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

Most common
dizziness (up to 9.9%)

Ajovy

Most common
injection site reactions (38% to 45%)

Maxalt vs. Ajovy Dosage

Maxalt

Dosage
Dosage Table
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

Dosage
Dosage Table
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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