Comparison Of 'Triptan' Drugs

Answer

You're right that there are a number of different 'Triptan' drugs on the market, and it can be difficult to sort through them all. I have included a chart in this answer that helps to break them down.

First and foremost, although there are plenty of Triptan options, and there are some minor differences between them, all Triptans are considered relatively comparable in terms of how well they work. Differences in efficacy, safety, and tolerability are small and highly individual.

Nevertheless, the minor differences between them can be impactful for certain individuals, so I have provided a breakdown in the section below.

Triptan Drug Comparison Chart

How Do 'Triptans' Work?

'Triptan' drugs are serotonin receptor agonists. They work by stimulating serotonin receptors (5-HT1B and 5-HT1D). Stimulation of these receptors inhibits vasodilation (i.e., promotes vasoconstriction) and inflammation. Additionally, Triptans are thought to work by altering the transmission of pain.

In general, Triptans are for the acute treatment of migraines and are considered most effective when used at the first sign of a migraine.

How Do Triptans Compare?

The chart above breaks down various aspects of Triptan drugs, including their dosing, how well they work, their onset of action, and the percentage of individuals that experience pain relief within a 2-hour window.

In terms of oral Triptans, studies show that rizatriptan (generic for Maxalt) is likely the most effective, but again, Triptans are all relatively comparable in this regard, and one may work better than another for specific individuals. In fact, a number of studies suggest that individuals who do not respond to one Triptan may respond to another.

Frovatriptan (generic for Frova) lasts the longest, and studies have evaluated it for the use of preventing menstrual migraine due to its long duration of action (it is not FDA-approved for this though).

Outside of your oral Triptan options, there are nasal sprays, patches, and injections.

Oral formulations of Triptans are the most popular, but because symptoms of migraine include nausea and vomiting, sometimes non-oral Triptans represent the best treatment option. 

The injections are the fastest acting, but come with the caveat that they need to be injected, which many individuals don't want to do. Nose spray products are another option that generally work faster than oral tablets.

Lastly, it is important to note that only two Triptans are approved for use in children, rizatriptan, and almotriptan.

Concerns

Studies show that, as a drug class, Triptans are effective and relatively safe for most individuals suffering from migraines.

There is some concern regarding the cardiovascular risk of using Triptans.

However, most studies have found no association between Triptan use and the risk of cardiovascular events such as stroke and heart attack in those who do not have certain cardiovascular risk factors. One such study reported the following:

In general practice, triptan treatment in migraine does not increase the risk of stroke, MI, cardiovascular death, IHD, or mortality. Triptans are prescribed to those less at risk of these events.

If you do have cardiovascular risk factors, such as a prior heart attack or stroke, Triptan medications are generally avoided. 

It is important to note that Triptans are associated with 'medication overuse headache'. For this reason, all Triptans are recommended to be limited to no more than 10 days of use per month.

Final Words

This answer isn't intended to be a complete analysis of Triptans, but rather a quick overview hitting on the important points. 

Thanks for your question and if you have anything else you want us to go over, reach back out to one of our pharmacists!