Maxalt vs. Emgality

See how Maxalt and Emgality compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Maxalt treats a migraine attack after it starts, while Emgality is used every month to lower how often migraines happen in the first place.

  • Maxalt is a pill or dissolvable tablet taken as needed, up to twice per attack, while Emgality is a self-injection given once a month.

  • Emgality is also FDA-approved for episodic cluster headache prevention, a use that Maxalt does not have.

Maxalt vs. Emgality Drug Summary

Maxalt

Maxalt (rizatriptan) is a triptan that treats migraine attacks that have already started. It comes as a regular tablet or a dissolvable tablet and is taken as a single dose at the first sign of a migraine, with a second dose allowed after two hours if needed.

Emgality

Emgality (galcanezumab) is a CGRP-blocking antibody used to prevent migraines before they start and to treat episodic cluster headache. It's given as a self-injection once a month, after an initial higher loading dose.

Maxalt vs. Emgality Side Effects

Maxalt

Most common
Dizziness (up to 9.9%)
Somnolence (up to 8.3%)
Asthenia/fatigue (up to 5%)
Nausea (up to 4%)

Emgality

Most common
Injection site reactions (up to 18%)
Injection site pain (10.1% to 11.6%)
Constipation (1.0% to 1.5%)
Vertigo (0.7% to 1.2%)

Maxalt vs. Emgality Dosage

Maxalt

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg or 10 mg repeat dose At the start
Maximum dose 5 mg or 10 mg repeat dose Same as starting
Dose changes None Fixed dose

Emgality

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 240 mg Day 1
Maximum dose 300 mg once monthly If needed
Dose changes 2 increases As tolerated

Maxalt vs. Emgality Indications

Maxalt

Maxalt is approved to treat migraine attacks once they've already started, in both adults and children ages 6 and up. It's taken as a single dose at the first sign of a migraine and can be repeated once if the first dose doesn't fully work.

  • Acute treatment of migraine with or without aura

  • Approved for adults and children ages 6 to 17

  • Taken at the onset of a migraine attack

  • Not approved for migraine prevention

Emgality

Emgality is approved to prevent migraines from occurring and to reduce attacks of episodic cluster headache, both in adults. It's given as a self-injection once a month and is not meant to treat a migraine that has already begun.

  • Preventive treatment of migraine in adults

  • Treatment of episodic cluster headache in adults

  • Given once monthly as a self-injection

  • Not approved for use under 18

Maxalt vs. Emgality Pros and Cons

Maxalt

Maxalt is a fast-acting oral triptan meant to stop a migraine once it starts, not to prevent future attacks. It carries cardiovascular restrictions and can't be combined with other triptans or ergot medications within 24 hours.

Pros

  • Can relieve a migraine already in progress the same day

  • Available as a dissolvable tablet that needs no water

  • FDA-approved for children ages 6 to 17

  • Second dose allowed during the same attack if needed

Cons

  • Cannot be used near other triptans or ergotamine medications

  • Contraindicated in people with coronary artery disease

  • Not intended for migraine prevention

  • Limited to an average of 4 treated headaches per month

Emgality

Emgality is a monthly injectable antibody that works ahead of an attack to lower how often migraines happen, and it's also approved for episodic cluster headache. It has a milder warning profile than triptans but doesn't help during an attack already in progress.

Pros

  • Only one injection needed per month

  • Also approved for episodic cluster headache prevention

  • No boxed warning and no cardiac contraindication

  • Reduces migraine frequency over time rather than treating single attacks

Cons

  • Not approved for use during an active migraine attack

  • Not approved for anyone under 18

  • Injection site reactions occur in a large share of patients

  • Can take several weeks to reach full preventive effect

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