Comprehensive medication guide to Symbravo including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Commercially insured patients may pay as little as $10 with the Symbravo On My Side Savings Program. Most Medicare Part D plans do not cover Symbravo; Medicaid plans usually cover it with prior authorization. Commercial/ACA plans have limited coverage and often require prior authorization and step therapy.
Estimated Cash Pricing
Approximately $1,382–$1,420 retail for 9 tablets without insurance; as low as $1,110–$1,143 with a GoodRx coupon. No generic is currently available.
Medfinder Findability Score
60/100
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Symbravo is a prescription oral tablet that combines two active ingredients: meloxicam (20 mg), a COX-2 preferential non-steroidal anti-inflammatory drug (NSAID), and rizatriptan (10 mg), a fast-acting triptan. Manufactured by Axsome Therapeutics, it received FDA approval on January 30, 2025, making it one of the newest prescription migraine medications available in the United States.
Symbravo is FDA-approved for the acute treatment of migraine with or without aura in adults. It is taken as needed when a migraine begins — it is not a preventive migraine medication, and it is not approved for cluster headache. The drug was formerly known by its development code AXS-07.
Symbravo is unique in using Axsome's proprietary MoSEIC (Molecular Solubility Enhanced Inclusion Complex) technology, which significantly improves the absorption speed of meloxicam — allowing both active ingredients to begin working in a coordinated, rapid manner that addresses multiple aspects of the migraine cascade simultaneously. No generic version of Symbravo is currently available.
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Symbravo works through a dual mechanism of action that targets two distinct phases of the migraine cascade. Migraine begins with the release of CGRP (calcitonin gene-related peptide) from trigeminal nerve terminals in the meninges. CGRP causes vasodilation and triggers an inflammatory cascade that releases prostaglandin E2 (PGE2), further amplifying pain.
Rizatriptan (5-HT1B/1D agonist): Binds to serotonin receptors on trigeminal nerve terminals to inhibit CGRP release, and constricts dilated meningeal blood vessels — targeting the first wave of the migraine cascade. Rizatriptan reaches peak plasma concentration approximately 30 minutes post-dose.
Meloxicam (COX-2 NSAID) via MoSEIC technology: Inhibits COX-2 enzymes to block prostaglandin E2 production, reducing meningeal inflammation and central pain sensitization. Standard meloxicam absorbs slowly (peak: hours); MoSEIC meloxicam peaks in approximately 45–60 minutes, targeting the inflammatory wave before it peaks at around 2 hours post-onset.
Clinical trials (MOMENTUM and INTERCEPT Phase 3 trials) demonstrated that Symbravo was superior to either component alone and to placebo in achieving 2-hour pain freedom and sustained 24-48 hour relief. The EMERGE trial showed Symbravo significantly outperformed oral CGRP inhibitors (gepants) in patients who had previously experienced inadequate responses to those drugs.
20 mg / 10 mg — Oral tablet
One tablet (meloxicam 20 mg and rizatriptan 10 mg) taken by mouth as needed for acute migraine. Maximum: 1 tablet per day.
Symbravo is not listed in any official FDA or ASHP drug shortage as of 2026. However, finding it in stock at a local pharmacy can be challenging. As a newly launched brand-name medication (approved January 2025) with no generic available, many pharmacies — particularly smaller independent ones — have not yet added it to their routine inventory. Stocking patterns vary significantly between pharmacy locations, even within the same chain.
Large national chains (CVS, Walgreens, Walmart Pharmacy, Kroger) are your best bets for finding Symbravo in stock or being able to quickly order it. Most pharmacies can special-order Symbravo within 1–2 business days if it's not currently on their shelves. Mail-order pharmacies (Express Scripts, CVS Caremark, OptumRx) may also be reliable options for 90-day supply fills.
To save time, use medfinder — a service that calls pharmacies near you on your behalf to check which ones have Symbravo in stock. Results are sent via text message, eliminating the need to call multiple pharmacies yourself.
Because Symbravo is not a DEA-scheduled controlled substance, any licensed prescriber with the authority to prescribe non-controlled medications can write a Symbravo prescription. There are no DEA registration requirements specific to Symbravo, and no federally mandated in-person visit requirements for obtaining a prescription.
Healthcare providers who commonly prescribe Symbravo include:
Neurologists and headache specialists — the primary specialists managing complex migraine
Primary care physicians (family medicine and internal medicine)
Nurse practitioners (NPs) — in most states with full prescribing authority
Physician assistants (PAs) — in states where they have independent prescribing authority
Symbravo can also be prescribed via telehealth platforms. Since it is not a controlled substance, no in-person evaluation is required under current federal law. Telehealth neurology services, headache-specific platforms, and general telehealth providers (Teladoc, MDLive) can all assess and prescribe Symbravo for appropriately diagnosed adult migraine patients.
