Which Triptan Medication Is Best for Migraine Relief?

A migraine is a personal experience. The symptoms you feel — and the things you do to make those symptoms go away — vary for everyone. 

Some people like to stick to lifestyle changes alone as a form of treatment. Others prefer medications or medical devices. You may even lean on natural treatments or your own tips and tricks for managing them. 

When it comes to prescription medications, many prevent migraines from happening in the first place. Many more are used to treat headache symptoms after they’ve started. Triptans are one large group of migraine medications. They treat acute migraines, but there’s a lot you should know before you turn to them for relief.

What are triptans?

Triptans are first-choice prescription medications for treating moderate to severe migraines. They’re used soon after migraine pain has started, even if you experienced signs or symptoms of migraine aura. Triptans may not work if they’re taken during the aura phase.

Depending on your symptoms, triptans are used in many ways. Oral tablets are the most widely available version. But they also come as orally disintegrating (dissolving) tablets, nasal sprays and powders, and under-the-skin injections.

How do triptans work for migraines?

Serotonin is a chemical messenger in your body. It’s known for its role in affecting your mood, but it’s also thought to be involved in migraines.

Triptans work by attaching to certain serotonin receptors (chemical binding sites) in your brain. When they connect with these receptors, they’re thought to reduce blood vessel swelling that contributes to pain. They may also disrupt pain signals coming from your nerves. 

This effect isn’t local to your brain. Triptans can also connect with serotonin receptors in other parts of your body. This can contribute to side effects. 

Available triptans for migraine

Seven triptan medications are currently available in the U.S. Spoiler alert: One triptan isn’t considered better than the rest. The best treatment choice boils down to your personal preferences, symptoms, and medical history. We’ll lay out your options below so choosing is a little bit easier.

1. Sumatriptan

Sumatriptan is the original triptan. It comes in the most shapes and sizes. 

Generic and brand-name versions are available as an oral tablet, nasal spray or powder, and under-the-skin injection. A brand-name nasal powder is also available. 

2. Zolmitriptan

Zolmitriptan (Zomig, Zomig-ZMT) is another common triptan. It’s available as a tablet, disintegrating tablet, and nasal spray. The oral versions are only approved to treat migraines in adults, but the nasal spray can be used by kids 12 and older.

3. Rizatriptan

Rizatriptan (Maxalt, Maxalt-MLT) is an oral triptan that comes as a tablet and disintegrating tablet. Rizatriptan’s minimum age is the youngest of all triptans. It can treat migraines in adults and children ages 6 and older.

Rizatriptan appears to start working the fastest out of all oral triptans (about 30 minutes), but its effects also wear off the earliest. 

4. Eletriptan

Eletriptan (Relpax) is an oral tablet medication. Unlike the triptans above, it doesn’t come in other forms. It’s approved to treat migraines in adults.

In terms of effectiveness, one meta analysis found that eletriptan was more likely to lead to a pain-free response compared to other triptans (measured after 2 hours and 24 hours). However, effectiveness varies by situation. 

5. Frovatriptan

Frovatriptan (Frova) is another oral tablet medication. It’s approved to treat migraines in adults. Compared to other triptans, patience may be needed with frovatriptan. Frovatriptan takes longer to start working, but its effects tend to last the longest. 

6. Naratriptan

Naratriptan (Amerge) is also an oral tablet medication. It’s approved to treat migraines in adults. After frovatriptan, naratriptan lasts the second longest. But it may start working a bit faster than frovatriptan.

7. Almotriptan

Almotriptan is a generic-only tablet medication. Its brand name, Axert, is no longer available. 

Almotriptan’s approved uses are more specific than other triptans. In kids, ages 12 to 17, with a history of migraines, it can treat migraines that usually last more than 4 hours. It can also treat migraines in adults with a history of migraines. 

Is it OK to take triptans every day?

No. They should only be used as needed. 

If you use triptans too often, there’s a moderate risk of triptan overuse headaches. This is also called a medication overuse headache or rebound headache. They’re more likely to happen when you use a triptan 10 or more days per month. At most, try to only use triptans a few days throughout the week. 

However, if need be, you can take more than one dose on a given day. For most triptans, you can take a second dose at least 2 hours after your first dose. But this varies by medication. For the sumatriptan injection, a second dose may be used at least 1 hour after your first dose. For naratriptan, it’s at least 4 hours. The effectiveness of repeat almotriptan doses isn’t clear.

Are there side effects to taking triptans?

Yes. Triptans have possible side effects to keep in mind. Specific side effects vary by medication and formulation, but these are some of the most common ones:

• Nausea

• Dizziness

• Chest tightness

• Feeling pins and needles on your skin

• Facial redness

• Neck pain

• Chest pain

More serious side effects are also possible, albeit rare. These are mostly related to their serotonin-related effects on blood vessels. If you experience any of these, stop taking your triptan and seek medical attention as needed: 

• Heart rhythm changes

• Symptoms of a heart attack, like chest pain that won’t go away or gets worse

• Symptoms of a stroke, like one-sided body weakness or slurred speech

• Symptoms of serotonin syndrome (if combined with other medications that also affect serotonin), such as sweating, fast heart rate, or insomnia

Drug interactions are also possible. To help prevent these interactions, make sure your pharmacist and healthcare provider have an up-to-date list of all medications and supplements you take. 

Who shouldn’t take triptans for migraines?

Triptans aren’t for everybody. Due to potential risks, your healthcare provider may avoid prescribing a triptan if you have certain health conditions. These include:

• Certain types of migraine (hemiplegic or brainstem aura migraines)

• High blood pressure that’s uncontrolled

• Coronary artery disease 

• Peripheral artery disease

• Prior stroke or mini-stroke

• Severe liver or kidney failure

• Ischemic bowel disease

• Within the last 24 hours, you took a dose of a different triptan 

• Within the last 24 hours, you took a dose of an ergot alkaloid medication

• Within the last 2 weeks, a you took a dose of a monoamine oxidase inhibitor medication

How do I choose which triptan to take for migraines?

There’s not a one-size-fits-all approach for choosing a triptan. Your symptoms and medical history help dictate the best choice. If you have prescription insurance, your plan’s formulary could also play a deciding role. 

Still, there are some general trends to keep in mind.

If one triptan doesn’t work, your healthcare provider may recommend trying a different one. They could also adjust your dose, suggest a new formulation, or prescribe a preventative medication. 

How much do triptans cost?

There are many ways to save on your triptan medication. GoodRx can help you navigate your options, which may include GoodRx discounts, copay savings cards, and patient assistance programs. You can find triptan prices as low as $12 with a free GoodRx discount.

Why trust our experts?

Written by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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