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Ubrelvy vs Imitrex
Introduction
For patients suffering from migraines, specific drugs that target and neutralize chemical compounds in the brain associated with triggering pain can provide significant relief. Ubrelvy and Imitrex are two such medications often prescribed for migraine sufferers. Both impact different pathways in the brain but ultimately help to alleviate the severe headache and other symptoms related to migraines. Ubrelvy is a CGRP (Calcitonin gene-related peptide) receptor antagonist, which works by blocking the effect of CGRP, a molecule that is elevated during a migraine attack. On the contrary, Imitrex falls into a class of medications known as triptans; it functions by narrowing blood vessels around the brain and reducing substances in the body that can trigger headache pain, nausea, sensitivity to light and sound.
Ubrelvy vs Imitrex Side By Side
| Attribute | Ubrelvy | Imitrex |
|---|---|---|
| Brand Name | Ubrelvy | Imitrex |
| Contraindications | Should not be taken with MAO inhibitors or within 24 hours of other CGRP receptor antagonists or triptans due to the risk of serotonin syndrome. | Should not be taken with MAO inhibitors or within 24 hours of other triptans or ergotamines due to the risk of serotonin syndrome. |
| Cost | Around $900 for 10 tablets (50 mg each) | Around $180 for 9 doses of nasal spray (20 mg each); $1 - $15 per tablet for generic sumatriptan |
| Generic Name | Ubrogepant | Sumatriptan |
| Most Serious Side Effect | Allergic reactions, heart attack symptoms, high levels of serotonin in the body, unusual changes in mood or behavior, severe headache with vision changes, increased blood pressure | Signs of allergic reaction, changes in heartbeat, blood circulation problems, abdominal pain indicating liver problem, sudden/severe stomach pain with bloody diarrhea, unusual changes in mood or behavior |
| Severe Drug Interactions | MAO inhibitors, other CGRP receptor antagonists or triptans | MAO inhibitors, other triptans, ergotamines |
| Typical Dose | 50–100 mg as needed, not to exceed 200 mg in 24 hours | 25–100 mg taken orally with fluids, not to exceed 200 mg in 24 hours |
What is Ubrelvy?
Ubrogepant (the generic name for Ubrelvy) is a novel class of drugs known as gepants developed to treat migraines. Ubrogepant was first approved by the FDA in 2019 and it works by blocking CGRP receptors, which are believed to play a crucial role in migraine attacks. It is generally prescribed for the acute treatment of migraines with or without aura in adults. On the other hand, Sumatriptan (the generic name for Imitrex), belongs to an older class of migraine medications known as triptans and was initially approved by the FDA back in 1992. Imitrex functions differently from Ubrelvy; it narrows blood vessels around the brain and affects certain nerves that can relieve pain, nausea, light/sound sensitivity related to migraines. Although both medications are effective against migraines, they have different side effect profiles due to their differing mechanisms of action.
What conditions is Ubrelvy approved to treat?
Ubrelvy is approved for the treatment of acute migraine with or without aura in adults. It is not intended to prevent migraines, but rather to treat them once they have started.
On the other hand, Imitrex (sumatriptan) can be used both for treating acute migraine attacks with or without aura and also cluster headaches. However, like Ubrelvy, it's not indicated as a preventive medication for migraines or cluster headaches.
How does Ubrelvy help with these illnesses?
Ubrelvy aids in managing migraines by inhibiting the CGRP receptor, which is believed to play a crucial role in migraine attacks. By blocking this receptor, Ubrelvy can prevent a neurotransmitter called Calcitonin Gene-Related Peptide (CGRP) from attaching to it and triggering off pain signals that result in migraines. CGRP is a neuropeptide found throughout the body that plays an important part in transmitting pain and dilating blood vessels. During migraines, levels of CGRP are higher than usual. Therefore, by inhibiting the action of CGRP through its unique mechanism of action, Ubrelvy can help alleviate the painful symptoms associated with migraines and enable patients to better manage their condition.
What is Imitrex?
Imitrex is the brand name for sumatriptan, a medication that falls under the class of drugs known as triptans. It primarily works by stimulating serotonin (5-HT) receptors in the brain, which causes narrowing of blood vessels around your brain. This action alleviates migraine headaches and other related symptoms such as light sensitivity and nausea. It was approved first by FDA in 1992.
