Migraine headache affects 10% of people worldwide. People between 20 and 50 years old are the most commonly affected by this headache disorder. Women are three times more likely to develop migraines than men. Migraines cause severe headaches that are often characterized as throbbing in one area of the head -- this is actually one of the unique characteristics that distinguish between migraine and tension headache, as tension headache usually causes dull pain on both sides of the head.
In addition to the severe throbbing pain, migraines are also associated with other symptoms such as nausea, vomiting, and sensitivity to light and noise. Aura is another unique characteristic of migraine. Auras are visual disturbances described as flashing lights that can happen before or during a migraine attack.
The duration of a migraine can last between 4 to 72 hours. Migraine headaches can be very severe and debilitating. Not only can they reduce productivity by causing sick days at work or school, but migraines can also impact quality of life.
If you or your loved one suffer from migraines, a medication called sumatriptan may have been prescribed for you by your healthcare provider. Triptans are part of a class of medications that became available in 1993 for the treatment of migraine attacks after they start. There is no doubt about the role of triptans in the treatment of acute migraine; however, with new migraine medications approved for migraine treatment, you may wonder about the benefits of these new drug classes.
Ubrelvy is one of the newer migraine drugs approved in December of 2019. Similar to triptans, Ubrelvy is also used to treat migraine symptoms after they have started. Among the triptans drug class, Imitrex (sumatriptan) was the very first available in the market in 1993, and Imitrex remains one of the most commonly prescribed agents among triptans.
Please continue to read to learn about the similarities and differences between Ubrelvy and Imitrex and how they work to alleviate acute migraine symptoms.
What is Ubrelvy?
Ubrelvy basics
Ubrelvy is a prescription medication. Ubrelvy is the brand name containing the active ingredient, Ubrogepant. Currently, there is no generic version available for Ubrelvy. Currently, there is no generic version available for Ubrelvy.
Ubrelvy (ubrogepant) belongs to a drug class called calcitonin gene-related peptide (CGRP) antagonists.
How does Ubrelvy work?
As mentioned, Ubrelvy is classified as a calcitonin gene-related peptide (CGRP) antagonist; this medication works by blocking the activity of the CGRP protein. CGRP peptide is a protein that is believed to be contributing to the symptoms of migraine attacks by dilating blood vessels, leading to inflammation and the sensation of throbbing pain.
By inhibiting the CGRP protein from binding to its receptor, Ubrelvy helps relieve the migraine headache pain by reducing the inflammation of the affected blood vessels and which lead to associated symptoms such as nausea, vomiting, and sensitivity to light and sound.
What is Imitrex?
Imitrex basics
Imitrex is the brand name medication containing the active ingredient sumatriptan. Similar to Ubrelvy, Imitrex is a prescription medication from a healthcare provider.
Imitrex (sumatriptan) belongs to the triptans drug class; specifically, Imitrex is classified as a selective serotonin receptor agonist. Serotonin is a neurotransmitter or a chemical produced by nerve cells. Serotonin can be found in nerve cells in the brain and all over the body.
Unlike Ubrelvy, Imitrex is available as a generic medication called sumatriptan. Generic drugs generally are more affordable compared to their brand-name counterparts. Also Imitrex is available in several formats: tablets, nasal spray, stat dose starter kit, and stat dose cartridges.
How does Imitrex work?
As a selective serotonin receptor agonist, Imitrex binds to serotonin receptors 5-HT1B and 5-HT1D, which leads to vasoconstriction of the blood vessels.
While the exact mechanism of migraine headaches is not clearly understood, it is believed that nerve cells become inflamed and blood vessels dilate or widen during migraine attacks. This activity causes pain, inflammation, and other symptoms of a migraine headache.
Ubrelvy vs Imitrex - Which one is better?
At this time, there are no head-to-head clinical trials that directly compare Ubrelvy with Imitrex. However, there is data from other clinical trials indicate that triptans are similar to or more effective than ubrogepant (Ubrelvy), rimegepant (another CGRP antagonist), and lasmiditan (another class of migraine headache treatment).
