Zolmitriptan vs Sumatriptan: How Do These Treatments Compare
Zolmitriptan and Sumatriptan tablets are both prescription-only migraine pain relief medicines that are used to treat acute migraine headaches. These antimigraine agents only work once headache symptoms begin.
These medicines also work to help alleviate migraine symptoms, such as light sensitivity, nausea, and vomiting. Neither medication prevents migraines from occurring or reduces how frequently the migraines occur.
In this article, we explore the differences between Zolmitriptan and Sumatriptan, helping you to get a sense of which treatment might be suitable for you.
How Do Zolmitriptan and Sumatriptan Compare?
Zolmitriptan and Sumatriptan are both members of the drug class known as triptans. Triptans are used for the treatment of acute migraine attacks.
Below, we provide a high-level comparison of each before exploring each point in detail later in this article.
| Point of Comparison | Zolmitriptan Tablets | Sumatriptan Tablets |
| Active Ingredient | Zolmitriptan | Sumatriptan succinate |
| Usage | Acute treatment of migraines | Acute treatment of migraines |
| Effectiveness | Once taken, Zolmitriptan tablets typically work within 60 minutes. | Once taken, Sumatriptan tablets typically work within 30 to 60 minutes. |
| Ease of Use | Zolmitriptan is available as a nasal spray, oral tablet and oral tablet disintegrating. | Sumatriptan is available as an oral tablet, nasal spray, and subcutaneous solution. |
| Dosage & Direction of Use | Oral tablet: 2.5 mg Nasal spray: 2.5 mg, 5 mg Zolmitriptan must be taken exactly as prescribed by your doctor or healthcare provider. A second tablet may be taken if the migraine is not resolved in two or more hours. However, if symptoms still persist, do not take another dose. Your doctor will let you know what your maximum daily dosage is. | Oral tablet: 50 mg, 100mg Pre-filled syringes: 3 mg, 6 mg Nasal Spray: 10 mg, 20 mg Sumatriptan must be taken exactly as prescribed by your doctor or healthcare provider. If the migraine is not resolved by 2 hours after taking a dose of Sumatriptan or, returns after slight improvement, a second dose may be administered. The maximum daily dosage is 200 mg in a 24-hour period. |
| Side Effects |
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| Key Differences | Zolmitriptan appears to cross the blood-brain barrier and act directly on the central nervous system. | Sumatriptan works by narrowing the brain’s blood vessels. |
| Overall Satisfaction Rating | Most Zolmitriptan reviews are positive, and the medication is well tolerated. | Most reviews for Sumatriptan are positive, and the medication is well tolerated. |
Who Can Use?
Zolmitriptan
Most adults can safely take Zolmitriptan tablets. You should not take this medication if you have any of the following:
- Wolff-Parkison-White syndrome
- Coronary heart disease, chest pain, blood circulation problems, or a lack of blood supply to the heart
- Uncontrolled or severe hypertension (high blood pressure)
- A history of heart disease
- If you have taken an MAO inhibitor in the past 14 days
Tell your doctor or pharmacist if you are pregnant, breastfeeding, or are planning to become pregnant.
Sumatriptan
Sumatriptan tablets are generally safe for most adults, but the nasal spray form is only recommended for individuals under 65 years of age. While not approved for children, specialists may prescribe it to those aged six and above.
However, Sumatriptan isn't suitable for everyone. Before using it, inform your doctor if you suffer from any of the following:
- Circulatory issues in the legs, known as peripheral vascular disease
- Seizures or fits
- High blood pressure or hypertension
- Liver conditions, including liver disease
- Heart-related concerns, such as cardiovascular disease, angina, or arrhythmias
- Previous experiences with a stroke or mini-stroke
- Allergic reactions to Sumatriptan or other medications
- Pregnancy, attempts to conceive, or breastfeeding status
Effectiveness
Zolmitriptan
When it comes to efficacy, clinical studies found that:
- 27%-50% of patients responded positively to 1mg of Zolmitriptan
- 62%-65% of patients responded positively to 2.5mg of Zolmitriptan
- 59%-67% of patients responded positively to 5mg of Zolmitriptan
Sumatriptan
Sumatriptan is a new class of selective serotonin receptor agonists, similar to Zolmitriptan. It obstructs the transmission of pain signals to the brain and constricts blood vessels within the brain.
