Sumatriptan vs. Zolmitriptan for Migraine: Important Differences and Potential Risks.

Sumatriptan

(Imitrex)

Zolmitriptan

(Zomig)

Summary for Sumatriptan

Prescription only

Sumatriptan (Imitrex) is used to treat migraines with or without aura in adults. The medication is typically taken as a single dose for your migraine. But, it's possible that you can take it again 2 hours after the first dose if your migraine doesn't go away. Side effects of sumatriptan (Imitrex) include tingling or numbness of fingers or toes, feeling too warm or too cold, and fatigue. It can interact with antidepressants and other similar migraine medications. Sumatriptan (Imitrex) is available as a lower-cost generic tablet.

Indications for Sumatriptan

Treatment of migraine attacks with or without aura in adults

Pros and Cons for Sumatriptan

Pros

First-choice option for treating migraines
Can take with commonly used over-the-counter pain relievers like acetaminophen (Tylenol)
Can start relieving migraine headaches within 30 minutes to 2 hours
Available as a lower-cost generic

Cons

Can't use to prevent migraines
Must wait at least 2 hours after the first dose to take a second dose, if needed
Your migraines can get worse if you use this medication too often.
Unknown if it's safe or if it works well in children

Common Side Effects for Sumatriptan

Tingling or numbness of fingers or toes (3-5%)
Feeling too warm or too cold (2-3%)
Fatigue (2-3%)

Warnings for Sumatriptan

Heart problems and high blood pressure
Stroke or other brain injury
Extreme narrowing of blood vessels
Serotonin syndrome
Allergic reactions
Seizures

Summary for Zolmitriptan

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 Zolmitriptan

Treatment of migraine

Pros and Cons for Zolmitriptan

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 Zolmitriptan

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 Zolmitriptan

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