Alternatives to Reyvow If You Can't Fill Your Prescription

Reyvow Is Going Away — Here Are Your Options

If you've been relying on Reyvow (Lasmiditan) to treat your migraines, you've probably already heard the news: Eli Lilly is permanently discontinuing Reyvow, with U.S. distribution ending May 31, 2026.

That means it's time to find a new acute migraine medication that works for you. The good news? There are several effective alternatives available. In this guide, we'll walk you through what Reyvow does, how it works, and which medications can take its place.

What Is Reyvow and How Does It Work?

Reyvow (Lasmiditan) is a serotonin 5-HT1F receptor agonist, the first and only drug in the "ditan" class. It was FDA-approved in 2019 for the acute treatment of migraine with or without aura in adults.

Unlike triptans, which work on 5-HT1B/1D receptors and cause blood vessel constriction, Reyvow works by inhibiting neuronal firing in the trigeminal nerve pathway without affecting blood vessels. This made it especially valuable for patients with cardiovascular conditions who couldn't safely take triptans.

For a deeper dive, read our article on how Reyvow works.

However, Reyvow came with some drawbacks: it's a Schedule V controlled substance, it causes significant drowsiness and dizziness, and patients cannot drive for at least 8 hours after taking it. These factors, combined with competition from newer medications, likely contributed to Lilly's decision to discontinue it.

Alternative #1: Ubrelvy (Ubrogepant)

Ubrelvy is an oral CGRP receptor antagonist (a "gepant") approved for the acute treatment of migraine in adults. It's made by AbbVie (originally Allergan).

How It Works

Ubrelvy blocks calcitonin gene-related peptide (CGRP) receptors, which play a key role in migraine pain signaling. Like Reyvow, it does not cause vasoconstriction, making it safe for patients with cardiovascular risk factors.

Key Advantages Over Reyvow

• Not a controlled substance — easier to prescribe and refill
• No 8-hour driving restriction
• Can take a second dose if needed (at least 2 hours after the first)
• Fewer sedation-related side effects

What to Know

• Available in 50 mg and 100 mg tablets
• Common side effects include nausea and drowsiness (typically mild)
• Cash price is approximately $900–$1,200 for 10 tablets without insurance
• Most insurance plans cover Ubrelvy with prior authorization

Alternative #2: Nurtec ODT (Rimegepant)

Nurtec ODT is another CGRP receptor antagonist, made by Pfizer (originally Biohaven). What makes Nurtec unique is its dual approval — it can be used for both acute migraine treatment and migraine prevention.

How It Works

Like Ubrelvy, Nurtec blocks CGRP receptors. The orally disintegrating tablet (ODT) format means it dissolves on your tongue without water, which is convenient during a migraine when nausea is common.

Key Advantages Over Reyvow

• Dual use: treat migraines when they happen AND prevent them from occurring
• Not a controlled substance
• No driving restriction
• Dissolves on tongue — no need for water

What to Know

• Available as a 75 mg orally disintegrating tablet
• For prevention: take every other day
• Common side effects include nausea and stomach pain
• Cash price is approximately $900–$1,100 for 8 tablets

Alternative #3: Zavzpret (Zavegepant)

Zavzpret is the newest gepant, approved in 2023. It's a nasal spray, which sets it apart from the other options on this list.

How It Works

Zavzpret is a CGRP receptor antagonist delivered intranasally. The nasal delivery provides faster absorption compared to oral medications, which can be beneficial when migraines cause severe nausea or vomiting.

Key Advantages Over Reyvow

• Nasal spray format — helpful if you can't keep pills down during a migraine
• Fast onset of action
• Not a controlled substance
• No driving restriction

What to Know

• Available as a 10 mg nasal spray
• Common side effects include altered taste, nasal discomfort, and nausea
• Relatively new — insurance coverage may be more limited than Ubrelvy or Nurtec

Alternative #4: Sumatriptan (Generic Triptan)

If cost is a major concern and you don't have cardiovascular risk factors, Sumatriptan may be the most practical alternative. It's been available as a generic for years and is one of the most widely prescribed migraine medications in the world.

How It Works

Sumatriptan is a triptan (5-HT1B/1D receptor agonist) that works by constricting blood vessels and reducing inflammation in the brain. It has a well-established track record for migraine relief.

Key Advantages

• Very affordable: generic Sumatriptan costs as little as $5–$20 for 9 tablets
• Available in multiple forms: oral tablets, nasal spray, and injection
• Covered by virtually all insurance plans, usually without prior authorization

Important Limitation

Triptans cause vasoconstriction and are contraindicated in patients with coronary artery disease, stroke history, uncontrolled hypertension, or other cardiovascular conditions. If cardiovascular risk was the reason you were on Reyvow instead of a triptan, Sumatriptan is not a suitable substitute — talk to your doctor about a gepant instead.

Which Alternative Is Right for You?

The best Reyvow replacement depends on your individual situation:

• If you were on Reyvow because of cardiovascular risks: Ubrelvy, Nurtec, or Zavzpret (all gepants, no vasoconstriction)
• If you want prevention AND acute treatment: Nurtec ODT
• If nausea is a big problem during migraines: Zavzpret nasal spray or Nurtec ODT
• If cost is the top priority: generic Sumatriptan (if safe for you)
• If you want the closest experience to Reyvow: Ubrelvy (oral tablet, similar convenience)

Talk to your neurologist or prescriber about which option fits your medical history and lifestyle. For help finding a doctor, see our guide on finding a prescriber near you.

Final Thoughts

Losing access to Reyvow is frustrating, especially if it was the medication that finally worked for you. But the migraine treatment landscape has expanded significantly in recent years, and there are effective options that don't come with Reyvow's controlled substance restrictions or driving limitations.

Start the conversation with your doctor now — don't wait until your last Reyvow tablet is gone. And if you're trying to fill your remaining Reyvow prescriptions while supply lasts, Medfinder can help you find pharmacies with stock.