Unlike Ubrelvy, Imitrex does not inhibit CGRP (calcitonin gene-related peptide), but instead focuses its action on serotonin levels to relieve migraines. The side effect profile of Imitrex also differs from Ubrelvy; some people might experience sensations of tingling or warmth, while others may notice changes in their sense of taste.
Importantly though, it's crucial to remember that both drugs are used for acute treatment – they're intended to reduce symptoms during a migraine attack rather than preventing future ones.
What conditions is Imitrex approved to treat?
Imitrex is a well-established medication that's approved for the treatment of:
- Acute migraine attacks, with or without aura, in adults
- Acute episodes of cluster headaches in adults
Its proven effectiveness and history have made it a go-to choice for many healthcare professionals when treating these conditions.
How does Imitrex help with these illnesses?
Serotonin is a neurotransmitter that plays various roles in the body, contributing to feelings of well-being and happiness, regulating sleep patterns, and influencing pain thresholds among other things. Imitrex works by stimulating serotonin (5-HT) receptors in the brain which cause the muscles surrounding the blood vessels in the brain to contract. This constriction helps alleviate migraine headaches by reducing inflammatory substances that can lead to nerve sensitivity and pain. It is often used when patients do not respond adequately to "typical" over-the-counter analgesics or nonsteroidal anti-inflammatory drugs for their migraines. Ubrelvy, on the other hand, operates differently but falls under a newer class of medications called CGRP inhibitors specifically designed for treating acute migraine attacks rather than preventing them like some older migraine medications. Despite this advancement though, Imitrex still remains an effective treatment option due its long-standing track record and lower cost compared to some newer treatments.
How effective are both Ubrelvy and Imitrex?
Both ubrogepant (Ubrelvy) and sumatriptan (Imitrex) are effective medications in treating migraine attacks, but they operate via different mechanisms. Ubrelvy was approved by the FDA in 2019, several decades after Imitrex's approval in 1992. While both drugs aim to alleviate acute migraines, they act on different receptors within the body.
The effectiveness of Ubrelvy and Imitrex has been studied extensively; a direct comparison trial found that both drugs demonstrated similar efficacy in managing symptoms of migraines with comparable safety profiles. In this study, there were no significant differences between patients receiving Ubrelvy or those receiving Imitrex regarding pain reduction and side effects.
A review published in the Journal of Pain & Palliative Care Pharmacotherapy reported that Ubrelvy begins alleviating symptoms within one hour of administration and its effect can last up to 48 hours. Its side effect profile is quite favorable compared to other migraine medications as it does not cause vasoconstriction - a common issue with many other migraine treatments- making it safe for use even among patients with cardiovascular disease.
On the other hand, multiple studies have confirmed Imitrex's efficacy against migraines showing superior results over placebo treatment. Nevertheless, due to its mechanism of action causing vasoconstriction, caution must be exercised when prescribing it to patients with underlying heart conditions or uncontrolled hypertension. The evidence supports that sumatriptan significantly reduces moderate-to-severe headache pain within two hours compared to placebo.
Notably due to their unique pharmacology and safety profiles, either drug could be an optimal choice depending upon individual patient characteristics such as response rate or preexisting health conditions like cardiovascular diseases.
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At what dose is Ubrelvy typically prescribed?
Oral dosages of Ubrelvy range from 50–100 mg as needed, but research has shown that a single dose of 50mg is effective for relieving migraine in most people. If the migraine returns or if response to the initial dose is insufficient, a second dose may be administered at least two hours after the first dose. The maximum dosage should not exceed 200 mg in any twenty-four-hour period. Unlike Prozac and Wellbutrin which are used routinely, Ubrelvy and Imitrex are designed to be used when symptoms occur rather than daily.
At what dose is Imitrex typically prescribed?
Imitrex treatment for acute migraines is generally initiated at a dose of 25–100 mg, taken orally with fluids. If the migraine symptoms do not improve within two hours or return after temporary improvement, a second dose can be administered as long as it's at least two hours since the first dose. The maximum dosage in any 24-hour period should not exceed 200 mg. It is important to note that doses should be spaced adequately apart and only increased under medical supervision if there's no response to initial treatment after several attempts.
