Imigran vs Vydura for migraines

Wednesday, September 11, 2024

When it comes to migraines, it's not easy to find a single treatment that suits everybody. Medicines are one part of many things we can do to help manage migraines.

Adapting your lifestyle (for example, by getting enough sleep or limiting your caffeine intake) can help to prevent migraines. Still, sometimes migraines persist, leading to missed days from work and social events.

If paracetamol or ibuprofen does not help manage your symptoms, there are some specific anti-migraine medicines which might work better.

Here, we explain the main differences between Imigran (sumatriptan) and the newer migraine treatment, Vydura (rimegepant).

Why do we get migraines?

We do not yet understand what causes migraines.

Keeping a headache diary (like the N1-Headache app used by the NHS) can also help us understand how to avoid a migraine.

For example, migraines can be caused by:

Too much or too little sleep
Hormonal changes (e.g. during menopause)
Alcohol (particularly red wine)
Flashing lights or loud noises
Sudden heavy exercise
Weather changes
Food triggers (e.g. nitrates and artificial sweeteners)

By understanding your triggers, it is possible to avoid migraines entirely or reduce the intensity of them.

However, managing triggers is not always enough for everybody, and simple pain relief like paracetamol and ibuprofen does not always help the pain.

We know that migraine symptoms may be due to the temporary widening of blood vessels in the head. This is why anti-migraine medicines may be a more targeted treatment for a person with migraine, as they help by narrowing the blood vessels in your head or by preventing them from widening (1).

How does Imigran (sumatriptan) work?

Imigran is a brandedmmedicine containing sumatriptan. Sumatriptan helps reduce symptoms by narrowing the blood vessels in your head. It can work quite quickly to provide relief within a couple of hours, either by reducing pain or intensity or by making a migraine shorter.

Other medicines with a similar effect include rizatriptan (Maxalt) and zolmitriptan (Zomig), which are commonly known as "Triptans”.

How do I take Imigran (sumatriptan)?

You can take one dose as soon as a migraine begins. If your pain has not reduced or stopped after 2 hours, you can take another dose.

How does Vydura (rimegepant) work?

Vydura is a newer medicine which contains rimegepant (also known as a "Gepant" medicine). Rimegepant blocks a protein called "Calcitonin Gene-Related Peptide" (CRGP).

CGRP itself causes blood vessels to widen and has been linked to migraines (2).

Vydura is a medicine that blocks the effect of CRGP. This prevents blood vessels from further widening, which in turn alleviates migraine symptoms.

How do I take Vydura (rimegepant)?

You can take a dose when you feel symptoms of a migraine coming on. If appropriate, it can also be used as a preventative medicine if you have been diagnosed with chronic migraines. This medicine cannot be repeated more than once a day.

Imigran (Sumatriptan) and other "Triptans"	Vydura (Rimegepant)
Works by narrowing blood vessels.	Works by stopping blood vessels from widening.
Used to relieve a current migraine.	Can be used to relieve a current migraine or to prevent future ones.
Can repeat dose after 2 hours if needed.	One dose per day only.
Should be avoided for those with heart-related problems.	Can be taken by those with heart-related problems.
Available on the NHS.	In England, Scotland and Wales, Vydura is available on the NHS for prevention and active treatment of migraines only after other medicines have failed to work.
Risk of Medicines Overuse Headaches (4) (MOH). (Also known as "rebound headaches".)	Early indications that “Gepants” such as Vydura are not associated with MOH (5).

Other migraine medicines

Understanding your symptoms can help you determine which treatment is right for you. The table below may help you understand the options available.

Migraine type

Aim of treatment

Examples of medicines used

Acute migraine

To stop or shorten the length of a single migraine attack.

Paracetamol

Ibuprofen

Metoclopramide (anti-sickness)

Triptans (e.g. sumatriptan)

Gepants (e.g. rimegepant)

Chronic migraine

To prevent migraines from occurring (usually considered if you are having at least four attacks per month – See your GP).

Beta-blockers (e.g. propranolol)

Anti-depressants (e.g. amitriptyline)

Anti-convulsants (e.g. topiramate)

Gepants (e.g. rimegepant)

Which treatment is right for me?

For a current migraine attack, try paracetamol or ibuprofen first if you can. If these don’t help or help enough, a "Triptan" medicine such as Imigran may work better.

Some people might not find relief with medicines such as Imigran either. If this applies to you, you may respond well to Vydura. Start an online consultation or get in touch to find out if this is the right treatment for you.

Please note - if your migraines are severe or getting worse, are lasting longer than usual, are occurring more than once a week, or you are finding it difficult to control your symptoms, you should see your GP (3).

Can I get migraine medicines on the NHS?

Some anti-migraine medicines, including Triptans and preventative medicines such as beta-blockers, are available on the NHS.

Vydura has been approved by the NHS for treating an active migraine but only when other treatments have not worked or for people who cannot use triptans.

The NHS has also approved Vydura for migraine prevention after three other preventative medicines have failed to work.

Vydura is called Nurtec in the USA and other parts of the world, this is not unusual with medicines.

At Oxford Online Pharmacy, we aim to give you the information and support you need to manage your migraines. Use our online consultation tool to find out how you can access a private prescription that is suitable for you.