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Drug vs. Drug

Nurtec ODT vs. sumatriptan: Differences, similarities & side effects

Learn whether to opt for brand-name Nurtec or generic sumatriptan for migraine prevention or relief
Gerardo Sison medical writer headshot
By | Jun. 6, 2024
Two white pills with a "vs." between them: Nurtec ODT vs. sumatriptan: Differences, similarities & side effects

Key takeaways

  • Nurtec ODT, a CGRP antagonist, and sumatriptan, a serotonin receptor agonist, differ in how they work as migraine medications.

  • Sumatriptan is available in various forms and dosages, while Nurtec ODT is typically taken as a dissolving tablet.

  • Both drugs are used for acute migraine treatment, but only Nurtec ODT is also approved for migraine prevention.

  • Common side effects include nausea for Nurtec ODT and sensations like tingling and fatigue for sumatriptan.

In this article:

Migraines can be a crippling condition for many people, leading them to seek out effective treatment options. Two commonly prescribed medications for migraines include Nurtec ODT and sumatriptan succinate. Both medications are approved to treat the intense pain and other symptoms associated with migraine attacks. 

Although Nurtec ODT and sumatriptan are used for similar purposes, they differ in various ways, such as how they work, potential side effects, and the speed at which they provide relief. Pricing and insurance coverage for these medications can also vary, as Nurtec ODT is a newer brand-name drug while sumatriptan is a generic medication. Therefore, choosing a medication that fits your lifestyle and health needs can be key.

Read on to learn more about the similarities and differences between Nurtec ODT and sumatriptan. 

Nurtec ODT vs. sumatriptan: Key differences

The main difference between Nurtec ODT and sumatriptan is that Nurtec ODT is a brand-name drug that contains the active ingredient rimegepant while sumatriptan is a generic drug. Sumatriptan is also the active ingredient of the brand-name drugs Imitrex and Onzetra Xsail, among others. 

Mechanism of action

Nurtec ODT works differently from sumatriptan in the treatment of migraines. It works as a calcitonin gene-related peptide (CGRP) receptor antagonist that blocks the CGRP molecule, which is thought to play a role in migraines. Meanwhile, sumatriptan is a member of the selective serotonin receptor agonists drug class, also known as triptans. Sumatriptan targets serotonin receptors in the brain, leading to the constriction of blood vessels, thereby alleviating migraine symptoms.

Dosing and dosage forms

The typical administration of these medications also differs. While Nurtec ODT comes in a dissolving oral tablet form, sumatriptan is available in various forms, such as tablets, nasal sprays, and subcutaneous injections. The recommended dosage for Nurtec is one orally disintegrating tablet as needed. In contrast, sumatriptan’s dosage varies based on the form in which it is administered, and it can often be taken multiple times within 24 hours as specified by a healthcare provider.

 

Nurtec vs. sumatriptan comparison
Nurtec ODT Sumatriptan succinate
Drug class CGRP receptor antagonists, gepants  Selective serotonin receptor agonists, triptans
Brand/generic status Brand Generic
What is the generic or brand name? Brand: Nurtec ODT

Generic: Rimegepant

 Brand: Various, including Imitrex

Generic: Sumatriptan
What form(s) does the drug come in? Tablet, orally disintegrating Tablet 

Nasal spray

Injection, subcutaneous

Nasal powder
What is the standard dosage? Treatment of acute migraine: 75 mg as needed

Prevention of episodic migraine: 75 mg every other day

Maximum dosage of 75 mg per day and no more than 18 doses in a 30-day period

 Treatment of acute migraine: 

Tablets: One dose of 25 mg, 50 mg, or 100 mg; Then, a second dose at least 2 hours later as needed; Maximum dosage of 200 mg per day

Subcutaneous injection: One dose of 4 mg or 6 mg; Then, subsequent doses as needed after at least 1 hour, with a maximum dosage of 12 mg per day

Nasal spray: One dose of 5 mg, 10 mg, or 20 mg; Then, a second dose at least 2 hours later as needed; Maximum dosage of 40 mg per day
How long is the typical treatment? Long-term Long-term
Who typically uses the medication? Adults  Adults

 

Nurtec ODT vs. sumatriptan: Conditions treated

Nurtec ODT and sumatriptan are both medications prescribed for the treatment of migraine headaches, with or without aura, in adults. However, Nurtec ODT is also approved to prevent episodic migraines—migraines that occur less frequently. 

Although sumatriptan is not approved as a preventive treatment, unlike Nurtec ODT, sumatriptan injections are approved for cluster headaches—severe, recurrent headaches that occur in cyclical patterns or clusters. Nurtec ODT is not approved for this purpose, although it may sometimes be used off-label.

 

Compare conditions treated: Nurtec ODT vs. sumatriptan
Condition Nurtec ODT Sumatriptan succinate
Acute treatment of migraine with or without aura Yes Yes
Preventive treatment of episodic migraines Yes No
Cluster headaches Off-label Yes (injection only)

 

Is sumatriptan better than Nurtec ODT?

Nurtec ODT and sumatriptan are effective options for pain relief from migraines. The more appropriate option will depend on patient preferences, potential side effects, and other factors. Always consult a healthcare provider for the most effective treatment plan. 

One double-blind, randomized clinical trial compared the effectiveness of rimegepant with sumatriptan. It found that significantly more patients experienced complete relief from migraine pain two hours after taking rimegepant. Specifically, 31.4% of patients at the 75 mg dose, 32.9% at the 150 mg dose, and 29.7% at the 300 mg dose reported pain freedom with rimegepant, compared to only 15.3% of those who took a placebo. Sumatriptan showed similar effectiveness, with 35% of its users experiencing pain freedom. Therefore, Nurtec ODT is about as effective as sumatriptan in treating acute migraines.

