Zomig vs. Aimovig
See how Zomig and Aimovig compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Zomig treats a migraine attack after it starts, while Aimovig is taken monthly to help prevent migraines before they begin.
Zomig comes as a tablet, dissolving tablet, or nasal spray for use as needed, while Aimovig is a once-monthly self-injection.
Zomig carries cardiovascular warnings that Aimovig does not, since Aimovig works through a different, non-vasoconstricting mechanism.
Zomig vs. Aimovig Drug Summary
Zomig
Zomig (zolmitriptan) is a triptan that treats a migraine attack once it has started by narrowing blood vessels and blocking pain signals in the brain. It's taken as needed as a tablet, a dissolving tablet, or a nasal spray, with an option to repeat the dose after two hours if the headache returns.
Aimovig
Aimovig (erenumab-aooe) is a monoclonal antibody that blocks the CGRP receptor to help prevent migraines before they start. It's given as a subcutaneous injection once a month, at a dose of 70 mg or 140 mg, using a prefilled autoinjector or syringe.
Zomig vs. Aimovig Side Effects
Zomig
Aimovig
Zomig vs. Aimovig Dosage
Zomig
Aimovig
| 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 |
| 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 |
Zomig
| 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 |
Aimovig
| 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 |
Zomig vs. Aimovig Indications
Zomig
Zomig is FDA-approved to treat a migraine attack with or without aura, in adults, once it has already started. It is not approved to prevent migraines, treat cluster headaches, or for use in children under 12 with the tablet or ODT forms.
Treats an active migraine attack, not prevention
Approved for adults with or without aura
Available as tablet, ODT, or nasal spray
Not approved for cluster headache
Tablet/ODT not approved under age 12
Aimovig
Aimovig is FDA-approved for the preventive treatment of migraine in adults, meaning it's taken regularly to reduce how often migraines occur. It is not intended to stop an attack that has already started.
Prevents migraines rather than treating an attack
Approved for adults only
Given as a once-monthly injection
Not approved for acute migraine treatment
No pediatric indication established
Zomig vs. Aimovig Pros and Cons
Zomig
Zomig offers fast relief once a migraine starts and comes in multiple forms, including a nasal spray for people who have trouble swallowing during an attack. Its cardiovascular warnings mean it isn't an option for everyone, and it does nothing to reduce how often migraines occur.
Pros
Available as tablet, ODT, or nasal spray
Taken as needed, no daily routine required
Generic version available, roughly $13 to $1,332 a month depending on formulation
Can be redosed after 2 hours if a migraine returns
Cons
Contraindicated in patients with cardiovascular disease
Risk of medication overuse headache with frequent use
Not approved for migraine prevention
Serotonin syndrome risk when combined with SSRIs/SNRIs
Aimovig
Aimovig targets the CGRP pathway to help prevent migraines before they start, requiring just one injection a month instead of daily or as-needed dosing. It lacks the cardiovascular warnings seen with triptans, but it comes with a higher price tag and no generic option.
Pros
Only one injection needed per month
No cardiovascular contraindications like triptans
Fewer and milder reported side effects overall
May reduce reliance on acute migraine medication
Cons
No generic option, roughly $783 to $943 a month without insurance
Requires self-injection rather than a pill
Does not treat a migraine attack once it starts
Postmarketing reports of severe constipation and hypersensitivity
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