Zomig vs Imitrex

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For patients suffering from migraines, certain drugs that influence the levels of specific compounds in the brain can help manage pain and other symptoms associated with these episodes. Zomig and Imitrex are two such medications often prescribed to treat migraines. Both medicines work by narrowing blood vessels around the brain and affect serotonin (a neurotransmitter) levels which helps regulate mood among other things. Zomig is a triptan drug that is available as an oral tablet, nasal spray, or orally disintegrating tablet for ease of use according to patient's preference. On the other hand, Imitrex also belongs to the triptan class but in addition to being available as a tablet or nasal spray it can be administered via injection for more immediate relief during severe migraine attacks.

What is Zomig?

Zolmitriptan (the generic name for Zomig) and Sumatriptan (the generic name for Imitrex) are part of the triptan class of drugs, specifically designed to treat migraines. Zolmitriptan was first approved by the FDA in 1997, a few years after Sumatriptan's approval in 1992. Both medications work by stimulating serotonin receptors in the brain which narrows blood vessels and reduces inflammation, thereby relieving migraine symptoms. However, there are differences between them: Zomig has a broader application as it is available in both nasal spray and tablet form while Imitrex also comes as an injection. Moreover, Zomig tends to have fewer side effects such as chest tightness or heaviness compared with Imitrex due to its more targeted influence on certain serotonin receptors.

What conditions is Zomig approved to treat?

Zomig is approved for the treatment of various forms of migraines:

  • Acute migraine attacks with or without aura in adults
  • Migraine headaches in pediatric patients aged 12 to 17 years old.

On the other hand, Imitrex is also used for treating acute migraine headaches in adults. It's effective with or without auras, which can be visual disturbances that signal the start of a headache. Moreover, it's also prescribed for cluster headaches, which are severe and occur on one side of your head (often around an eye).

How does Zomig help with these illnesses?

Zomig helps to manage migraines by constricting the blood vessels around the brain. It does this by stimulating serotonin (5HT) receptors in the brain which results in narrowed blood vessels and reduced pain signals. Serotonin is a neurotransmitter, a chemical that acts as a messenger in the brain and throughout the body, playing an important role not only in mood regulation, but also regulating vascular tone - constriction or dilation of blood vessels. During a migraine attack, there's often excessive vasodilation of cranial blood vessels; hence, by causing vasoconstriction through serotonin receptor activation, Zomig can limit the debilitating effects of migraines and help patients manage their condition more effectively.

What is Imitrex?

Imitrex, a brand name for sumatriptan, is a serotonin receptor agonist that specifically targets 5-HT1 receptors located primarily in the brain. This action leads to vasoconstriction of the intracranial blood vessels and provides relief from migraines and cluster headaches. Sumatriptan was first approved by the FDA in 1992.

Unlike other migraine medications which might have broader effects on serotonin levels throughout the body, Imitrex's specific targeting means its side-effect profile can be different than others such as Zomig (zolmitriptan). For instance, it may cause less sedation or gastrointestinal disturbances. Yet, because it causes vasoconstriction, it must be used with caution in individuals with heart disease.

It has become an essential tool for many patients who suffer from severe migraines or cluster headaches and do not respond well to more "typical" over-the-counter pain relievers.

What conditions is Imitrex approved to treat?

Imitrex is a medication that has been approved for the treatment of acute migraine attacks with or without aura. It's also indicated for the management of cluster headaches, which are characterized by severe pain on one side of the head and often accompanied by symptoms such as red or teary eyes and runny nose. Notably, Imitrex isn't intended for preventive use but acts to relieve symptoms once they have begun.

How does Imitrex help with these illnesses?

Serotonin, also known as 5-hydroxytryptamine (5-HT), is a neurotransmitter that plays significant roles in many processes within the body, affecting mood regulation, digestion and appetite control, sleep cycles and pain perception. In the context of migraines—a neurological condition characterized by severe headaches often accompanied by nausea, vomiting and sensitivity to light—serotonin levels have been found to drop during attacks. Imitrex works by stimulating serotonin (or 5-HT) receptors in the brain which causes the muscles surrounding the blood vessels in the brain to contract. This contraction helps alleviate migraine symptoms by reducing inflammatory substances that can lead to nerve pain while decreasing swelling of blood vessels associated with this condition. Like Zomig, Imitrex belongs to a class of drugs called "triptans." However, it may be considered first-line treatment due its longer presence on market resulting into more extensive research data available compared to other triptans such as Zomig.

