Emgality vs. Zomig for Migraine: Important Differences and Potential Risks.

Key takeaways

Emgality (galcanezumab) and Zomig (zolmitriptan) are both used to manage migraines, but they work differently and are used in different ways. Emgality is a monoclonal antibody that prevents migraines and treats cluster headaches by blocking a protein called calcitonin-gene related peptide (CGRP). It is given as a monthly injection under the skin. On the other hand, Zomig is a triptan that treats migraines by attaching to serotonin receptors to reduce blood vessel swelling and pain signals. Zomig is taken as needed at the first sign of a migraine and comes in tablet, orally disintegrating tablet, and nasal spray forms. Emgality is only available as a brand-name medication, while Zomig is available in both brand-name and generic forms. Emgality is used for prevention, whereas Zomig is used for immediate relief. Common side effects of Emgality include injection site reactions, while Zomig can cause dizziness and chest pain.

Emgality

(galcanezumab)

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Zolmitriptan

(Zomig)

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Summary for Emgality

Prescription only

Emgality (galcanezumab or galcanezumab-gnlm) is an injectable medication that can help prevent migraine attacks in adults. It can also help treat cluster headaches in adults. This medication is a monoclonal antibody that works as a CGRP antagonist. It blocks the CGRP protein in the brain that can cause migraine and headache pain. Emgality (galcanezumab) comes as a prefilled pen and syringe. You inject one dose of the medication under the skin monthly. Some common side effects include pain, itching, and redness at the injection site.

Indications for Emgality

Prevention of migraines in adults
Treatment of episodic (occasional) cluster headaches in adults

Pros and Cons for Emgality

Pros

Only needs to be given once a month
Good option for people who have a hard time taking medications by mouth
Generally well tolerated

Cons

Not a good option for people who don't like needles
Need to store in a refrigerator
Not known if the medication works well or is safe in children, during pregnancy, or while breastfeeding

Common Side Effects for Emgality

Pain, itching, warmth, and other injection site reactions (18%)

Warnings for Emgality

Serious allergic reactions
High blood pressure
Raynaud's phenomenon

Summary for Zomig

Prescription only

Zolmitriptan (Zomig) is used for the short-term treatment of migraines. You typically take just one dose when you have a migraine. Zolmitriptan (Zomig) can cause side effects like dizziness and chest, neck, or jaw pain. This medication is a tablet that you swallow. It also comes as an orally disintegrating tablet (ODT) and a nasal spray, which can be good options for people who have trouble swallowing pills during a migraine. Zolmitriptan (Zomig) is available by prescription only as a brand-name and generic medication; it's not found over the counter.

Indications for Zomig

Treatment of migraine

Pros and Cons for Zomig

Pros

One of the first-choice options for adults to treat moderate or severe migraine
Works within 2 hours after taking the dose
Has ODT and nasal spray forms, so it's a good option for people who have trouble swallowing pills during a migraine

Cons

Not used for other types of headaches
Doesn't prevent migraines from happening
Can worsen your headaches if you take the medication for more than 9 days in a month

Common Side Effects for Zomig

Tablets and orally disintegrating tablets

Nausea (up to 9%)
Dizziness (up to 8%)
Pins and needles feeling in the arms or legs (up to 7%)
Neck, throat, or jaw pain, tightness, or pressure (up to 7%)
Sleepiness (up to 6%)
Feeling warm or cold (up to 6%)
Body weakness (up to 5%)
Dry mouth (up to 5%)
Chest pain, tightness, pressure, or heaviness (up to 3%)

Nasal spray

Unusual taste (up to 17%)
Dizziness (6%)
Pins and needles feeling in your arms or legs (5%)
Throat pain (4%)
Feeling warm (4%)
Dry mouth (3%)
Body weakness (3%)

Warnings for Zomig

Heart attack and chest pain (angina)
Irregular heart rhythm (arrhythmias)
Stroke or other brain injury
Blood vessel issues
Serotonin syndrome
High blood pressure
Caution use in people with phenylketonuria (PKU) - for orally disintegrating tablet only