Sumatriptan, Vydura Rimegepant & Rizatriptan: Which is best for me?
Reviewed by our clinical team
Dealing with regular migraines can be hard, particularly when they’re serious or regular enough to stop you living your life. The good news is that you’re not alone, with over 6 million people in the UK experiencing migraines regularly, researchers are working hard to better understand and treat the condition.
Unfortunately, there are so many different types of migraine that it can be a bit of a challenge to find a treatment that works for you.
Medicines like Sumatriptan, Rizatriptan, and Vydura are all very popular migraine treatments, but work in slightly different ways. Some treatments are also not suitable for every type of migraine.
In this article, we’ll look at these treatment options to help you get a clearer picture of how each treatment works, as well as their potential benefits and drawbacks.
Remember, the ideal treatment varies from person to person. So, while this guide is a good start, it's always best to have a chat with your doctor to find the best option for you.
What are the best migraine medications?
Understanding migraines means recognising they're not a one-size-fits-all condition. Different types of migraines come with their own symptoms and triggers. The ideal medication for one might not be suitable for another.
Learning more about the different types of migraine, from the stages of migraines to specific conditions like hemiplegic migraine or silent migraines, can help you better understand your own condition and find the most effective treatment.
Here, we’ve listed the three most common migraine medications - Sumatriptan, Rizatriptan, and Vydura - as well as how they work, and when they’re the best treatment option.
Sumatriptan for migraines
Sumatriptan is one of the most common migraine treatments, and works by reducing inflammation (swelling) in the brain, sometimes caused by chemical imbalances, stress, or other factors.
What is Sumatriptan used for?
Some migraines are down to something called ‘vasodilation’, when blood vessels in the brain expand (or dilate) very rapidly, causing head pain and other symptoms. Although we don’t know exactly why this happens, Sumatriptan can help reduce the symptoms by narrowing these blood vessels (vasoconstriction). This helps many people find relief during a migraine attack.
More information on how Sumatriptan works can be found in our Sumatriptan advice blog.
Sumatriptan benefits
- Reduces the pain and intensity of migraines
- Can make migraines shorter
- Offers relief from associated symptoms like sensitivity to light or nausea
- Acts quickly, often providing relief within a couple of hours
Sumatriptan side effects
Like all medications, Sumatriptan comes with the possibility of side effects. Thankfully, these are relatively minor, but if you’re taking Sumatriptan, you should always keep in touch with your doctor and let them know if you notice anything unusual. Side effects of Sumatriptan include:
- Heaviness, pressure or tightness in the chest
- Nausea
- Vomiting
- Tiredness
- Dizziness
- Shortness of breath
Important: if you have an allergic reaction to Sumatriptan, such as a rash, spots, wheezing, swollen face, eyelids, or lips, you should seek go to A&E, as this can potentially be very serious.
Rizatriptan for migraines
Another common type of migraine medication is Rizatriptan, which works in a similar way to Sumatriptan. They’re both part of the same family of medications, known as ‘triptans’ (more on that below.)
What is Rizatriptan used for?
Like Sumatriptan, Rizatriptan works by narrowing the blood vessels around the brain when they become dilated. This action can help to ease the pain and other symptoms that come with migraines.
For a deeper dive into how Rizatriptans work, you can check out our online guide.
Rizatriptan benefits
As it is another type of medication in the same family, Rizatriptan offers very similar relief to Sumatriptan:
- Quickly reduces the severity of migraines
- Shortens the length of migraine attacks
- Eases related symptoms, like sound or light sensitivity
- Fast-acting, providing relief in a short span of time
Rizatriptan side effects
While Rizatriptan is a big help to many, it's very important to be aware of potential side effects. As with Sumatriptan, these are quite mild, but you should keep an eye out for them if you’re due to start Rizatriptan, and let your doctor know.
Some of the most common side effects of Rizatriptan include:
- Drowsiness or dizziness
- Nausea and vomiting
- Dry mouth
- Heart racing
- Headaches
- Sleep disturbance
- Muscle or joint stiffness
Some people might experience pain or tightness in the chest when taking triptans. If this chest pain is very bad, or doesn’t pass quickly, call 999. Again, if you notice symptoms of an allergic reaction (rash, swelling, wheezing etc) you should go to A&E.
Rizatriptan vs Sumatriptan
When choosing between Rizatriptan and Sumatriptan for migraine relief, it can be helpful to understand the similarities and differences between them.
Both are part of the same family of medications, known as triptans, and work by narrowing the blood vessels around the brain, helping to reduce migraine symptoms. While they work in a similar way, they might differ in terms of how quickly they work, how long for, and potential side effects.
