If your migraine episodes stop responding to sumatriptan, you have a few options. These include different forms of sumatriptan, like a nasal spray, other types of triptans, and newer migraine rescue meds.

Sumatriptan (Imitrex) is a commonly prescribed migraine medication. It belongs to a class of drugs known as triptans, which treat migraine attacks.

But sumatriptan doesn’t work for everyone. Sumatriptan is thought to treat less than 60% of migraine episodes.

It can also stop working for you, even if you’ve been using it for years. It’s also possible for sumatriptan to effectively treat some migraine episodes but not others.

If one medication has worked for you in the past, you may be able to find a substitute. If you haven’t found an effective medication yet, there are still others you can try. Here are some options to consider:

Sumatriptan is commonly taken as an oral tablet, but it’s available in other forms. You can take sumatriptan as a nasal spray, an injection pen, and a rectal suppository.

If the oral form of sumatriptan has stopped working for you, there is a good chance you’ll have better luck with a delivery method that gets the medication into your bloodstream faster.

A 2014 research review found that subcutaneous (under the skin) injections of sumatriptan were more effective than other delivery methods. Sumatriptan injections also provided faster pain relief, especially when taken at the beginning of a migraine attack.

But sumatriptan injections also had a higher risk of side effects than other delivery methods. And the cost of the medication can be prohibitive if insurance doesn’t cover it.

The triptan family is large, and sumatriptan is only one of your options. If you’ve had success with sumatriptan in the past, your next step might be to try a different triptan.

Because these medications work similarly, there is a chance that one will work better than sumatriptan.

Other options include:

  • almotriptan (Axert)
  • eletriptan (Relpax)
  • frovatriptan (Frova)
  • naratriptan (Amerge)
  • rizatriptan (Maxalt)
  • zolmitriptan (Zomig)

Work with a healthcare professional to determine if switching to another type of triptan may help you find relief.

If your migraine treatment isn’t working, start keeping a record of the details around each migraine attack.

Bring your migraine diary with you to your next doctor’s appointment. Reviewing these details can help your doctor look for clues about why your treatment plan isn’t working.

In your migraine diary, be sure to take note of details such as:

  • the date, day of the week, and time of day
  • how long the episode lasted
  • any symptoms you experienced
  • how severe your symptoms were
  • any rescue medications you took, and whether or not a second dose was needed
  • how well the treatment worked (and how long it took to notice improvement)
  • how quickly you took your rescue treatment after symptoms began
  • any treatment side effects you experienced
  • any triggers you may have come across before the migraine attack

Triptans are just one class of drugs that can be used during a migraine attack to help you find relief.

If sumatriptan isn’t working, ask your doctor about other medications you can take to treat a migraine attack, such as:

Certain devices are also available to treat migraine. Known as neuromodulation devices, these tools work to increase or decrease nervous system activity, which can help reduce migraine attacks.

One device, known as the Cefaly, is available over the counter. It’s believed that using this device can help reduce the number of migraine days and lead to less dependency on rescue medication. Cefaly is also considered to be safe and well-tolerated by most people.

While other devices are also available, they require a prescription from your doctor. And they’re not yet widely prescribed. Neuromodulation devices can be a good option if other, more traditional migraine treatments aren’t working well for you.

These devices are also a good option for people who can’t take triptans because of other medical conditions.

According to the American Migraine Foundation, not all health insurance plans cover the cost of migraine treatment. And every insurance company is different.

So in order to know what your health insurance company will cover (or not), you’ll need to contact them directly.

Ask what steps you need to take to get your migraine treatments covered. Some may require you to try certain drug classes before they’ll cover others. Or, if your doctor is prescribing a medication for “off label” use, meaning it’s not technically indicated for migraine, your insurance plan may deny coverage of that drug.

Playing an active role in your migraine care and learning to advocate for what you need can help you get the right treatment.

Sumatriptan is commonly prescribed for migraine relief but it doesn’t work for everyone.

Other options include different forms of sumatription, other triptans, and migraine devices. Knowing what steps to take and advocating for yourself can help you find a treatment plan that does work to alleviate migraine pain.

To find more support about migraine, visit Healthline’s migraine hub.