| Migraine Disorders
Relpax vs Tosymra
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Relpax vs Tosymra with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsTosymra has a higher rate of injection site reactions vs Relpax based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tosymra but not Relpax, including UnitedHealthcare
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Category
Relpax
Tosymra
At A Glance
Oral
As needed
5-HT1B/1D agonist (triptan)
Nasal spray
Per migraine attack
5-HT1B/1D receptor agonist
Indications
- Migraine Disorders
- Migraine Disorders
Dosing
Migraine Disorders 20 mg or 40 mg orally for acute treatment; a second dose may be taken at least 2 hours after the first if migraine has not resolved or returns; maximum 80 mg/day.
Migraine Disorders 10 mg as a single spray in one nostril; max 30 mg in 24 hours with doses separated by at least 1 hour.
Contraindications
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or history or current evidence of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication such as dihydroergotamine (DHE) or methysergide
- Hypersensitivity to eletriptan or any excipient (angioedema and anaphylaxis seen)
- Recent use (within at least 72 hours) of potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke or transient ischemic attack (TIA) or history of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medication, or another 5-HT1 agonist
- Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor
- Hypersensitivity to sumatriptan
- Severe hepatic impairment
Adverse Reactions
Most common (>=2%) Asthenia, nausea, dizziness, somnolence, headache, paresthesia, flushing/feeling of warmth, chest tightness/pain/pressure, abdominal pain/discomfort, dry mouth, dyspepsia, dysphagia
Serious Myocardial ischemia and myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increase in blood pressure, hypersensitivity reactions
Postmarketing Seizure, vomiting
Most common (>=2%) Atypical sensations, tingling, dizziness/vertigo, warm/hot sensation, burning sensation, feeling of heaviness, flushing, weakness, neck pain/stiffness, chest discomfort, drowsiness/sedation
Serious Myocardial ischemia/infarction, arrhythmias, cerebrovascular events, vasospasm reactions, serotonin syndrome, increase in blood pressure, hypersensitivity reactions, seizures
Postmarketing Hypotension, palpitations, dystonia, tremor
Pharmacology
Eletriptan is a selective 5-HT1B/1D receptor agonist (triptan) that acts on intracranial blood vessel receptors and trigeminal sensory nerves to produce cranial vessel constriction and inhibit pro-inflammatory neuropeptide release.
Sumatriptan is a selective 5-HT1B/1D receptor agonist that exerts its therapeutic effects through agonist activity at 5-HT1B/1D receptors on intracranial blood vessels and sensory nerves of the trigeminal system, resulting in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Relpax
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (0/12) · Qty limit (9/12)
Tosymra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
UnitedHealthcare
Relpax
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (7/8)
Tosymra
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Relpax
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Tosymra
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Relpax.
No savings programs available for Tosymra.
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RelpaxView full Relpax profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.