Provider Briefing: Reyvow Is Being Permanently Discontinued

If you prescribe acute migraine treatments, this update is essential. Eli Lilly has voluntarily discontinued Reyvow (Lasmiditan), the only FDA-approved ditan-class medication. This is not a temporary shortage — it's a permanent market exit.

This article provides a comprehensive clinical overview for neurologists, headache specialists, primary care physicians, and other prescribers who need to understand the implications and develop transition plans for affected patients.

Discontinuation Timeline

Here's the confirmed timeline based on FDA Drug Shortages data and Eli Lilly communications:

• November 2025: FDA Drug Shortages tracker lists Reyvow (50 mg and 100 mg tablets) as "to be discontinued"
• November 2025: Eli Lilly confirms voluntary global discontinuation as a business decision
• May 31, 2026: U.S. distribution of both strengths officially ends
• Post-May 2026: Remaining pharmacy inventory may be dispensed until depleted; no new supply will be manufactured

Eli Lilly has stated unequivocally that this decision is not related to safety, efficacy, or quality concerns. The drug's clinical profile remains unchanged — the issue is purely commercial.

Prescribing Implications

Current Patients on Reyvow

Patients currently stabilized on Reyvow will need to transition to alternative acute migraine therapy. Key considerations:

• Proactive communication: Don't wait for patients to call with an unfilled prescription. Reach out to Reyvow patients now to discuss alternatives
• Remaining refills: Existing prescriptions can still be filled while pharmacy supply lasts. Patients may benefit from filling their remaining refills promptly
• No taper required: Reyvow is taken as-needed for acute migraine attacks, so there's no discontinuation syndrome or tapering concern
• Controlled substance considerations: As a Schedule V drug, ensure e-prescribing records are updated and outstanding prescriptions are managed per state regulations

New Prescriptions

Writing new Reyvow prescriptions in 2026 is not advisable unless the patient has a specific clinical need and you've confirmed pharmacy availability. Starting a patient on a medication that will be unavailable within months creates unnecessary disruption.

Current Availability Picture

As of early 2026, Reyvow availability varies significantly by region and pharmacy:

• Major chain pharmacies (CVS, Walgreens) are depleting stock faster due to higher patient volume
• Independent and specialty pharmacies may retain stock longer
• Wholesale distribution continues through May 31, 2026 — pharmacies can still place orders
• No generic Lasmiditan exists or is expected in the near term

For real-time availability information, Medfinder for Providers can help your practice identify pharmacies with current inventory to direct patients toward.

Cost and Access Considerations

While Reyvow remains available, the financial landscape for patients:

• Cash price: $850–$1,100 for 8 tablets
• Reyvow Savings Card: Still active as of early 2026 for commercially insured patients — may reduce cost to $0 per fill (up to $3,400/year savings). Not available for government insurance
• Lilly Cares Foundation: Patient assistance program for uninsured/underinsured patients meeting income criteria — provides Reyvow at no cost
• Discount cards: SingleCare, GoodRx, and similar programs offering $689–$800 for 8 tablets

These programs may be phased out as the drug leaves the market. Advise patients to take advantage of savings programs while they remain active.

Alternative Medications: Clinical Comparison

The primary alternatives fall into two categories: gepants and triptans.

CGRP Receptor Antagonists (Gepants)

These are the most pharmacologically comparable alternatives for patients who were prescribed Reyvow specifically because triptans were contraindicated:

• Ubrelvy (Ubrogepant): 50 mg or 100 mg oral tablet. May repeat dose after ≥2 hours. Not a controlled substance. No significant driving impairment. Most similar convenience profile to Reyvow
• Nurtec ODT (Rimegepant): 75 mg orally disintegrating tablet. Dual indication for acute treatment and episodic migraine prevention (every other day dosing). Useful for patients who may also benefit from preventive therapy
• Zavzpret (Zavegepant): 10 mg intranasal spray. Fastest absorption among gepants. Particularly useful for patients with significant nausea/vomiting during attacks

Triptans

For patients without cardiovascular contraindications who were on Reyvow for other reasons (e.g., triptan non-response, patient preference):

• Sumatriptan: Available as oral tablet (25/50/100 mg), nasal spray, and subcutaneous injection. Generic cost as low as $5–$20. First-line for most patients
• Rizatriptan, Zolmitriptan, Eletriptan: All available as generics with varying onset profiles

Critical reminder: Patients who were specifically placed on Reyvow due to cardiovascular disease, uncontrolled hypertension, cerebrovascular disease, or peripheral vascular disease should NOT be switched to triptans. Gepants are the appropriate alternative class for these patients.

For patient-facing information on alternatives, you can direct patients to our alternatives guide.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder offers real-time pharmacy availability information that can help your office:

• Direct patients to specific pharmacies with Reyvow in stock
• Reduce phone tag between your office, patients, and pharmacies
• Streamline the prescription transfer process

Prior Authorization Support

When transitioning patients to gepants, be prepared for prior authorization requirements. Most insurers require documentation that the patient has:

• Tried and failed (or has contraindications to) at least 2 generic triptans
• A documented migraine diagnosis
• Current Reyvow use with documented discontinuation as justification for the switch

The Reyvow discontinuation itself may serve as compelling justification for PA approval of a gepant, even in patients who haven't formally failed triptans.

Patient Communication Templates

Consider proactively reaching out to patients currently on Reyvow with a brief communication covering:

• The discontinuation and timeline
• Recommendation to schedule a visit to discuss alternatives
• Reassurance that effective options exist
• Links to patient resources like the Medfinder Reyvow update for patients

Looking Ahead

The loss of the ditan class from the market leaves a gap for a specific patient population — those with cardiovascular contraindications to triptans who also don't respond well to gepants. While gepants cover most of this ground, some patients had unique success with Reyvow's serotonergic mechanism.

No new ditans are currently in late-stage development. The migraine pipeline continues to focus on CGRP-pathway targets and novel mechanisms, but the 5-HT1F receptor agonist approach appears to be on hold for the foreseeable future.

For providers seeking to stay current on migraine medication access issues, Medfinder for Providers offers ongoing updates and tools.

Final Thoughts

The Reyvow discontinuation requires proactive management. Identify your affected patients now, initiate transition conversations early, and leverage tools like Medfinder to help patients access remaining supply during the transition period.

The earlier you plan, the smoother the transition will be for your patients — and your practice.