Maxalt vs. Ajovy
See how Maxalt and Ajovy compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Maxalt is taken to stop a migraine attack that has already started, while Ajovy is used to prevent migraines from happening in the first place.
Maxalt is a pill or dissolving tablet taken as needed, while Ajovy is a self-injection given once a month or once every three months.
Maxalt can relieve pain within hours, but Ajovy needs time to build a preventive effect and cannot stop an attack that is already underway.
Maxalt vs. Ajovy Drug Summary
Maxalt
Maxalt is a triptan that treats a migraine attack after it has already started, working by narrowing blood vessels and blocking pain pathways in the brain. It comes as a standard tablet or a fast-dissolving tablet taken by mouth as soon as symptoms begin.
Ajovy
Ajovy is a CGRP monoclonal antibody that prevents migraines before they start by blocking a protein involved in triggering attacks. It is injected under the skin once a month, or once every three months at a higher dose.
Maxalt vs. Ajovy Side Effects
Maxalt
Ajovy
Maxalt vs. Ajovy Dosage
Maxalt
Ajovy
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg | At the start |
| Maximum dose | 5 mg or 10 mg repeat | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 225 mg | At the start |
| Maximum dose | 675 mg | 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 | If needed |
| Dose changes | 2 increases | As tolerated |
Ajovy
| STAGE | DOSE | WHEN |
| Starting dose | 225 mg | At the start |
| Maximum dose | 675 mg | If needed |
| Dose changes | 1 increase | As tolerated |
Maxalt vs. Ajovy Indications
Maxalt
Maxalt is FDA approved for the acute treatment of migraine with or without aura in adults and children ages 6 to 17. It is meant to be taken at the onset of a migraine attack and is not intended for daily prevention.
Acute treatment of migraine attacks in adults
Approved for children ages 6 to 17
Treats migraine with or without aura
Not approved for migraine prevention
Ajovy
Ajovy is FDA approved for the preventive treatment of migraine in adults, reducing how often attacks occur over time. It is also approved for episodic migraine prevention in children 6 to 17 who weigh at least 45 kg, but it does not treat an attack once it starts.
Preventive treatment of migraine in adults
Approved for episodic migraine in kids 6-17 (45kg+)
Reduces migraine frequency over time
Not approved to stop an active migraine attack
Maxalt vs. Ajovy Pros and Cons
Maxalt
Maxalt offers fast relief once a migraine attack begins, with decades of clinical use behind it. It is not an option for people with cardiovascular disease and cannot be combined with another triptan or an ergotamine medication within 24 hours.
Pros
Taken only when a migraine starts, no ongoing schedule
Available as a pill or fast-dissolving tablet, no injection
Often relieves pain within 1 to 2 hours
Long track record with over 25 years of use
Cons
Contraindicated in people with heart disease or vasospastic conditions
Cannot be combined with other triptans or ergotamines within 24 hours
Not intended for more than about 4 headache days a month
Can cause dizziness, drowsiness, or fatigue after each dose
Ajovy
Ajovy prevents migraines from happening rather than stopping an attack in progress, and its monthly or quarterly injection avoids daily pills. It carries less cardiovascular risk than triptans but takes weeks to reach full effect and requires self-injection.
Pros
Prevents migraines before they start, cutting overall frequency
Injected only once a month, or once every 3 months
No cardiovascular contraindications like triptans have
Few side effects beyond injection site reactions
Cons
Does not treat a migraine attack that has already started
Requires self-injection rather than a pill
Can take weeks to reach full preventive effect
May cause new or worsening Raynaud's phenomenon in rare cases
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