Another study found that triptans like sumatriptan and zolmitriptan were generally more effective than CGRP antagonists like rimegepant and ubrogepant in achieving migraine relief at the two-hour mark. However, triptans had a higher risk of adverse events than the CGRP antagonists.

RELATED: How long does Nurtec take to work? │Nurtec (rimegepant) alternatives: What can I take instead of Nurtec?

Nurtec ODT vs. sumatriptan: Insurance coverage and cost comparison

Many insurance plans may cover Nurtec ODT, but coverage can vary greatly. Therefore, it’s important to check with your specific insurer. In addition, Nurtec ODT may be covered under Medicare Part D plans, but inclusion depends on individual plan formularies. 

Sumatriptan is a generic drug typically less expensive than brand-name options and is commonly covered by commercial insurance and Medicare Part D plans. For those paying out of pocket, discounts on Nurtec ODT and sumatriptan may be available through SingleCare, potentially reducing the cost substantially.

 

Compare cost & coverage: Nurtec ODT vs. sumatriptan
Nurtec ODT Sumatriptan succinate
Typically covered by insurance? Yes Yes
Typically covered by Medicare Part D? Yes Yes
Quantity 8, 75 mg tablets 9, 100 mg tablets
Average retail price $1,354 $163
SingleCare price $850 $7

 

Nurtec ODT vs. sumatriptan side effects

The most common side effects of Nurtec ODT are nausea and indigestion. Common side effects of sumatriptan may include sensations of tingling or numbness, fatigue, chest pain, and dizziness. 

In terms of serious side effects, both medications can potentially lead to more significant issues, although these are rare. Sumatriptan could cause increases in blood pressure or, very rarely, cause heart-related problems like heart attacks in certain at-risk individuals. Similarly, though Nurtec is typically well-tolerated, it might cause allergic reactions in some patients. Consult a healthcare professional for a complete list of potential side effects.

 

Compare side effects of Nurtec ODT vs. sumatriptan
Nurtec ODT  Sumatriptan succinate, 25 mg tablet
Side effect Applicable? Frequency Applicable? Frequency
Nausea Yes 2% Yes N/A
Stomach pain/indigestion Yes 2% Yes  N/A
Tingling or numbing feeling No – Yes 3%
Fatigue No  – Yes 2%
Chest pain No – Yes 1%
Dizziness No – Yes N/A
Drowsiness No  – Yes N/A
Warm or cold feeling No – Yes  N/A
Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.
Source: DailyMed (Nurtec ODT), DailyMed (sumatriptan succinate)

Nurtec ODT and sumatriptan drug interactions

Nurtec ODT may interact with certain antibiotics, antifungals, antivirals, and anticonvulsants, among other drugs, which can affect how the drug is metabolized or processed by the liver. These interactions may lead to increased or decreased levels of Nurtec ODT in the bloodstream, increasing the risk of side effects or decreasing the drug’s effectiveness.

Sumatriptan can also have serious interactions with other drugs. For example, combining sumatriptan with ergot-containing drugs, which are also used to treat migraines, is unsafe because it can lead to severe and prolonged blood vessel contractions. In addition, using sumatriptan with monoamine oxidase inhibitors can double the effects of sumatriptan in the body, increasing health risks. Taking sumatriptan alongside certain antidepressants may trigger serotonin syndrome, a potentially life-threatening condition characterized by an excess of serotonin in the brain.

Tell your healthcare provider about any medications you take, including supplements and over-the-counter medicines, before starting Nurtec ODT or sumatriptan.

 

Compare Nurtec ODT vs. sumatriptan drug interactions
Drug Drug class Nurtec ODT Sumatriptan succinate
Nizoral (ketoconazole) 

Diflucan (fluconazole) 

Vfend (voriconazole)

 Antifungal Yes No
Norvir (ritonavir) 

Reyataz (atazanavir)

 Antiviral Yes No
Ketek (telithromycin) 

Biaxin (clarithromycin) 

Rifadin (rifampin)

 Antibiotic Yes No
Tegretol (carbamazepine) 

Dilantin (phenytoin) 

Luminal (phenobarbital)

 Anticonvulsant Yes No
Cafergot (ergotamine/caffeine) 

D.H.E. 45 (dihydroergotamine) 

Migranal (dihydroergotamine nasal)

 Ergot alkaloids No Yes
Nardil (phenelzine) 

Marplan (isocarboxazid)

 Monoamine oxidase inhibitors  No Yes
Prozac (fluoxetine) 

Zoloft (sertraline) 

Lexapro (escitalopram)

 Selective serotonin reuptake inhibitors (SSRIs) No Yes
Effexor (venlafaxine) 

Cymbalta (duloxetine) 

Pristiq (desvenlafaxine)

 Serotonin-norepinephrine reuptake inhibitors (SNRIs) No Yes
Consult a healthcare professional for other possible drug interactions.

Nurtec ODT and sumatriptan drug warnings

Nurtec ODT and sumatriptan come with specific warnings. In rare cases, Nurtec ODT may cause serious allergic reactions, with symptoms like trouble breathing and rash. Allergic reactions may occur days after first taking the drug and require immediate medical attention.

People who have heart-related health risks should get checked by a healthcare provider before using sumatriptan, as it can lead to serious heart problems. In addition, if you experience irregular heartbeats, seizures, or unusual symptoms like extreme agitation while taking sumatriptan, stop taking the medication immediately. Chest pain after taking sumatriptan is typically not heart-related, but those at high risk for heart disease should be cautious and consult their healthcare provider.

It is not known whether Nurtec ODT can harm an unborn baby, while animal studies have found that sumatriptan may cause harm to an unborn baby. Always consult a healthcare provider before taking any medications while pregnant or breastfeeding. 

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