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Onzetra vs. Cafergot

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Onzetra (sumatriptan) and Cafergot (ergotamine/caffeine) are both used to treat migraines, but they have some key differences. Onzetra is a triptan that works by tightening blood vessels in the brain and stopping the release of sensory chemicals. It is available as a nasal powder that you blow into your nose using a special device. Onzetra can provide relief within 30 minutes to 2 hours and is a first-choice option for short-term migraine treatment. In contrast, Cafergot combines ergotamine and caffeine to tighten blood vessels and calm parts of the brain. It is available as an oral tablet or a rectal suppository. Cafergot is not recommended for daily or long-term use and is not safe during pregnancy. While Onzetra is only available as a brand medication, Cafergot tablets are available as a lower-cost generic. Both medications have serious side effects, but Cafergot has additional risks like fibrosis and dangerously low blood flow to the brain and limbs.

Onzetra

(sumatriptan)

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Cafergot

(ergotamine / caffeine)

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Summary for Onzetra

Prescription only

Onzetra (sumatriptan) is a triptan that's used to treat migraine attacks with or without aura in adults. Onzetra (sumatriptan) is a device with a mouthpiece. It comes with separate nosepieces containing the medication that you attach to the device. You use the mouthpiece and nosepiece together to inhale the medication through your nose by using the power of your breath. Onzetra (sumatriptan) is available by prescription only and is a brand-name medication. Common side effects are changes in taste and discomfort in the nose.

Indications for Onzetra

  • Short-term treatment of migraines with or without aura in adults

Pros and Cons for Onzetra

Pros

  • Can start to relieve migraine pain within 30 minutes
  • A first-choice option for short-term treatment of migraines in adults
  • A good option for people who have trouble swallowing pills and who don't want to use an injection

Cons

  • Can cause nose or throat irritation and an unusual taste in your mouth after use
  • Need to use 1 nosepiece in each nostril to get the full dose
  • Only available as a brand-name product in one strength

Common Side Effects for Onzetra

  • Unusual taste in the mouth (20%)
  • Nasal discomfort (11%)
  • Runny nose (5%)

Warnings for Onzetra

  • Heart problems and high blood pressure
  • Stroke or other brain injury
  • Blood vessel spasms
  • Serotonin syndrome
  • Allergic reactions
  • Seizures
  • Nose or throat irritation

Summary for Cafergot

Prescription only

Cafergot (ergotamine / caffeine) is used to treat cluster headaches and migraines in adults. It's available as a tablet that's taken by mouth, as well as a suppository that's inserted into the rectum. Typically, you take a dose as soon as you feel a headache coming on. But there's a limit to how many doses you can take each week because taking this medication too often can lead to serious side effects, such as vomiting and numbness. Brand name Cafergot is discontinued.

Indications for Cafergot

Pros and Cons for Cafergot

Pros

  • Suppository is a good option for people who've trouble swallowing pills
  • Tablet is available as a lower-cost generic
  • Can start to feel relief after a half hour (for the tablets) or an hour (for the suppository); and you may take an additional dose if no relief

Cons

  • Not for daily or long-term use
  • Can't take while pregnant
  • Not safe for use for people with kidney or liver problems
  • Rectal suppository is brand name only and requires refrigeration

Common Side Effects for Cafergot

  • Nausea

Warnings for Cafergot

  • Dangerously low blood flow to your brain and limbs
  • Fibrosis (scarring)
  • Allergic reaction to yellow dye

Prices with our coupons for Onzetra vs. Cafergot

Price Card Drug Icon
Onzetra1 carton / 16 nosepieces of 11mg
$908.65-
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Ergotamine/Caffeine30 tablets / 1mg/100mg
$112.30$540.36
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