Imitrex vs. Maxalt
See how Imitrex and Maxalt compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Imitrex and Maxalt are both triptans used to stop a migraine attack that has already started, not to prevent future attacks.
Imitrex comes as a tablet, injection, or nasal spray, while Maxalt is only available as a standard or orally disintegrating tablet.
Maxalt is FDA-approved for children ages 6 to 17, while Imitrex tablets are approved for adults only.
Imitrex vs. Maxalt Drug Summary
Imitrex
Imitrex (sumatriptan) is a triptan that treats acute migraine attacks, with or without aura, in adults. It is taken as a tablet at the first sign of a migraine, with a second dose allowed after two hours if needed. It also comes as an injection or nasal spray for faster relief.
Maxalt
Maxalt (rizatriptan) is a triptan that treats acute migraine attacks, with or without aura, in adults and children ages 6 to 17. It is taken as a tablet or a fast-dissolving orally disintegrating tablet at the onset of a migraine, with a second dose allowed after two hours. It is only available in oral form.
Imitrex vs. Maxalt Side Effects
Imitrex
Maxalt
Imitrex vs. Maxalt Dosage
Imitrex
Maxalt
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg, 50 mg, or 100 mg | At the start |
| Maximum dose | Repeat dose, max 200mg/day | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg | At the start |
| Maximum dose | 5 mg or 10 mg repeat dose | If needed |
| Dose changes | 2 increases | As tolerated |
Imitrex
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg, 50 mg, or 100 mg | At the start |
| Maximum dose | Repeat dose, max 200mg/day | If needed |
| Dose changes | 1 increase | As tolerated |
Maxalt
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg | At the start |
| Maximum dose | 5 mg or 10 mg repeat dose | If needed |
| Dose changes | 2 increases | As tolerated |
Imitrex vs. Maxalt Indications
Imitrex
Imitrex is FDA-approved for acute treatment of migraine with or without aura in adults, and its injectable form is also approved for cluster headache. It works best when taken right at the first sign of a migraine attack. It is not intended to prevent migraines from occurring.
Acute treatment of migraine with or without aura in adults
Injectable form also approved for cluster headache
Available as tablet, injection, or nasal spray
Not approved for migraine prevention
Maxalt
Maxalt is FDA-approved for acute treatment of migraine with or without aura in adults and children ages 6 to 17. It comes as a standard tablet or an orally disintegrating tablet that dissolves without water. Like Imitrex, it treats attacks already underway rather than preventing them.
Acute treatment of migraine with or without aura in adults and children 6-17
Not approved for cluster headache or migraine prevention
Available as standard tablet or orally disintegrating tablet
Not studied for use beyond 4 headaches per 30 days
Imitrex vs. Maxalt Pros and Cons
Imitrex
Imitrex, one of the original triptans, has decades of clinical use and offers tablet, injection, and nasal spray options for acute migraine relief. Its injectable form is uniquely approved for cluster headache as well. It is not approved for use in children.
Pros
Comes as tablet, injection, or nasal spray for flexible dosing
Injectable form is also FDA-approved for cluster headache
Decades of real-world use since its 1992 approval
Cons
Tablets are not approved for use in patients under 18
Chest, neck, or jaw pressure sensations occur in up to 8% of users
No orally disintegrating tablet option available
Maxalt
Maxalt is a triptan approved for both adults and children ages 6 to 17, with a standard tablet and a fast-dissolving orally disintegrating version. It does not come as an injection or nasal spray, so it cannot be used for cluster headache. Its most common side effects involve dizziness and drowsiness rather than the chest or throat sensations seen with some triptans.
Pros
FDA-approved for children ages 6 to 17, not just adults
Available as an orally disintegrating tablet that needs no water
Lower rate of chest, neck, or jaw pressure sensations (up to 4%)
Cons
Not available as an injection or nasal spray, so no cluster headache use
Higher rates of dizziness (up to 9.9%) and somnolence (up to 8.3%)
Orally disintegrating version contains phenylalanine
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