Triptans: Uses, most common brand names, and safety information
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Migraine headaches occur in approximately 12% of people 12 years of age and older in the US. It is almost three times more common in women (17%) than in men (6%). Migraines are an important public health problem and accounted for around 4 million emergency room visits in 2016. The acute treatment of migraine headaches often includes nonsteroidal anti-inflammatory drugs (NSAIDs) and selective serotonin receptor agonists, which are also called triptans. Over-the-counter NSAIDs such as Aleve (naproxen) and Motrin (ibuprofen) are typically used for mild migraine headaches, while triptans are used for moderate to severe migraine headaches.
The list below includes FDA-approved triptans and their pricing:
List of Triptans
Imitrex is indicated to treat migraine and cluster headaches.
Imitrex Statdose (sumatriptan)
Imitrex Statdose is indicated to treat migraine and cluster headaches.
Imitrex Nasal Spray (sumatriptan)
Imitrex Nasal Spray is indicated to treat migraine and cluster headaches.
Onzetra Xsail (sumatriptan)
Onzetra Xsail is indicated to treat migraine and cluster headaches.
Tosymra is indicated to treat migraine and cluster headaches.
Axert is indicated to treat migraine headaches.
Relpax is indicated to treat migraine headaches.
Frova is indicated to treat migraine headaches.
Maxalt is indicated to treat migraine headaches.
Maxalt MLT (rizatriptan)
Maxalt MLT is indicated to treat migraine headaches.
Amerge is indicated to treat migraine headaches.
Zomig is indicated to treat migraine headaches.
Zomig ZMT (zolmitriptan)
Zomig ZMT is indicated to treat migraine headaches.
Zomig Nasal Spray (zolmitriptan)
Zomig Nasal Spray is indicated to treat migraine headaches.
Treximet is indicated to treat migraine headaches.
What are triptans?
Triptans are a class of anti-migraine medications used to treat moderate to severe migraine headaches or mild cases that did not respond to other treatments. They cause vasoconstriction to help provide migraine relief from symptoms such as nausea, vomiting, headache pain, or sensitivity to light and sound. The first triptan drug, sumatriptan, was launched in the Netherlands in 1991 and became available in the US in 1993. Today, there are several triptans available in various dosage forms, including oral tablets, orally dissolving tablets, subcutaneous injections, and nasal sprays.
How do triptans work?
Triptans work by selectively binding and stimulating the 5-HT1B and 5-HT1D serotonin receptors. Stimulating 5-HT1B receptors causes the vasoconstriction of dilated blood vessels in the brain, which is thought to play a role in the throbbing pain experienced during a migraine attack. When triptans bind to 5-HT1D receptors, they block the transmission of pain signals to the brain as well as inhibit inflammation and vasodilation. Triptans do not have any significant activity at other serotonin receptors throughout the body.
What conditions are triptans used to treat?
Triptans are used in several conditions, including:
- Acute or episodic migraines, with or without aura
- Cluster headaches (sumatriptan only)
Are triptans safe?
The use of triptans is relatively safe and effective when taken as prescribed. Before beginning treatment with triptans, tell your healthcare provider if you have any of the following medical conditions:
- High blood pressure (hypertension)
- Heart disease
- History of heart attack or stroke
- Coronary artery disease
- Hemiplegic migraines
- Peripheral vascular disease
- Raynaud’s disease
- Severe liver or kidney disease
- Are taking medications or supplements that increase serotonin such as selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), or other antidepressants
- Are taking ergot alkaloids or beta-blockers such as propranolol
- Are pregnant, plan on becoming pregnant, or are breastfeeding
What are the common side effects of triptans?
The adverse effects you experience from triptans will depend on several factors including the medication and dose. Some common side effects of triptans seen in clinical trials when compared to placebo include:
- Tingling sensations
- Hot or cold sensations
- Neck or throat pain
- Chest pain
- Injection site reactions
- Medication-overuse headache when taken too often
Triptans can sometimes cause more serious side effects, including:
- Severe hypersensitivity reactions
- Serotonin syndrome when given with other medications that increase serotonin
- Increased risk of stroke and heart attack
- Increased blood pressure
- Fast or irregular heartbeat
This is not a complete list of side effects and we encourage you to consult with your healthcare provider for medical advice about any possible side effects.
Who should not take triptans?
You should not take triptans if you are over the age of 65 or have a known hypersensitivity to any ingredients in the product’s formulation. You should also avoid these medications if you have a history of heart attack, stroke, coronary artery disease, hemiplegic migraines, uncontrolled high blood pressure, peripheral vascular disease, or severe liver or kidney disease.
What is the best triptan for migraine?
According to a meta-analysis and systematic review from 2014, the triptans that would be most likely to consistently stop migraine symptoms were Maxalt (rizatriptan), Relpax (eletriptan), and Axert (almotriptan).
What is the difference between Ubrelvy and triptans?
Ubrelvy and triptans work differently but are both effective in treating adults with acute migraines with or without aura. They both have been found to produce pain relief at an average of 2 hours after treatment. Most triptans have generics available so their average cost will be less than Ubrelvy. Typically Ubrelvy is used when you have failed other treatments such as NSAIDs, ergotamine, or triptans. Ubrelvy may also be a safer option in patients with a history of heart disease as it does not cause vasoconstriction.
How long does it take triptans to work?
Most people will see an improvement in symptoms within 2 hours of taking an oral triptan. Sumatriptan can start working within 20 to 60 minutes when taken by mouth. Subcutaneous sumatriptan works faster, within 10 to 15 minutes, and the nasal spray in about 15 minutes.
How much do triptans cost?
Triptans are very expensive with an average cost of around $5,000 per year.
You can purchase Triptans for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.
Related resources for triptans