Most types of triptans are equally effective, but one study showed that Rizatriptan was quicker at reducing pain than Sumatriptan. Generally, people will have different tolerances to triptans, and your doctor might try different types to see which helps the most.
Vydura (Rimegepant) for migraines
Affecting more than one billion people worldwide, with symptoms that can often be disabling, migraines are a popular area of scientific research. New treatments, based on new data, appear regularly, offering relief for people who might not have benefited from older treatments.
One of these newer treatments is Vydura, sometimes called ‘Rimegepant’, an alternative to traditional triptan medications.
What is Rimegepant used for?
Rimegepant, available under the brand name Vydura in the UK, offers another method for tackling migraines. Unlike triptans, which work by narrowing blood vessels, Rimegepant blocks a specific protein called CGRP, which has been linked to migraines, from being absorbed in the brain.
This unique action helps many people who don’t benefit from triptans get relief from their symptoms. We’re still learning more about the CGRP protein and how it triggers migraines, but you can get the facts here.
Rimegepant benefits
- Offers a fresh approach to migraine treatment, different from triptans
- Can reduce both the pain and length of migraines
- Provides relief from various associated symptoms including aura and nausea
- Suitable for those who might not respond well to other treatments
Rimegepant side effects
Every medication has the potential for side effects, and Rimegepant is no exception. Clinical trials showed that, while generally well-tolerated by most people, some people might experience:
- Mild injection-site reactions (such as pain, swelling and skin reactions)
- Constipation
- Itching
- Muscle spasms
As it’s a newer treatment, your doctor might ask you to stay in touch and regularly update them on new side effects. Not only does this help researchers learn more about the long-term effects of the drug but can also help you find out what works best for you.
What is the latest treatment for migraines?
With so much research into migraines, there’s a constant flow of new treatments that promise to change the way many experience and manage their migraines. Let's dive into some of the newest treatment options available today, as well as their pros and cons.
Botox injections for migraines
Botox injections were originally created as a type of cosmetic procedure to smooth wrinkles on the face, but have since been used to treat conditions like neck spasms, overactive bladder, lazy eyes, and more recently, migraines.
Botox gets its name from its main ingredient, botulinum toxin, the same toxin which causes a type of food poisoning known as botulism. However, it’s very safe in this form, and works by interrupting chemical signals which cause muscles to contract or tighten.
Similarly, Botox can also be used to interrupt messages between the brain and nerves that extend from the spinal cord, reducing the impact of migraines, and is a licenced treatment for chronic migraines in the UK. However, you’ll need to speak to your GP to access this specialist treatment.
Holistic care plan
Some headache specialists prefer to focus less on medication as a cure for migraines, and instead on a comprehensive approach which focuses on both the physical and emotional aspects of migraine. This approach combines medications, therapies, and lifestyle changes - such as diet and exercise - in a way that is customised to each individuals needs.
While this can be very effective, it can be hard to access long-term, supported headache care like this, and it might not be available to or effective for everyone.
Zavzpret (zavegepant) nasal spray
A newcomer to the migraine relief scene, Zavegepant - sometimes called Zavzpret - is another type of gepant medication designed to target CGRP proteins in the brain to prevent inflammation. Unlike Rimegepant, which is usually sold as wafers or given as an injection, Zavzpret is given as a nasal spray, making it more accessible.
Some studies have shown Zavspret to be effective at providing direct and fast-acting relief. It was only made available in the UK very recently and there’s limited long-term data to back this up. So, we don’t know the long-term effects.
It's exciting to see the development of new migraines treatments, but as with all medical decisions, it's crucial to weigh up the pros and cons and get advice from your doctor before seeking them out.
Summary
The wide variety of migraine treatments can be overwhelming at first, but understanding your options is the first step to finding the right treatment for you.
Whether you're considering well-established treatments such as triptans or newer medications like gepants, knowing your options, personal situation, and speaking to your doctor all play a crucial role.
If you want to know more about migraines, migraine treatments, or are looking for advice on how to minimise the impact of your migraine triggers, take a look at our other migraine resources:
References
https://pubmed.ncbi.nlm.nih.gov/12463279/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8904749/
https://migrainetrust.org/live-with-migraine/healthcare/treatments/calcitonin-gene-related-peptide-monoclonal-antibodies/
https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/botox-injections/
https://www.nationalmigrainecentre.org.uk/understanding-migraine/factsheets-and-resources/botox/
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00517-8/
https://www.pfizer.com/news/press-release/press-release-detail/pfizers-zavzprettm-zavegepant-migraine-nasal-spray
https://www.nice.org.uk/guidance/ta260/documents/migraine-chronic-botulinum-toxin-type-a-final-scope2