What are the most common side effects for Ubrelvy?
Potential side effects that may be experienced by individuals taking Ubrelvy include:
- Nausea
- Sleepiness/drowsiness
- Dry mouth
- Fatigue (general weakness)
When comparing this to Imitrex, possible common side effects with Imitrex can include:
- Flushing (feeling of warmth and redness in the skin)
- Dizziness
- A sensation of tingling or numbness
- Weakness
- Discomfort or tightness in the chest
Remember, everyone reacts differently to medication. Side effects are possible but do not occur for everyone. If you experience any severe or persistent symptoms while on either of these medications, it is recommended that you seek medical attention immediately.
Are there any potential serious side effects for Ubrelvy?
Ubrelvy, similar to other migraine medications, can potentially cause side effects in rare cases. These may include:
- Allergic reactions such as hives, difficulty breathing or swallowing, swelling of your face, lips, tongue or throat
- Heart attack symptoms including chest pain spreading to your jaw or shoulder accompanied by nausea and sweating
- High levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate
- Unusual changes in mood or behavior
- Severe headache with vision changes and buzzing in your ears
- Increased blood pressure - severe headache blurred vision pounding in neck/ears
On the other hand Imitrex also has its own potential side effects which might include:
Serious cardiac events like myocardial infarctions even resulting in death Cerebrovascular events including ischemic stroke and transient ischemic attacks. Vision problems that could be a sign of high fluid pressure within the eye.
If you notice any of these symptoms while taking Ubrelvy or Imitrex it is important to seek medical help immediately.
What are the most common side effects for Imitrex?
Imitrex, another medication for migraines, has a different set of potential side effects that you may experience. These can include:
- Feelings of tingling or numbness
- Dizziness or feeling faint
- Warm or cold sensations
- Feeling weak or tired
- Discomfort in the chest area
- Flushing (warmth, redness, or tingly feeling under your skin)
- A sensation of pressure or tightness affecting any part of your body.
Remember everyone's reaction to a medication is unique and not all people will necessarily experience these side effects. It's important to monitor how you feel when starting any new medication and communicate with your healthcare provider about any concerns.
Are there any potential serious side effects for Imitrex?
While Imitrex is generally well-tolerated and effective in treating migraines, some users may experience severe side effects. These could include:
- Signs of allergic reaction or serious skin reactions: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing
- Changes in heartbeat such as fast or irregular heartbeats
- Blood circulation problems manifesting as cold hands and feet, paleness, blue-colored fingers/toes/nails
- Abdominal pain that might signal a liver problem
- Sudden/severe stomach/abdominal pain accompanied by bloody diarrhea
- Unusual changes in mood or behavior like agitation and hallucinations If you experience any of these symptoms while taking Imitrex, stop its use immediately and seek urgent medical attention.
Contraindications for Ubrelvy and Imitrex?
Both Ubrelvy and Imitrex, like many other migraine medications, can potentially exacerbate certain symptoms in some patients. If you notice an increase in frequency or severity of headaches, chest pain, palpitations or any unusual side effects after taking these medications, it is crucial to seek immediate medical attention.
Neither Ubrelvy nor Imitrex should be taken if you are using or have recently used monoamine oxidase (MAO) inhibitors as this can cause serious drug interactions. Always inform your healthcare provider about the medications you're currently on; MAOIs will require a period of about two weeks to be completely cleared from your system before starting treatment with Ubrelvy or Imitrex.
It's also important not to take these drugs within 24 hours of each other due to the risk of serotonin syndrome - a condition characterized by agitation, hallucinations, rapid heartbeat and fever amongst others. As always consult with your doctor before making changes to medication regimen.
How much do Ubrelvy and Imitrex cost?
For the brand name versions of these drugs:
- The price of 10 tablets of Ubrelvy (50 mg) averages around $900, which works out to about $90 per tablet.
- The price for a pack containing 9 doses of Imitrex nasal spray (20 mg each) is approximately $180, which equates to roughly $20 per dose.
Thus, on a per-dose basis, Ubrelvy is significantly more expensive than Imitrex. However, it's important to note that cost should not be the primary consideration in determining which drug is right for you; rather effectiveness and side-effect profile are key factors in making this decision.