An evaluation of Sumatriptan's effectiveness revealed that the 25mg dose was slightly less effective than the 50mg and 100mg doses. Interestingly, the 50mg dose was found to be just as effective as the 100mg dose but with a reduced occurrence of side effects.
Studies indicate that 60% to 80% of patients experience significant relief when using a triptan medication.
How quickly does each treatment take effect?
Zolmitriptan
Zolmitriptan in tablet form, once taken as soon as migraine symptoms begin, generally works within 60 minutes, with a significant headache response reported in 2 hours. All doses of Zolmitriptan nasal spray work as early as 15 minutes after administering it.
Sumatriptan
When taken at the onset of migraine symptoms, Sumatriptan in tablet form typically starts to work within a timeframe of 30 to 60 minutes.
Ease of Use
Zolmitriptan
Zolmitriptan is available in tablet form and single-use intranasal spray. Tablets are swallowed whole with a glass of water. The nasal spray is sprayed directly into one nostril while the other is blocked with your finger.
Sumatriptan
Sumatriptan comes in several forms: tablets, pre-filled syringes (auto-injectors), and nasal spray. The tablets should be taken orally with a glass of water. The pre-filled syringes are typically injected into the thigh and start to take effect in about 10 to 15 minutes. For the nasal spray it's sprayed into one nostril while blocking the other nostril with your finger.
Adhering to the guidelines your doctor or pharmacist provides is crucial when using any form of Sumatriptan.
Dosages
Zolmitriptan
Zolmitriptan is available as:
- 2.5 mg and 5 mg oral tablet
- 2.5 mg and 5 mg single-use nasal spray
The recommended dose of Zolmitriptan for an adult to treat a migraine is 2.5 mg or 5 mg. For children under the age of 12, the safety and efficacy of the drug are not established. Talk to your doctor to discuss frequency and dosage.
Sumatriptan
Sumatriptan is available in various forms and dosages:
- Nasal spray in 10 mg and 20 mg strengths
- Oral tablets in 50 mg and 100 mg strengths
- Pre-filled syringes in 3 mg and 6 mg strengths
For adults, the recommended doses of Sumatriptan are 25 mg, 50 mg, and 100 mg. The 50 mg and 100 mg doses may be more effective than the 25 mg dose, but a 100 mg dose may not necessarily be more effective than a 50 mg dose.
It's crucial to take the initial dose of Sumatriptan as soon as you notice migraine symptoms. It's important to remember that Sumatriptan is not intended for migraine prevention.
Side Effects
Zolmitriptan
Common side effects of Zolmitriptan may include:
- Drowsiness
- Sweating
- Dizziness or feeling faint
- Heartburn
- Dry mouth
- Nausea
- Feeling cold or warm
- Heavy feeling anywhere in the body
Serious side effects of Zolmitriptan include:
- Hives, itching, or skin rash
- Hallucinations
- Fever
- Agitation
- Loss of coordination
- Fainting
- Chest pain or pressure
- A feeling of tightness in the chest, neck, throat, or jaw
- Difficulty breathing
- A slow heartbeat
- A fast or irregular heartbeat
- Blurred vision
Sumatriptan
Common side effects of Sumatriptan can include:
- Nausea or vomiting
- Dizziness
- Flushing or sensations of warmth
However, there are more serious side effects to be aware of:
- Chest tightness or tingling
- A feeling of heaviness in the body
- Tingling or tightness in other parts of the body, like the arms, legs, or face
Allergic reaction symptoms specific to Sumatriptan might include:
- Wheezing or difficulty in speaking
- Trouble breathing
- Severe tightness in the throat or chest
- Swelling of the face, throat, tongue, or lips
It's crucial to seek immediate medical help if you experience any signs of an allergic reaction to Sumatriptan or Zolmitriptan.
Remember, not everyone will experience these side effects. If you do encounter mild side effects that persist, it's advisable to speak with your doctor or pharmacist.
If you experience serious side effects or a severe allergic reaction, make your way to A&E or call 999 immediately.
Key Difference Between Zolmitriptan and Sumatriptan?
Zolmitriptan
Zolmitriptan was created with the goal of providing a centrally acting drug that is more rapidly orally absorbed than Sumatriptan. Zolmitriptan, unlike Sumatriptan, crosses the blood-brain barrier and acts directly on the central nervous system.
