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
Emgality
Maxalt vs. Emgality Dosage
Maxalt
Emgality
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 240 mg | Day 1 |
| Maximum dose | 300 mg once monthly | If needed |
| Dose changes | 2 increases | As tolerated |
Maxalt
| 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
| 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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