| Migraine Disorders
Tosymra vs Ubrelvy
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Tosymra vs Ubrelvy 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 signalsUbrelvy has a higher rate of injection site reactions vs Tosymra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ubrelvy but not Tosymra, including UnitedHealthcare
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Category
Tosymra
Ubrelvy
At A Glance
Nasal spray
Per migraine attack
5-HT1B/1D receptor agonist
Oral
As needed
CGRP receptor antagonist
Indications
- Migraine Disorders
- Migraine Disorders
Dosing
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.
Migraine Disorders 50 mg or 100 mg orally as needed; a second dose may be taken at least 2 hours after the initial dose; maximum 200 mg per 24-hour period. Dose reductions apply with moderate or weak CYP3A4 inhibitors, BCRP and/or P-gp only inhibitors, and in patients with severe hepatic or severe renal impairment (CLcr 15-29 mL/min); avoid in end-stage renal disease.
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 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
- Concomitant use of strong CYP3A4 inhibitors
- History of serious hypersensitivity to ubrogepant or any component of UBRELVY (reactions have included anaphylaxis, dyspnea, and facial or throat edema)
Adverse Reactions
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
Most common (>=2%) Nausea, somnolence, dry mouth
Serious Hypersensitivity reactions, hypertension, Raynaud's phenomenon
Postmarketing Hypersensitivity (anaphylaxis, dyspnea, facial or throat edema, rash, urticaria, pruritus), hypertension, Raynaud's phenomenon
Pharmacology
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.
Ubrogepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; by blocking CGRP receptor signaling it inhibits a pathway implicated in migraine pathophysiology.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Tosymra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
Ubrelvy
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (12/12) · Qty limit (12/12)
UnitedHealthcare
Tosymra
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Ubrelvy
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (8/8)
Humana
Tosymra
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Ubrelvy
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Tosymra.
Cost estimate not availableHealthWell: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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TosymraView full Tosymra profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.