose | 300 mg once monthly | If needed |
| Dose changes | 2 increases | As tolerated |
Ubrelvy
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg or 100 mg orally | At the start |
| Maximum dose | 50 mg or 100 mg (2nd dose) | If needed |
| Dose changes | 1 increase | As tolerated |
Emgality
| STAGE | DOSE | WHEN |
| Starting dose | 240 mg | Day 1 |
| Maximum dose | 300 mg once monthly | If needed |
| Dose changes | 2 increases | As tolerated |
Ubrelvy vs. Emgality Indications
Ubrelvy
Ubrelvy is FDA-approved for the acute treatment of migraine with or without aura in adults. It's taken as needed when a migraine starts, not on a fixed schedule. It is not approved to prevent migraines or for use in children.
Acute treatment of migraine with aura
Acute treatment of migraine without aura
Not approved for migraine prevention
Not approved for pediatric patients
Emgality
Emgality is FDA-approved to prevent migraines in adults, reducing how often they occur. It's also approved to treat episodic cluster headache using a different, higher dose. It is not approved to treat an active migraine attack or for use in children.
Preventive treatment of migraine in adults
Treatment of episodic cluster headache in adults
Not approved for acute migraine treatment
Not approved for pediatric patients
Ubrelvy vs. Emgality Pros and Cons
Ubrelvy
Ubrelvy works fast as a rescue tablet for a migraine already underway, with no titration or loading dose required. It carries important drug interaction warnings, especially with CYP3A4 inhibitors, and may need dose adjustments in some patients. It does not reduce how often migraines occur.
Pros
Oral tablet, no injections needed
Taken only when a migraine strikes, no fixed schedule
Second dose available same day if the first doesn't fully work
No loading dose or titration period before it starts working
Cons
Must be taken with each attack, doesn't prevent migraines
Interacts with many common drugs metabolized by CYP3A4
Contraindicated with strong CYP3A4 inhibitors
Needs dose adjustment for severe kidney impairment
Emgality
Emgality is dosed just once a month after a single loading dose, making it convenient for long-term migraine prevention. It requires self-injection and takes time to reach full effect, so it isn't useful during an active migraine. It carries fewer drug interaction concerns since it isn't processed through the liver's CYP3A4 pathway.
Pros
Only needs to be dosed once a month after the first dose
Approved for both migraine prevention and cluster headache
First FDA-approved drug shown to reduce cluster headache attacks
Fewer drug interaction concerns than oral CGRP tablets
Cons
Requires self-injection, which some patients dislike
Needs a loading dose before reaching the regular monthly dose
Injection site reactions are common
Takes weeks to build up effect, not for an active migraine
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