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Zomig vs. Cafergot

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

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.

Zolmitriptan

(Zomig)

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Cafergot

(ergotamine / caffeine)

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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

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 Zomig vs. Cafergot

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Zolmitriptan3 dose packs / 3 tablets of 5mg
$24.04$90.94
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Ergotamine/Caffeine30 tablets / 1mg/100mg
$112.30$540.36
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