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

Most common
chest/neck/jaw pressure (up to 8%)
paresthesia (up to 6%)
malaise/fatigue (up to 3%)
warm/cold sensation (up to 3%)

Maxalt

Most common
dizziness (up to 9.9%)
somnolence (up to 8.3%)
asthenia/fatigue (up to 5%)
pain/pressure sensation (up to 4%)

Imitrex vs. Maxalt Dosage

Imitrex

Dosage
Dosage Table
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

Dosage
Dosage Table
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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