Ubrelvy vs. Nurtec: Differences, similarities & side effects

In this article:

• Key differences
• Conditions treated
• Insurance coverage and cost
• Side effects
• Interactions and warnings
• Bottom line: Ubrelvy vs. Nurtec

In this article

• Key differences
• Conditions treated
• Insurance coverage and cost
• Side effects
• Interactions and warnings
• Bottom line: Ubrelvy vs. Nurtec

Ubrelvy (ubrogepant) and Nurtec ODT (rimegepant) are two brand-name prescriptions indicated for the treatment of acute migraine headaches with or without aura. Nurtec has also been approved to prevent migraine headaches. Ubrelvy and Nurtec belong to a drug class called oral calcitonin gene-related peptide (CGRP) antagonists, also called gepants. They work by blocking the action of CGRP, a protein known to trigger migraines. Though very similar, these drugs have slight differences in their side effects and specific uses.

Nurtec vs. Ubrelvy: Key differences

“Ubrelvy is used to treat migraines with or without aura. Nurtec ODT is taken to treat migraines with or without aura and also to prevent episodic migraines,” says Inna Melamed, Pharm.D., a functional medicine practitioner and author of Digestive Reset. 

CGRP receptor antagonists are a class of drugs that help treat migraines by blocking CGRP, a protein that dilates blood vessels and causes inflammation in the brain. In other words, these drugs stop migraine pain in its tracks. Nurtec can be used as a preventive treatment due to its longer half-life, providing significant pain relief for up to 48 hours, per Lauren R. Natbony, MD, headache specialist and medical director of Integrative Headache Medicine of New York.

Aside from Nurtec being longer-lasting, Nurtec is a dissolvable tablet that can be taken without water, while Ubrelvy comes in a conventional oral tablet. Dr. Natbony says that Nurtec’s dissolvable form may be preferred if a patient is experiencing nausea at the onset of a migraine attack. The easier it is to take the medicine quickly and without triggering a gag reflex, the better. 

Finally, these acute migraine treatments have different dosing schedules. When used preventively, Nurtec is taken once every two days. When used to stop a migraine, Nurtec is a one-and-done dissolvable tablet, but Ubrelvy comes with the option of a repeat dose if the pain persists after two hours. According to Dr. Natbony, some patients value the freedom to safely take another Ubrelvy if they still haven’t found relief.

Is Ubrelvy better than Nurtec?

Both Ubrelvy and Nurtec are effective at treating existing migraines, and Nurtec can also help prevent future attacks. However, Dr. Natbony says that deciding which one is “better” depends on several factors, such as medical history, other medications, and even personal preference. 

In a review of four randomized controlled trials, a total of 3,827 migraine patients received a 75-mg dose of rimegepant, the active ingredient in Nurtec. Around 59% reported pain relief versus 45% on placebo, 36% had relief from their most bothersome symptom versus 25% on placebo, and around 21% of patients were pain-free versus 13% on placebo.

Pooled data from two randomized, placebo-controlled trials with 50-mg doses of Ubrelvy had similar findings. The trials included 2,240 participants, and after two hours, about 62% reported pain relief versus 49% on placebo, 39% had relief from their most bothersome symptom versus 28% on placebo, and about 21% were pain-free versus 13% on placebo.

Ultimately, the most effective medication should only be determined by your healthcare provider, who fully understands your medical conditions, history, and other medications you’re taking.

Nurtec vs. Ubrelvy: Insurance coverage & cost comparison

The cost of Urbrelvy and Nurtec with insurance varies. Many health insurance and Medicare plans cover these prescription medications, but coverage is not universal. It’s a good idea to check with your insurance company or Medicare Part D plan for more information.

Without insurance, Ubrelvy costs about $1,442 for 10, 100 mg tablets, and Nurtec costs about $1,372 for 8, 75 mg orally disintegrating tablets. That’s about $144 per Ubrelvy dose versus $172 per Nurtec dose. Monthly costs vary depending on how often a person experiences migraine attacks. 

With a SingleCare coupon, you may be able to save money on Ubrelvy and Nurtec, bringing the cost down to about $97 per Ubrelvy tablet and about $109 per Nurtec tablet.

Nurtec vs. Ubrelvy side effects

The most common side effect of Ubrelvy and Nurtec is nausea. However, Ubrelvy and Nurtec are both “generally well-tolerated,” according to Dr. Natbony. Still, she emphasizes that individual patient reactions can differ. That’s why it’s important to consult a healthcare provider for a complete list of adverse effects and potential risks.

Common side effects of Nurtec include:

• Nausea
• Indigestion
• Stomach pain

Common side effects of Ubrelvy include:

• Nausea 
• Sleepiness

Serious side effects are also possible with either drug, including serious allergic reactions, high blood pressure, and Raynaud’s phenomenon, which may require medical attention. Watch for symptoms such as swelling of the face or throat, chest pain, numbness or color changes in fingers or toes, or sudden increases in blood pressure. 

Nurtec & Ubrelvy drug interactions and warnings

Experts emphasize that Nurtec and Ubrelvy can interact with many other medications. Dr. Melamed points out that there are 154 known drug interactions with Nurtec alone. The good news is that these interactions tend to be mild—typically a decrease in the migraine medication’s effectiveness or an increase in common side effects. 

Common drug interactions with Nurtec and Ubrelvy involve the following:

• CYP3A4 inhibitors (such as ketoconazole, itraconazole, and clarithromycin): Slow the breakdown of Nurtec or Ubrelvy, increasing the risk of side effects of Nurtec or Ubrelvy.
• CYP3A4 inducers (such as phenytoin, rifampin, dexamethasone, and St. John’s wort): Speed up the metabolism of Nurtec and Ubrelvy, potentially making the migraine medicines less effective.

For those considering Nurtec or Ubrelvy for migraines, Dr. Natbony suggests informing a healthcare provider or pharmacist of all medications and supplements being taken in order to avoid drug interactions.

Nurtec and Ubrelvy are considered to be safe when used as indicated. However, they do come with potentially serious warnings, especially hypersensitivity reactions. In addition, these migraine medications may sometimes increase blood pressure or worsen pre-existing hypertension, and they’ve also been linked to new or worsening Raynaud’s phenomenon (reduced blood flow in fingers and toes).

As for other precautions, Dr. Natbony says that patients with liver or kidney issues may require a nonstandard dosage or be recommended to avoid Ubrelvy or Nurtec. She also says that the general recommendation is to discontinue these medications while pregnant or breastfeeding, even though one clinical trial suggests that potential infant exposure to Nurtec through breast milk is very low.

Bottom line: Ubrelvy vs. Nurtec

Nurtec and Ubrelvy are both effective options to help treat migraine disorders. Nurtec has also been approved for the prevention of episodic migraines. When taken at the start of a migraine attack, these migraine drugs have been proven to be effective at reducing symptoms and shortening the duration of discomfort.

Only a healthcare professional can offer medical advice on which antimigraine medication, Ubrelvy versus Nurtec, is suitable for you.

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