Ubrelvy vs. Nurtec: Differences, similarities & side effects

Key differences │ Conditions treated │ Insurance and cost │ Side effects │ Interactions │ Warnings │ Bottom line

Ubrelvy (ubrogepant) and Nurtec ODT (rimegepant orally disintegrating tablets) 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 approved 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 prevent the continuation of migraine pain by blocking CGRP, a protein that activates brain receptors that send pain signals. In other words, they stop migraine pain in its tracks. Nurtec can be used as a preventive treatment because it has a 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, Ubrelvy and Nurtec differ in form: 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 in its tracks, 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.

Nurtec vs. Ubrelvy: Conditions treated

Ubrelvy and Nurtec have both been approved by the Food and Drug Administration (FDA) for treating migraine with or without aura. They are abortive treatments, not a cure, for migraine disorders. In other words, they can be taken at migraine onset to stop or reduce migraine attack symptoms.

“While individual responses may vary, both Nurtec and Ubrelvy are recognized for their swift action, often alleviating pain and symptoms within two hours,” Dr. Natbony says. 

Nurtec is also FDA approved for the prevention of episodic migraines. Some doctors also prescribe Ubrelvy off-label for migraine prevention, according to Dr. Melamed.

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 milligram (mg) dose of rimegepant, the active ingredient in Nurtec. After two hours, 58.6% reported pain relief, 20.6% reported significant freedom from pain, and 36% reported freedom from the most bothersome symptom.

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, 20% reported freedom from pain, and 39% reported the absence of their most bothersome symptom, such as nausea and sensitivity to light.

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 depends on a patient’s insurance plan. Many health insurance and Medicare plans cover these migraine 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 $1,361 for 10, 100 mg tablets, and Nurtec costs about $1,325 for 8, 75 mg orally disintegrating tablets. That’s about $136 per Ubrelvy dose versus $165 per Nurtec dose. Monthly costs vary depending on how often the patient experiences migraine attacks. 

With a SingleCare coupon, you can save money on Ubrelvy and Nurtec, bringing the cost down to about $96 per Ubrelvy tablet and about $106 per Nurtec tablet.

* This is the typical cost at time of publication. Cost varies by pharmacy, dosage, and location. 

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 essential to consult a healthcare provider for the complete list of side effects and potential risks specific to each patient’s situation.

Source: DailyMed (Nurtec ODT/Ubrelvy)

Nurtec & Ubrelvy drug interactions

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 the risk of side effects. 

Common drug interactions with Nurtec and Ubrelvy include CYP3A4 inhibitors, such as the antifungals ketoconazole and itraconazole or the antibiotic clarithromycin. These may slow the body’s elimination of the migraine drug, increasing the risk of side effects.

It’s also best to avoid CYP3A4 inducers, such as the anticonvulsant phenytoin, the antibiotic rifampin, the corticosteroid dexamethasone, or the over-the-counter supplement St. John’s wort. These may increase the body’s elimination of Nurtec or Ubrelvy, making them less effective at treating migraines.

If you’re considering Nurtec or Ubrelvy for migraines, Dr. Natbony suggests informing your healthcare provider or pharmacist of all medications and supplements you’re taking in order to avoid drug interactions.

Nurtec & Ubrelvy drug warnings

Nurtec and Ubrelvy are considered to be safe when used as indicated. Side effects are uncommon and mild, with the exception being an allergic reaction. Anyone who has trouble breathing or develops a severe rash after taking Nurtec or Ubrelby should seek medical attention, as these are signs of an allergic reaction.

As for other warnings, 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 FDA approved 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.