Both Ubrelvy and Imitrex are used to treat acute migraine attacks with or without aura in adults. Both of these medications are not used to prevent migraines. In other words, both Ubrelvy and Imitrex are not preventive migraine medications; thus, you should take Imitrex or Ubrelvy once the migraine headache has started to alleviate the symptoms.
Notably, Imitrex (sumatriptan) remains the first-choice therapy to treat migraine headaches. Another advantage of Imitrex is that it is available as a more affordable generic version of medication. You can use Imitrex in combination with over-the-counter pain relief, such as Tylenol (acetaminophen), for additional pain relief.
For both Imitrex and Ubrelvy, 2 hours is the minimum time to wait for a second dose if the first dose has not provided adequate relief.
What are the side effects and warnings for these two migraine medications?
Ubrelvy (ubrogepant)
The common side effects of Ubrelvy are dry mouth, nausea, and drowsiness.
While Ubrelvy is generally well-tolerated by most people, if you have certain medical conditions, Ubrelvy may not be the safest option for you. Inform your healthcare provider about all of your medical conditions and history, especially if the following applies to you:
• Allergic reaction: you should not take Ubrelvy if you are allergic to Ubrelvy (ubrogepant) or any of Ubrelvy’s ingredients. Ask your doctor or pharmacist about all the ingredients of Ubrelvy.
• Kidney disease or liver disease: If your kidneys or liver are not working as well as they should, your body may be unable to eliminate Ubrelvy as expected. Too much Ubrelvy in the bloodstream can lead to an accumulation of Ubrelvy in the body, leading to unwanted adverse effects. This risk is increased if you have severe kidney or liver disease.
• However, this does not mean you cannot take Ubrelvy; your doctor will help you decide if Ubrelvy is safe. Your doctor may also adjust the dosage of Ubrelvy and monitor your liver and kidney functions through blood tests to ensure its safety.
Imitrex (sumatriptan)
Imitrex's common side effects include fatigue and sensitivity to temperature (either feeling too warm or too cold); Imitrex can also cause a tingling feeling or numbness in fingers or toes.
Imitrex is generally safe for most people. Your doctor can help you decide if Imitrex and other triptan medications are suitable for you. The following health conditions can increase the risks of harmful adverse effects caused by Imitrex therapy:
• Cardiovascular diseases such as heart problems, high blood pressure, and high blood cholesterol;
• Stroke and other brain problems;
• Serotonin syndrome;
• Allergic reaction to sumatriptan and its ingredients;
• Severe liver disease;
• Seizures;
The bottom line
Imitrex (sumatriptan) is the first-choice medication for the treatment of acute migraine attacks. Ubrelvy is a good option if Imitrex (sumatriptan) or other triptan medications are not providing adequate relief for your migraine headache. If you have been taking Imitrex or another triptan medication for some time and you haven't gotten good relief from your migraine headache, talk to your healthcare provider regarding another option to treat migraine, such as Ubrelvy.
Another thing to remember is that Ubrelvy can be safely taken together with Imitrex. This combination of medications seems to be tolerated by people who do not get enough relief from migraine headaches from either drug by itself.
As always, to prevent harmful adverse effects, you should inform your healthcare provider of all your medical conditions and medications, including prescription medication, over-the-counter products, and herbal supplements.
References
1. https://jamanetwork.com/journals/jama/fullarticle/2787727#:~:text=Migraine%20affects%20an%20estimated%20more,Are%20Episodic%20and%20Chronic%20Migraine%3F
2. https://www.ncbi.nlm.nih.gov/books/NBK554507/
3. https://americanheadachesociety.org/wp-content/uploads/2018/05/John_Rothrock_and_Deborah_Friedman_-_Triptans.pdf
4. https://pubmed.ncbi.nlm.nih.gov/32573795/
5. https://icer.org/wp-content/uploads/2020/10/Acute-Migraine-RAAG-022420_-1.pdf
6. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fd9f9458-fd96-4688-be3f-f77b3d1af6ab
7. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=584abe73-8290-4484-ff8e-5890831c095e
8. https://www.ncbi.nlm.nih.gov/books/NBK470206/
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