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

Key takeaways

Vyepti (eptinezumab) and zolmitriptan (Zomig) are both used to manage migraines, but they work differently and are used in different ways. Vyepti is a CGRP receptor blocker given as an intravenous infusion every three months to prevent migraines. On the other hand, zolmitriptan is a triptan that you take at the first sign of a migraine to relieve pain. It comes in various forms, including tablets, orally disintegrating tablets, and a nasal spray. Vyepti is administered by a healthcare professional, while you can take zolmitriptan yourself at home. Vyepti is used for prevention of migraines, whereas zolmitriptan is used for immediate relief of migraines. Side effects for Vyepti are generally mild, like common cold symptoms, while zolmitriptan can cause dizziness, chest pain, and other more serious side effects, like irregular heart rhythm. Both medications are only available as brand-name.

Vyepti

(eptinezumab)

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Zolmitriptan

(Zomig)

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Summary for Vyepti

Prescription only

Vyepti (eptinezumab or eptinezumab-jjmr) is a medication that's used to prevent migraines in adults. The dose is given as an infusion through the veins at a provider's office or clinic every 3 months. Side effects aren't common, but they can include common cold symptoms, itching, and flushing. Vyepti (eptinezumab) is only available as a brand name.

Indications for Vyepti

Prevention of migraines in adults

Pros and Cons for Vyepti

Pros

Works well to lower the number of migraines you get
Taken only every 3 months
Few side effects

Cons

Given as an infusion through the veins (IV)
Needs to be given by a healthcare provider
Hasn't been studied well enough in children or in older adults, so it's not completely known how well the medication works for them

Common Side Effects for Vyepti

Common cold symptoms (6-8%)

Warnings for Vyepti

Allergic reactions

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