What is an alternative medication for Ubrelvy?: Exploring Your Migraine Treatment Options

October 11, 2025 •

4 min read

According to the Migraine Research Foundation, migraine affects over 39 million Americans, many of whom rely on acute treatments like Ubrelvy (ubrogepant) to stop an attack. However, if Ubrelvy is ineffective, poorly tolerated, or not covered by insurance, it's natural to seek an alternative medication for Ubrelvy. Fortunately, significant advances in migraine pharmacology offer a wide and expanding range of options.

Quick Summary

This article explores a comprehensive list of prescription and over-the-counter migraine treatments for those seeking an alternative to Ubrelvy. It details options from the newer CGRP inhibitor class (gepants), older triptans, ditans, and other common headache medications.

Key Points

Nurtec ODT offers dual-use and a different formulation: As an orally disintegrating tablet, Nurtec ODT is used for both acute and preventive migraine treatment and is an effective alternative for those with nausea.
Zavzpret is a fast-acting nasal spray: The newest gepant, Zavzpret, is administered as a nasal spray, providing rapid relief and bypassing the gastrointestinal tract, which is beneficial for those with severe nausea.
Triptans are an established and lower-cost alternative: Medications like Imitrex (sumatriptan) are widely available, have a proven track record, and come in various forms, including generic tablets, though they carry a risk for patients with cardiovascular disease.
Ditans offer relief without vasoconstriction: Reyvow (lasmiditan) is a newer class of medication that works differently than triptans, making it a suitable option for patients who cannot take vasoconstrictive drugs.
Older therapies and NSAIDs are still relevant: For milder attacks, over-the-counter and prescription NSAIDs or combination analgesics can be effective, sometimes used with other acute treatments.
Consider cost and potential side effects: The cost of newer brand-name gepants can be high, and different medications have unique side effect profiles and administration methods that should be discussed with a doctor.

Ubrelvy (ubrogepant) is an oral medication belonging to a class of drugs known as calcitonin gene-related peptide (CGRP) receptor antagonists, or gepants. It is specifically approved for the acute treatment of a migraine attack as it is happening. It works by blocking CGRP, a peptide believed to be involved in the cascade of events that cause a migraine. While effective for many, finding a suitable alternative is common for reasons including side effects, cost, or a lack of effectiveness. This guide outlines the different classes of medications available and how they compare to Ubrelvy.

Newer CGRP Antagonists (Gepants)

As part of the same class as Ubrelvy, other gepants offer a similar mechanism of action but with different formulations, dosing schedules, and potential side effect profiles.

Nurtec ODT (Rimegepant)

Nurtec ODT is a unique gepant because it is approved for both the acute treatment of a migraine attack and the preventive treatment of episodic migraine. Unlike Ubrelvy, which is a standard oral tablet, Nurtec ODT is an orally disintegrating tablet (ODT) that dissolves on or under the tongue. This feature makes it an excellent alternative for patients who experience severe nausea and vomiting during a migraine attack, as it bypasses the need to swallow a pill. While both drugs have been shown to be effective, some studies suggest Nurtec ODT may have a slightly quicker onset of action.

Zavzpret (Zavegepant Nasal Spray)

Zavzpret is another oral gepant, but it is formulated as a nasal spray, making it another fast-acting option for acute treatment. It can provide relief within 15 to 30 minutes, which can be critical during a rapidly escalating migraine. The nasal spray delivery avoids the gastrointestinal tract entirely, making it ideal for those who suffer from significant nausea or gastroparesis during an attack. Common side effects specific to the nasal spray include a bad taste in the mouth and nasal discomfort.

Traditional Triptan Medications

For decades, triptans were the first-line prescription treatment for many people with migraines. They work differently than gepants by causing the blood vessels around the brain to narrow and reducing pain signals. Triptans are not suitable for individuals with a history of heart conditions or uncontrolled high blood pressure due to their vasoconstrictive properties. However, for those without these contraindications, triptans offer a well-understood, often lower-cost alternative, especially since many are available as generics.

Imitrex (Sumatriptan)

One of the most well-known triptans, Imitrex, is available in multiple forms, including oral tablets, nasal spray, and injection. This variety of formulations allows for flexibility, particularly for those with nausea or very severe, rapid-onset migraines. Generic sumatriptan is significantly less expensive than brand-name gepants.

Other Triptans

Other popular triptans include Maxalt (rizatriptan), Zomig (zolmitriptan), and Relpax (eletriptan), each with unique properties, onset times, and half-lives. For example, Maxalt is available as an orally disintegrating tablet, similar to Nurtec ODT.

Ditans: Another Acute Option

Reyvow (lasmiditan) is a newer class of medication called a ditan, which also works on serotonin receptors but without causing blood vessel constriction. This makes it a potential alternative for patients with cardiovascular risk factors who cannot take triptans. Like Ubrelvy, it is used for the acute treatment of migraine. However, because it affects the central nervous system, it carries a higher risk of side effects like dizziness and sedation compared to gepants and triptans, and patients are advised not to drive for several hours after taking it.

