| Migraine Disorders
Ubrelvy vs Onzetra Xsail
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Ubrelvy vs Onzetra Xsail 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 signalsOnzetra Xsail has a higher rate of injection site reactions vs Ubrelvy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onzetra Xsail but not Ubrelvy, including UnitedHealthcare
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Category
Ubrelvy
Onzetra Xsail
At A Glance
Oral
As needed
CGRP receptor antagonist
Nasal powder
As needed
5-HT1B/1D agonist (triptan)
Indications
- Migraine Disorders
- Migraine Disorders
Dosing
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.
Migraine Disorders 22 mg (one 11 mg nosepiece per nostril) intranasally as a single dose; if migraine unresolved at 2 hours or returns, a second 22 mg dose may be administered at least 2 hours after the first; maximum 44 mg per 24 hours.
Contraindications
- 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)
- Ischemic coronary artery disease or coronary artery vasospasm, including Prinzmetal's angina, or other significant underlying cardiovascular disease
- Wolff-Parkinson-White Syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medications, 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%) 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
Most common (>=2%) Abnormal taste, nasal discomfort, rhinorrhea, rhinitis
Serious Myocardial ischemia, myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increased blood pressure, hypersensitivity reactions, seizures
Postmarketing Epistaxis
Pharmacology
Ubrogepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; by blocking CGRP receptor signaling it inhibits a pathway implicated in migraine pathophysiology.
Sumatriptan is a selective 5-HT1B/1D receptor agonist that constricts intracranial blood vessels and inhibits pro-inflammatory neuropeptide release from the trigeminal system, relieving migraine headache.
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Most Common Insurance
Anthem BCBS
Ubrelvy
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (12/12) · Qty limit (12/12)
Onzetra Xsail
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Ubrelvy
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (8/8)
Onzetra Xsail
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Ubrelvy
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Onzetra Xsail
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Onzetra Xsail.
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UbrelvyView full Ubrelvy profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.