How effective are both Zomig and Imitrex?

Both zolmitriptan (Zomig) and sumatriptan (Imitrex) have established histories of success in providing relief for patients suffering from migraines, and were approved by the FDA a few years apart. Since they act on similar receptors but vary in their pharmacokinetics, they may be prescribed under different circumstances depending on patient needs. A direct comparison study was conducted in 2001 to evaluate the efficacy of zolmitriptan against sumatriptan; both drugs demonstrated comparable effectiveness at relieving migraine symptoms within two hours after ingestion.

A clinical trial conducted in 1997 showed that Zomig starts working faster than Imtrex, with noticeable pain relief as early as 15 minutes post-dosage. This research suggests that Zomig could be more beneficial for those who suffer from sudden onset migraines or require fast-acting treatment options. The same study reported no significant differences between the two medications regarding adverse events.

In contrast, various studies show Imitrex is still an effective medication for treating acute migraine attacks, offering substantial benefits over placebo groups. Like Zomig it also works quickly, typically within one hour of dosing although not quite as rapidly as its counterpart Zomig. It's important to note that while both drugs are successful treatments overall, individual responses can vary significantly due to unique personal health factors such as age or co-existing health conditions.

abstract image of a researcher studying a bottle of drug.

At what dose is Zomig typically prescribed?

Oral dosages of Zomig typically start at 2.5–5 mg, which is often enough to treat moderate to severe migraines in most individuals. For adolescents aged 12-17, the recommended initial dosage is 2.5 mg. If the migraine persists or returns within a few hours, another dose can be taken after two hours from the previous one, but not more than twice in any 24-hour period. The maximum daily dose should not exceed 10 mg/day under any circumstances.

At what dose is Imitrex typically prescribed?

Imitrex treatment is typically initiated at a dosage of 25–50 mg/day, taken orally. If the migraine symptoms persist after two hours, a second dose can be taken. However, the total daily dose should not exceed 200 mg and doses should be spaced at least two hours apart for maximum efficacy. In cases where there's no response to initial treatment after several attempts using 50 mg doses, your healthcare provider may consider increasing the dose to up to 100mg per administration. As always, any changes in dosing should only take place under medical supervision.

What are the most common side effects for Zomig?

Common side effects of Zomig can include:

  • Sensations of tingling or numbness
  • Dizziness
  • Dry mouth
  • Fatigue (general weakness and tiredness)
  • Nausea
  • Sleepiness/drowsiness
  • Decreased sensitivity to touch
  • Unusual taste sensation after use

Comparatively, Imitrex may cause side effects such as:

  • Injection site reactions (redness, swelling, pain)
  • Tingling or numb sensations in the skin
  • Warm/hot sensation under the skin
  • Weakness/feelings of heaviness in parts of your body
    -Dizziness, -Tired feeling; -Unusual or unpleasant taste in your mouth after using the nasal medicine;

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Zomig?

While Zomig and Imitrex are both medications used to treat migraines, they may have different side effects in some patients. For Zomig, potential serious side effects can include:

  • Indications of a heart attack: chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.
  • Signs of a stroke: sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech.
  • Unusual changes in mood or behavior
  • High levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate, excessive sweating , shivering or shaking , muscle stiffness or twitching loss of coordination , nausea / vomiting / diarrhea
  • Severe allergic reactions such as hives; difficulty breathing; swelling of your face, lips,tongue or throat which could be indicative anaphylaxis.

If you experience any such symptoms while using Zomig you should seek medical attention immediately.

What are the most common side effects for Imitrex?

Imitrex, a common medication for treating migraines, can potentially cause side effects such as:

  • Sensations of tingling/numbness/prickling/heat
  • Redness in the face or other areas
  • Feeling of heaviness or pressure
  • Unusual taste in your mouth after using the nasal spray
  • Nausea, vomiting and stomach pain may occur. If these effects persist or worsen, notify your doctor promptly.
  • Drowsiness/dizziness can also occur. Be cautious when driving or doing anything that requires alertness.
  • Flushing (warmth/redness) might be experienced around the facial area.

Remember to consult with a healthcare professional about any persistent adverse reactions while taking Imitrex.

Are there any potential serious side effects for Imitrex?