Zolmitriptan also has an improved oral bioavailability compared to Sumatriptan, allowing Zolmitriptan to act faster.
Sumatriptan
Sumatriptan is available as a nasal spray, oral tablet, and as a subcutaneous solution, whereas zolmitriptan is only available as a nasal spray and oral tablet. A total of 91 drugs are known to interact with Sumatriptan, while 141 drugs are known to interact with Zolmitriptan.
Interactions with other medicines
Zolmitriptan
Medications that interact with Zolmitriptan and should not be taken together include:
- Other serotonin receptor agonists such as eletriptan, almotriptan, rizatriptan, Sumatriptan
- Ergot alkaloids such as bromocriptine, cabergoline, ergonovine, pergolide, and others
- MAOIs such as Marplan, Parnate, or Nardil
- Certain medications for depression, anxiety or psychotic disorders.
Sumatriptan
Certain medications are known to interact with Sumatriptan and should not be taken concurrently:
- Monoamine oxidase inhibitors (MAOIs) like Carbex, Parnate, Eldepryl, Nardil, and Marplan
- Specific drugs used for treating depression, psychotic disorders, or anxiety
- Ergot alkaloids, including ergotamine, dihydroergotamine, and methylergonovine
- Other migraine medications such as Almotriptan, Rizatriptan, Zolmitriptan, and Naratriptan
It's important to inform your pharmacist or doctor about any prescription medications, over-the-counter drugs, herbs, or dietary supplements you are currently taking. This information is crucial for ensuring safe and effective use of your medications.
How much does each cost?
How much does each of these antimigraine medications cost?
| Medication | 3 Tablets | 6 Tablets | 12 Tablets | 18 Tablets |
| Sumatriptan 50mg | £6.99 | £9.99 | £18.99 | £26.99 |
Sumatriptan 100mg | N/A | £11.99 | £20.99 | £28.99 |
Zolmitriptan 2.5mg | N/A | £39.99 | £69.99 | N/A |
Thoughts from customers
Zolmitriptan
Most customers have positive reviews for Zolmitriptan. They reported that Zolmitriptan is effective for immediate pain relief, is affordable, and positively impacts common and long-standing infections. Some customers mentioned that they experienced common side effects such as drowsiness.
Sumatriptan
Many users have shared positive feedback about Sumatriptan, noting its effectiveness in quickly addressing and alleviating migraine symptoms. However, some users have also reported experiencing side effects while taking this medication.
Conclusion
Zolmitriptan and Sumatriptan tablets are both effective in providing relief for acute migraines and their related symptoms. It's essential to consult with your doctor to determine which prescription medication is most suitable for your specific healthcare needs.
If you struggle with migraines and need a course of treatment, Cloud Pharmacy can help. Following an online consultation, one of our prescribers will ensure that you receive the right migraine medication the very next day.
FAQs
How do Zolmitriptan and Sumatriptan work?
Zolmitriptan and Sumatriptan are both selective serotonin receptor antagonists. They work by narrowing the blood vessels in the brain that the migraine has temporarily widened.
Can you take Sumatriptan and Zolmitriptan together?
No. It is strongly advised not to take Zolmitriptan and Sumatriptan together as these medications cause severe and significant drug interactions.
Can you drink whilst on Zolmitriptan or Sumatriptan?
When on Zolmitriptan or Sumatriptan, alcohol consumption should be avoided or limited as alcohol can increase the nervous system effects such as dizziness, difficulty concentrating, or drowsiness.
There are no known alcohol interactions with Sumatriptan.
Which is better, Zolmitriptan or Sumatriptan?
While some studies suggest Zolmitriptan may be more effective than Sumatriptan, which is better, it comes down to personal preference and needs.
Can I take either Zolmitriptan or Sumatriptan with paracetamol or ibuprofen?
Sumatriptan can be taken with over-the-counter pain relief, such as paracetamol or ibuprofen.
You can take Zolmitriptan with paracetamol or ibuprofen. However, paracetamol or ibuprofen must be taken 30 to 60 minutes before taking Zolmitriptan.
Where can I buy Zolmitriptan and Sumatriptan?
You can buy Zolmitriptan and Sumatriptan online at Cloud Pharmacy after consulting with one of our healthcare professionals or pharmacists.
Are Zolmitriptan or Sumatriptan over-the-counter medications?
No, they are both prescription medications that require a prescription from a doctor to purchase.
