Maxalt vs. Aimovig
See how Maxalt and Aimovig compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Maxalt is a fast-acting tablet taken during a migraine attack, while Aimovig is a once-monthly injection taken regularly to prevent migraines before they start.
Because they work differently, some patients use both together, taking Maxalt for breakthrough attacks while on Aimovig for ongoing prevention.
Maxalt carries cardiovascular warnings that Aimovig does not, since Aimovig works through a different mechanism outside the heart's blood vessels.
Maxalt vs. Aimovig Drug Summary
Maxalt
Maxalt (rizatriptan) is a triptan that treats migraine attacks after they start by narrowing blood vessels and blocking pain signals. It comes as a standard tablet or an orally disintegrating tablet taken at the first sign of a migraine, with a repeat dose allowed after two hours if needed. It is approved for adults and children ages 6 to 17.
Aimovig
Aimovig (erenumab-aooe) is a monoclonal antibody that blocks the CGRP receptor to prevent migraines before they begin. It is given as a self-administered injection once a month using a prefilled autoinjector or syringe. It is approved only for adults and is not used to treat an attack already in progress.
Maxalt vs. Aimovig Side Effects
Maxalt
Aimovig
Maxalt vs. Aimovig Dosage
Maxalt
Aimovig
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg repeat dose | At the start |
| Maximum dose | 5-10 mg repeat dose | Same as starting |
| Dose changes | None | Fixed dose |
| STAGE | DOSE | WHEN |
| Starting dose | 70 mg once monthly | At the start |
| Maximum dose | 140 mg once monthly | If needed |
| Dose changes | 1 increase | As tolerated |
Maxalt
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg repeat dose | At the start |
| Maximum dose | 5-10 mg repeat dose | Same as starting |
| Dose changes | None | Fixed dose |
Aimovig
| STAGE | DOSE | WHEN |
| Starting dose | 70 mg once monthly | At the start |
| Maximum dose | 140 mg once monthly | If needed |
| Dose changes | 1 increase | As tolerated |
Maxalt vs. Aimovig Indications
Maxalt
Maxalt is FDA-approved for the acute treatment of migraine attacks, with or without aura, in adults and children ages 6 to 17. It works best when taken as soon as migraine symptoms begin. It is not approved for migraine prevention or for cluster headache.
Acute treatment of migraine with or without aura
Approved for adults and children ages 6-17
Taken as needed at onset of migraine symptoms
Not approved for migraine prevention
Aimovig
Aimovig is FDA-approved for the preventive treatment of migraine in adults, reducing how often migraines occur over time. It is not intended to stop a migraine attack that has already started. It is given as a regular monthly injection rather than an as-needed dose.
Preventive treatment of migraine in adults only
Reduces migraine frequency with regular use
Not approved for treating an active migraine attack
Given once monthly regardless of symptoms
Maxalt vs. Aimovig Pros and Cons
Maxalt
Maxalt works quickly to relieve migraine pain once an attack has started, with an orally disintegrating option for people who have trouble swallowing pills. It carries cardiovascular contraindications that limit its use in people with heart disease and cannot be combined with other triptans or ergotamines. It has been available since 1998, giving prescribers decades of real-world experience with the drug.
Pros
Fast-acting relief once a migraine attack begins
Orally disintegrating tablet option needs no water
Approved for children ages 6-17, unlike Aimovig
Decades of clinical use since 1998
Cons
Contraindicated in ischemic or vasospastic heart disease
Cannot be used within 24 hours of another triptan
Not meant for more than about 4 headache days a month
Treats attacks after they start, not prevention
Aimovig
Aimovig targets the CGRP receptor to reduce how often migraines happen, sparing patients the need to treat each attack individually. It avoids the cardiovascular contraindications that limit triptan use, but it requires a monthly self-injection and does not help during an active attack. It has been used since 2018, with a growing body of long-term safety data.
Pros
Prevents migraines rather than just treating attacks
No cardiovascular contraindications like triptans
Only one injection needed per month
Can be combined with acute treatments like Maxalt
Cons
Requires a self-administered injection every month
Does not relieve an attack already in progress
Approved for adults only, not children
Constipation can occasionally become serious
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