No. Symbravo (meloxicam and rizatriptan) is not a DEA-scheduled controlled substance. It does not contain opioids, benzodiazepines, stimulants, or any other controlled ingredients. Because it is not scheduled, any licensed prescriber can write a Symbravo prescription — including primary care physicians, nurse practitioners, and physician assistants — without needing a DEA registration number specifically for Symbravo.
Additionally, since Symbravo is not a controlled substance, it can be prescribed via telehealth without in-person visit requirements, 90-day supplies can be dispensed without the monthly limits typical of controlled medications, and there are no state-specific controlled substance prescribing restrictions that apply to Symbravo. Standard prescription rules apply.
The most commonly reported adverse reactions in clinical trials (occurring in ≥1% of patients, more often than placebo):
Dizziness
Somnolence (drowsiness)
Nausea
Fatigue
Muscle tightness
Symbravo carries a Boxed Warning for:
Serious cardiovascular thrombotic events (heart attack, stroke) — increased risk with NSAID use
Serious gastrointestinal adverse events (bleeding, ulceration, perforation)
Serious allergic reactions (anaphylaxis)
Serious skin reactions (Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis)
Serotonin syndrome (risk increased with serotonergic medications)
Medication overuse headache (with frequent use ≥10 days/month)
Renal toxicity (especially in patients with dehydration, kidney disease, or on diuretics/ACE inhibitors)
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Sumatriptan/Naproxen (generic Treximet)
Closest alternative — also a triptan/NSAID combination tablet. Generic available at significantly lower cost (~$30–$100 for a pack of tablets). Uses sumatriptan + naproxen instead of rizatriptan + meloxicam.
Rizatriptan (generic Maxalt)
The triptan component of Symbravo, available as a generic. Fast-acting; available as oral tablets and orally-dissolving wafers. Typically $15–$40/month for generic.
Ubrelvy (ubrogepant)
CGRP receptor antagonist (gepant) for acute migraine. No vasoconstriction — preferred for patients with cardiovascular risk factors. Often better covered by commercial plans than Symbravo.
Nurtec ODT (rimegepant)
CGRP receptor antagonist approved for both acute and preventive migraine treatment. Orally dissolving tablet — no water needed. Good insurance coverage on many commercial plans.
Prefer Symbravo? We can find it.
MAO-A Inhibitors (phenelzine, tranylcypromine)
majorContraindicated. MAO inhibitors slow rizatriptan metabolism, causing dangerously elevated drug levels. 14-day washout required before using Symbravo.
Other Triptans
majorContraindicated within 24 hours. Combining two triptans increases risk of cardiovascular adverse effects and excessive vasoconstriction.
Ergotamine / Dihydroergotamine (DHE)
majorContraindicated within 24 hours due to risk of dangerous vasoconstriction.
Warfarin and Anticoagulants
majorThe NSAID component increases bleeding risk. INR monitoring recommended for patients on warfarin who also use Symbravo.
SSRIs and SNRIs
moderateIncreased GI bleeding risk (NSAID + antiplatelet effect of SSRIs/SNRIs) and rare serotonin syndrome risk (rizatriptan + serotonergic drugs). Monitor for symptoms.
ACE Inhibitors and ARBs
moderateMeloxicam may reduce antihypertensive effectiveness. Combined use also increases risk of acute kidney injury, especially with dehydration or renal impairment.
Propranolol
moderatePropranolol significantly increases rizatriptan plasma exposure. Patients on propranolol typically require the lower 5 mg rizatriptan dose — consult physician before using Symbravo (which contains a fixed 10 mg dose).
Lithium
moderateNSAIDs reduce renal clearance of lithium, potentially raising serum lithium to toxic levels. Monitor lithium levels closely.
Diuretics
moderateNSAIDs may reduce diuretic effectiveness and increase sodium retention. Increased risk of renal complications in at-risk patients.
Corticosteroids
moderateCombination with NSAIDs significantly increases GI bleeding and ulceration risk.
Other NSAIDs (ibuprofen, naproxen)
majorAvoid concomitant use. Additive NSAID-related risks for GI bleeding and kidney injury.
Symbravo represents a meaningful advancement in acute migraine treatment — a dual-mechanism approach combining rapid triptan action with fast-absorbing NSAID anti-inflammatory coverage in a single tablet. Its Phase 3 clinical data is compelling, particularly the EMERGE trial results showing superiority over oral CGRP inhibitors in patients who had previously found gepants inadequate. For migraine patients with unmet needs on current therapy, Symbravo is a clinically strong option to discuss with your prescriber.
The main practical challenges in 2026 are access-related: limited pharmacy stocking as a new drug, limited insurance coverage, and high retail cash price. However, all of these are surmountable — the Symbravo On My Side Savings Program significantly reduces cost for commercially insured patients, prior authorization can unlock coverage on many plans, and availability is improving as the drug builds its prescribing track record.
If you've been prescribed Symbravo and need help locating it at a pharmacy, medfinder calls pharmacies near you to find which ones have it in stock and texts you the results — saving you hours of phone calls and frustration.
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