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

Most common
Dizziness (up to 9.9%)
Somnolence (up to 8.3%)
Asthenia/fatigue (up to 5%)

Aimovig

Most common
Injection site reactions (5-6%)
Constipation (up to 3%)
Cramps/muscle spasms (up to 2%)

Maxalt vs. Aimovig Dosage

Maxalt

Dosage
Dosage Table
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

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.