Ubrelvy is a newer medication and currently does not have a generic version available. Generic versions of Imitrex (sumatriptan), however, offer lower costs:
- Sumatriptan oral tablets can be found available in packs from as low as 9 up to 100 with strengths ranging from 25mg to 100mg. The cost varies widely depending on quantity and strength but usually falls between $1 - $15 per tablet.
- Sumatriptan injections or nasal sprays also come at cheaper rates compared to their branded counterpart with prices typically falling within the range of ~$50-$150 for multiple dose packs. Again exact pricing will vary based on location and packaging size among other factors.
Popularity of Ubrelvy and Imitrex
Ubrogepant, known by its brand name Ubrelvy, is a relatively new medication introduced in 2020 for treating migraines. As it was recently approved by the FDA and only available in branded form, it was estimated to have been prescribed to approximately 200,000 people in the US within its first year of availability.
On the other hand, Sumatriptan (brand name Imitrex) has been on the market since 1991 and is now available as a generic drug. It accounted for just over 10% of all triptan prescriptions (a class of drugs specifically used for migraines), making it one of the most commonly prescribed medications for this condition. In fact, sumatriptan was prescribed to around 8 million people in the USA during 2020 alone.
While both medications are effective at relieving migraine symptoms such as pain, nausea and sensitivity to light or sound; ubrogepant might be preferred because unlike sumatriptan - which constricts blood vessels and thus can't be taken by patients with certain cardiovascular conditions - ubrogepant does not carry these risks.
Conclusion
Both Ubrelvy (ubrogepant) and Imitrex (sumatriptan) have been shown to be effective in treating acute migraine attacks, as supported by numerous clinical trials and studies. These drugs can sometimes be used together under careful medical supervision, but they do interact with each other and this combination should only be prescribed by a healthcare professional who has considered the benefits versus risks. They work differently: Ubrelvy is a CGRP receptor antagonist which blocks the effects of CGRP, a neuropeptide involved in migraine pathophysiology; while Imitrex is a serotonin agonist that constricts blood vessels in the brain.
Imitrex has been around longer than Ubrelvy, so it's generally considered first-line therapy for migraines. However, if patients don't respond well or can't tolerate Imitrex due to its cardiovascular side effects like chest pain or tightness, then ubrogepant may be an alternative option.
Ubrelvy and sumatriptan are both available in generic form which provides significant cost savings especially for those paying out-of-pocket. As with many medications, it might take some time before you notice their effectiveness.
The side effect profiles of these two drugs are similar overall: most common ones include nausea and dizziness. But unlike triptans like sumatriptan which carry risk of certain cardiovascular events due to vasoconstriction properties – ubrogepant does not share this risk because of its different mechanism of action. However, patients must always monitor their symptoms when beginning treatment with either drug and seek immediate medical attention if any new or worsening symptoms arise.
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Refrences
- Scott, L. J. (2020, February). Ubrogepant: First Approval. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-020-01264-5
- Jakate, A., Boinpally, R., Butler, M., Lu, K., McGeeney, D., & Periclou, A. (2020, June 23). Evaluation of the Pharmacokinetic Interaction of Ubrogepant Coadministered With Sumatriptan and of the Safety of Ubrogepant With Triptans. Headache: The Journal of Head and Face Pain. Wiley.http://doi.org/10.1111/head.13862
- Silberstei, S. D. (1994, July). Serotonin (5‐HT) and Migraine. Headache: The Journal of Head and Face Pain. Wiley.http://doi.org/10.1111/j.1526-4610.1994.hed3407408.x
- Dechant, K. L., & Clissold, S. P. (1992, May). Sumatriptan. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-199243050-00010
- Blumenfeld, A. M., Goadsby, P. J., Dodick, D. W., Hutchinson, S., Liu, C., Finnegan, M., … Szegedi, A. (2021, March). Efficacy of ubrogepant based on prior exposure and response to triptans: A post hoc analysis. Headache: The Journal of Head and Face Pain. Wiley.http://doi.org/10.1111/head.14089
- Zhang, Z., Shu, Y., Diao, Y., Du, Y., Chen, L., Liu, Y., & Du, B. (2021, February 26). Calcitonin gene-related peptide receptor antagonist ubrogepant for the treatment of acute migraine. Medicine. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1097/md.0000000000024741