Key takeaways
Zolmitriptan (Zomig) and ergotamine/caffeine (Cafergot) are both used to treat migraines, but they have some key differences. Zolmitriptan is a triptan that attaches to serotonin receptors to reduce blood vessel swelling and pain signals in the brain. It comes as a tablet, orally disintegrating tablet, and nasal spray. Ergotamine/caffeine combines an ergot derivative and caffeine to tighten blood vessels and calm the brain. It's available as a tablet and a rectal suppository. Zolmitriptan is generally taken as a single dose at the first sign of a migraine, while ergotamine/caffeine can be taken in multiple doses but has strict weekly limits to avoid serious side effects. Zolmitriptan is not recommended for those with severe liver problems, while ergotamine/caffeine is not safe for people with kidney or liver issues and cannot be used during pregnancy. Both medications require a prescription and are available in lower-cost generic forms.
