What is the fastest migraine relief medicine in Europe and the UK? [2024 Update]

Over 1 billion people worldwide are affected by migraines each year. 90% of people report being unable to work or perform daily activities during a migraine attack. This makes migraine the sixth most-disabling disease in the world ¹. It's clear that an effective, and fast, treatment is of high priority. 

If you're suffering from migraines and you need a fast pain relief, here's a list of the fastest remedies for migraine available in Europe and the UK in 2023. 

What is the first line of medication for migraines?

That depends on how severe your migraine attack is. Typically, mild and moderate migraines are treated with acetaminophen or nonsteroidal anti-inflammatory drugs (such as Ibuprofen). 

However, these treatments are often insufficient to address severe migraine attacks. The first-line treatments in such cases can be either triptans or gepants. 

What is the fastest acting triptan?

Triptans target specific serotonin receptors in the brain, known as 5-HT1B and 5-HT1D. When triptans attach to these receptors, they cause the blood vessels in the brain, which expand and cause pain during a migraine, to narrow down. This action helps in reducing the migraine pain.

How fast a triptan works depends on several factors, including the way it is administered. Taken as pills, triptans work the slowest. The pain relief is faster with nasal sprays and the fastest with an injection. 

The fastest acting triptans available in 2023 are:

#1: Imigran (sumatriptan)

In Europe and the UK, sumatriptan is not available over the counter and you will need a prescription to get it. Sumatriptan comes as tablets, a nasal spray, or injection. Due to its injectable form, it's the fastest acting triptan at the moment.

How fast does sumatriptan work?

• The tablets take between 30 and 60 minutes to provide pain relief.
• The nasal spray usually works within 15 minutes.
• The injection provides relief within 10 to 15 minutes ². 

#2: Maxalt (rizatriptan)

Rizatriptan is also a prescription-only migraine medicine. It only comes as a tablet. Even so, it is a relatively fast-working triptan.

How fast does rizatriptan work?

You have a 20% probability of pain reduction within 30 minutes of taking rizatriptan. In any case, within 30 minutes to 2 hours, you should expect your migraine attack to subside ⁴. 

 #3: Zomig (zolmitriptan)

Similar to other triptans, zolmitriptan is available in Europe and the UK by prescription only. One difference between sumatriptan and zolmitriptan is that the latter does not come in the form of an injection. It's only available as an oral tablet or nasal spray. 

How fast does zolmitriptan work?

Most people experience pain relief within 1 to 2 hours of taking Zomig (zolmitriptan) ³.

Do triptans work for everyone?

Unfortunately, not all migraines are helped by triptans. In some cases, triptans are not recommended - e.g. if you have heart disease, hypertension or peripheral artery disease. Or, due to drug interactions. It can also be that a triptan doesn't relieve your migraine attacks, or has stopped working for you ⁵. 

Luckily, there are other fast-working migraine medicines to consider in these cases: gepants. 

What is the fastest-acting gepant?

Gepants bind to CGRP receptors on the trigeminal nerve and suppress the release of CGRP, which normally prolongs and sustains migraine attacks. Unlike triptans, gepants don't tighten the blood vessels. Instead, they prevent them from dilating. That's what makes gepants a safer choice for people with heart conditions, who would normally not be prescribed triptans. 

The fastest-acting gepants available in 2023 are:

#1: Zavzpret (zavegepant)

Zavegepant is the first and currently only gepant available as a nasal spray. This also makes it the fastest-acting migraine relief medicine among the gepants. Unfortunately, it is only approved and available in the USA at the moment. It's unclear if and when Zavzpret's EMA approval or MHRA approval might be coming.

How fast does zavegepant work?

Zavegepant's pivotal Phase 3 study demonstrated pain relief within 15 minutes of administration. Within 2 hours from administration, patients reported being free from the most bothersome symptoms ⁷.

Buy Zavzpret

#2: Ubrelvy (ubrogepant)

Ubrogepant comes in the form of tablets. Currently, it's only approved and available in the USA. There is no timeline available for Ubrelvy's EMA approval or its potential availability on the NHS in the UK.

How fast does Ubrelvy work?

Typically, ubrogepant relieves pain within 1.5 to 2 hours. Its maximum effect is achieved between 3 and 8 hours from administration ⁶.

Buy Ubrelvy

#3: Vydura (rimegepant)

Rimegepant is available as an orally disintegrating tablet. It's currently approved and available in the UK and Europe ⁸. 

How fast does rimegepant work?

Most people experience pain relief within 2 hours of taking rimegepant. Many patients report sustaining these effects up to 48 hours after administration ⁹. 

What if the fastest migraine relief medicine isn't approved (yet) in your country?

Most gepants are not yet approved or available outside of the USA. If you're based elsewhere, suffering from migraine attacks and don't qualify for treatment with triptans, you might be wondering if there's a way to access fast-acting gepants such as Zavzpret before they're locally approved.

Yes, there is. 

Most countries have regulations in place that allow patients to import medicines that aren't yet approved or available locally, as long as they are prescribed by a doctor and are for personal use only. In these cases, you can buy Zavzpret, Ubrelvy, or other fast-acting migraine remedies as an Individual Named Patient. 

Do you have a prescription for Zavzpret, Ubrelvy or another migraine medicine not yet approved in your country? Our team at Everyone.org can help you access it immediately. Get in touch to find out more.  

Get in touch

References:

1. Migraine Statistics and Facts. Migraine.com, 19 April 2021.
2. Common questions about sumatriptan. NHS, Accessed 4 December 2023.
3. Pope, Carmen. How long does Zomig take to work? Drugs.com, 1 December 2022.
4. Anderson, Leigh Ann. How long does it take for Maxalt to work? Drugs.com, 13 June 2023.
5. Pietrangelo, Ann, and Murtaza Cassoobhoy. Migraine Medications Don't Work? Here's What to Do. WebMD, 12 February 2023.
6. Puckey, Melisa. What is Ubrelvy used for and how fast does Ubrelvy work? Drugs.com, 19 June 2023.
7. Pfizer's ZAVZPRET™ (zavegepant) Migraine Nasal Spray Receives FDA Approval. Pfizer, 10 March 2023.
8. Vydura | European Medicines Agency. European Medicines Agency, 25 April 2022.
9. Rimegepant Approved by the FDA. American Headache Society, Accessed 4 December 2023.