| Migraine Disorders
Tosymra vs VYEPTI
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Tosymra vs Vyepti 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 signalsVyepti has a higher rate of injection site reactions vs Tosymra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vyepti but not Tosymra, including UnitedHealthcare
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Category
Tosymra
Vyepti
At A Glance
Nasal spray
Per migraine attack
5-HT1B/1D receptor agonist
IV infusion
Every 3 months
CGRP 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 100 mg by IV infusion every 3 months; some patients may benefit from 300 mg by IV infusion every 3 months.
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
- Serious hypersensitivity to eptinezumab-jjmr or any excipient, including anaphylaxis and angioedema
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%) nasopharyngitis, hypersensitivity reactions
Postmarketing anaphylaxis, fatigue, 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.
Eptinezumab-jjmr is a humanized IgG1 monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor, thereby preventing CGRP-mediated effects relevant to migraine.
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Most Common Insurance
Anthem BCBS
Tosymra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
Vyepti
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Tosymra
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Vyepti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Tosymra
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Vyepti
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
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.