Older and Adjunctive Therapies

Many people also find relief from older, non-specific migraine treatments, which can be used alone or in combination with other medications. These include:

Non-steroidal anti-inflammatory drugs (NSAIDs): Prescription-strength NSAIDs like Cambia (diclofenac) can be very effective for mild to moderate migraines, with the added benefit of being readily available and inexpensive. Some OTC NSAIDs, like ibuprofen or naproxen, can also be helpful.
Combination analgesics: A combination of acetaminophen, aspirin, and caffeine, found in products like Excedrin Migraine, has long been a standard for less severe attacks.
Anti-nausea medications: For patients with severe nausea and vomiting, anti-emetics like metoclopramide can be prescribed alongside other acute treatments.
Ergotamines: Medications like Trudhesa (dihydroergotamine) nasal spray are sometimes used for individuals with prolonged or difficult-to-treat migraines.

Comparing Ubrelvy Alternatives


Feature	Ubrelvy (ubrogepant)	Nurtec ODT (rimegepant)	Zavzpret (zavegepant)	Triptans (e.g., sumatriptan)	Reyvow (lasmiditan)
Drug Class	CGRP Receptor Antagonist (Gepant)	CGRP Receptor Antagonist (Gepant)	CGRP Receptor Antagonist (Gepant)	Serotonin Receptor Agonist (Triptan)	Serotonin 5-HT(1F) Agonist (Ditan)
Administration	Oral tablet	Orally Disintegrating Tablet (ODT)	Nasal Spray	Tablet, nasal spray, injection	Oral tablet
Uses	Acute migraine treatment	Acute treatment & prevention	Acute migraine treatment	Acute treatment & cluster headache	Acute migraine treatment
Cardiovascular Risk	Low; safe for those with heart issues	Low; safe for those with heart issues	Low; safe for those with heart issues	Risk of vasoconstriction; contraindicated in heart disease	Low; no vasoconstriction
Onset	~2 hours	~1-2 hours	As little as 15-30 minutes	Varies by formulation (tablet slower than injection)	~20-40 minutes
Key Considerations	Standard oral option. Can be taken twice in 24 hours.	Dissolves quickly, good for nausea. Dual-use for prevention.	Rapid onset, ideal for severe nausea/vomiting. Nasal-specific side effects.	Widely available, generic options (lower cost), multiple delivery methods.	No vasoconstriction, but higher risk of sedation/dizziness. Avoid driving.

Conclusion

For those seeking an alternative medication for Ubrelvy, the landscape of migraine treatments offers a variety of effective options. Newer gepants like Nurtec ODT and Zavzpret provide alternative administration methods and dual-action benefits, while traditional triptans remain a cost-effective choice for many without cardiovascular risk factors. The introduction of ditans like Reyvow and the continued use of older adjunctive therapies further expand the possibilities. The best choice depends on individual health needs, comorbidities, cost considerations, and personal preference, underscoring the importance of discussing these options with a healthcare provider to find the most suitable treatment path.

For more detailed information on comparing the newer and older acute migraine medications, resources like Migraine Again offer valuable insights for navigating your options.

Frequently Asked Questions

While both Ubrelvy and Nurtec ODT are CGRP inhibitors used for acute migraine treatment, Nurtec ODT is also approved for the preventive treatment of episodic migraine. Additionally, Nurtec ODT is an orally disintegrating tablet (ODT) that dissolves on the tongue, unlike Ubrelvy's standard oral tablet form.

Yes. Zavzpret is a newer gepant available as a nasal spray, which can provide rapid relief for those who experience nausea and vomiting with their migraines. Older triptans, like Imitrex (sumatriptan), are also available as nasal sprays and injections.

Yes, but only under the guidance of a healthcare provider. Triptans like Imitrex cause vasoconstriction and are not recommended for individuals with certain cardiovascular conditions or uncontrolled high blood pressure, a risk factor not associated with gepants like Ubrelvy.

Gepants, including Ubrelvy, have a low risk of cardiovascular side effects, making them a safer option for people with heart problems. However, they are typically more expensive brand-name drugs. Triptans, especially generics like sumatriptan, are often much less expensive but should be avoided by patients with cardiovascular risk factors due to their vasoconstrictive properties.

Reyvow is a ditan medication used for acute migraine treatment. Unlike triptans, it does not cause blood vessel constriction, making it a safe alternative for patients with cardiovascular disease. However, it can cause dizziness and drowsiness, and patients should not drive after taking it.

For milder migraines, over-the-counter options like NSAIDs (ibuprofen, naproxen) and combination analgesics containing acetaminophen, aspirin, and caffeine can be effective. Some individuals also find relief with supplements like magnesium or CoQ10, though these are typically for prevention rather than acute treatment.

The best way to choose is to consult your doctor. They will consider your medical history (including any cardiovascular issues), potential side effects, dosing preference (oral, nasal, injection), cost, and how often you experience migraines to recommend the most suitable alternative for your specific needs.