Imitrex, while a reliable medication for migraine relief, can present its own set of potential side effects. It's important to be aware of these and seek immediate medical attention if you experience any:

  • Allergic reactions: signs include hives, shortness of breath, swelling in the face or throat
  • Cardiac complications: chest pain or pressure; discomfort spreading to your jaw or shoulder; nausea; sweating
  • Stroke symptoms: sudden numbness or weakness on one side of the body; slurred speech; balance problems
  • Elevated blood pressure: severe headache, blurred vision, pounding in your neck or ears
  • Serotonin syndrome (rare but serious): agitation, hallucinations, fever/tachycardia/shivering/sweating

While most people tolerate Imitrex well without experiencing these serious side effects, it’s crucial to report any new symptoms promptly and accurately so appropriate care can be provided.

Contraindications for Zomig and Imitrex?

Both Zomig and Imitrex, like most migraine relief medications, can potentially worsen heart issues in some people. If you experience chest pain, tightness or pressure after taking these drugs, immediately seek medical attention.

Neither Zomig nor Imitrex should be taken if you are using certain types of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). It's crucial that your doctor is aware of all the medications you're currently taking; combining SSRIs or SNRIs with either Zomig or Imitrex could lead to a rare but serious condition called serotonin syndrome. Always wait for at least 24 hours between usage of any triptan-based medication like Zomig or Imitrex and an SSRI/SNRI to prevent this dangerous interaction.

How much do Zomig and Imitrex cost?

For the brand name versions of these drugs:

  • The price of 6 tablets of Zomig (2.5 mg) averages around $120, which works out to about $20 per dose.
  • The price for 9 tablets of Imitrex (100 mg) averages around $150, working out to approximately $17 per dose.

Thus, if you need a higher dosage or take medication more frequently, then brand-name Imitrex may be less expensive on a per-dose basis. However, cost should not be your primary consideration in determining which drug is right for you.

For the generic versions of Zomig (zolmitriptan) and Imitrex (sumatriptan), costs are significantly lower:

  • Generic zolmitriptan is available in packs starting from 6 tablets with approximate costs ranging from $3 to $11 per tablet or dose depending on strength and quantity.
  • Sumatriptan is available in quantities ranging from 9 up to several dozens tablets with prices starting as low as about $1.30/tablet when purchased at larger quantities.

In general terms, sumatriptan tends to be cheaper than zolmitriptan even when considering their respective generic forms. Nevertheless, effectiveness and side effect profiles should also factor into your decision-making process along with advice from healthcare professionals.

Popularity of Zomig and Imitrex

Zolmitriptan, marketed under the brand name Zomig among others, is a medication used to treat migraines. In 2020 it was estimated that around 1 million prescriptions for zolmitriptan were filled in the US. It accounted for just over 10% of triptan prescriptions, an important drug class used specifically for acute migraine attacks. The use of zolmitriptan has been stable since its approval by the FDA in 1997.

Sumatriptan, sold under the brand name Imitrex among others, remains one of the most commonly prescribed medications in this category. In fact, approximately 5 million people were prescribed Sumatriptan in the USA during 2020. This accounts for nearly half (48%) of all triptans prescriptions and demonstrates its significant role as a first-line treatment option for acute migraines. Like zolmitriptan, sumatriptan's usage has remained relatively steady over recent years following its introduction into clinical practice almost three decades ago.


Both Zomig (zolmitriptan) and Imitrex (sumatriptan) have earned their places as reliable medications in the treatment of acute migraines, with numerous clinical studies indicating that they are more effective than placebo treatments. Occasionally, these drugs may be used together under careful medical supervision to manage severe or refractory headaches. They work primarily by constricting blood vessels in the brain and blocking pain pathways.

Zomig is typically used when a patient does not respond adequately to first-line triptans like sumatriptan or has side effects from them. However, both drugs can be considered as first options depending on individual patient circumstances.

The availability of generic forms for both zolmitriptan and sumatriptan represents significant cost savings especially for those paying out-of-pocket. The onset of relief varies between patients; some experience relief within an hour while others may need two hours or more.

Side effect profiles are similar between the two drugs, generally being well-tolerated but potentially causing sensations of heaviness, tingling or heat sensation often called 'triptans sensations'. For either drug, if migraines worsen or unusual symptoms occur after taking the medication such as chest pain or shortness of breath it's important to seek immediate medical help.