All questions are answered by:
Richard Wenzel, PharmD
Diamond Headache Clinic Inpatient Unit
St. Josephýs Hospital, Chicago, IL

Perhaps more than any group of medications, the triptans have contributed to the improved recognition and treatment of migraine and other types of headache. Introduced in the United States in 1993, these drugs have been an important catalyst for research, advanced healthcare professionalsý understanding of migraine, and offered an effective drug option to halt attacks, all of which ultimately benefitted thousands of migraine sufferers.

There are now seven triptans available in the U.S. The triptans appear to act in migraine by binding to selected receptors for serotonin found in the blood vessels (5HT1B) and nerve endings (5HT1D). By binding to these receptors, triptans keep migraines from developing or cause them to end.

Each type of triptan binds to different combinations of serotonin receptors, which is why patients often have to try more than one kind of triptan to find one that works for them. For example, sumatriptan and zolmitriptan sprays have been found to be effective for cluster headache as well as migraine. Frovatriptan is unique in that it has a long half-life of about 26 hours, which is helpful for patients who experience migraines that persist for several days, or for those who have been prone to a recurrence of their headaches with other triptans.

Despite their numerous advantages, cost concerns have consistently surrounded triptans. While prices vary, the expense for oral tablets typically exceeds $12, while nasal sprays exceed $20 and injections can exceed $40. These prices, especially for patients experiencing frequent migraine attacks, can cause financial burdens.

One way to address cost issues is through generic versions of brand-name medications. In the not too distant future, generic triptans are expected in this country. Imitrexý was the first triptan approved in the U.S.; thus, this drug will undoubtedly be the first available in a generic version.

The process by which the Food and Drug Administration (FDA) approves generic medications can be complicated and lengthy, and delays are common. Therefore, the following dates are only estimates for the arrival of generic triptans:

  • Imitrex (sumatriptan) nasal spray and injection – 2008
  • Imitrex (sumatriptan) tablets – 2009
  • Zomig (zolmitriptan) tablets and nasal spray – 2013
  • Maxalt (rizatriptan) tablets – 2010
  • Amerge (naratriptan) tablets – 2010
  • Axert (almotriptan) tablets – 2012
  • Relpax (eletriptan) tablets – 2013
  • Frova (frovatriptan) tablets and Imitrex tablets – 2013

Generic medications are safely and effectively consumed by millions of people every day for the treatment of a variety of conditions. Once approved, patients should feel confident that their generic triptan will treat their migraine attacks in the same manner as their brand-name drug. The obvious difference will be financial relief!