Maxalt vs. Nurtec

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

Key Takeaways

  • Maxalt is a triptan used only to stop a migraine attack once it starts, while Nurtec is a CGRP blocker approved for both treating attacks and preventing episodic migraine.

  • Maxalt is contraindicated in people with heart disease and cannot be combined with other triptans, while Nurtec has no cardiovascular restriction.

  • Nurtec reports fewer common side effects in trials but has no generic version and typically costs more per month than Maxalt.

Maxalt vs. Nurtec Drug Summary

Maxalt

Maxalt (rizatriptan) is a triptan that binds serotonin 5-HT1B/1D receptors to stop a migraine attack once it starts. It comes as a standard tablet or an orally disintegrating tablet, taken as a single dose at the first sign of migraine pain. A second dose can be taken two hours later if the migraine returns.

Nurtec

Nurtec (rimegepant) is a CGRP receptor antagonist that blocks a protein involved in migraine pain signaling. It is an orally disintegrating tablet used either to treat a migraine attack as it happens or, taken every other day, to prevent episodic migraines. It is the only oral CGRP medication approved for both uses in one formulation.

Maxalt vs. Nurtec Side Effects

Maxalt

Most common
Dizziness (up to 9.9%)
Somnolence (up to 8.3%)

Nurtec

Most common
Nausea (up to 2.7%)
Abdominal pain/dyspepsia (up to 2.4%)

Maxalt vs. Nurtec Dosage

Maxalt

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

Nurtec

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 75 mg as needed At the start
Maximum dose 75 mg every other day If needed
Dose changes 1 increase As tolerated

Maxalt vs. Nurtec 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 only meant to stop an attack already underway, not to prevent future ones.

  • Treats migraine with or without aura

  • Approved for adults and children 6-17

  • Not approved for migraine prevention

  • Not approved for cluster headache

Nurtec

Nurtec is FDA-approved for the acute treatment of migraine in adults and, taken every other day, for prevention of episodic migraine. It is not approved for chronic migraine prevention or cluster headache.

  • Treats migraine with or without aura

  • Prevents episodic migraine in adults

  • Approved for adults only

  • Not approved for chronic migraine prevention

Maxalt vs. Nurtec Pros and Cons

Maxalt

Maxalt has been available since 1998 and is sold as a generic, which usually makes it easier to get through insurance. It only treats attacks already in progress and carries cardiovascular restrictions that rule it out for some patients.

Pros

  • Available as a generic, historically cheaper than Nurtec (roughly $800-$935 vs $1,000-$1,376 per month)

  • Fast-acting for attacks already underway

  • Approved for children ages 6 and older

  • Long safety track record since 1998

Cons

  • Not approved to prevent migraines

  • Contraindicated in people with heart disease

  • Cannot be combined with other triptans or ergots within 24 hours

  • Limited to roughly 4 treatment days per month

Nurtec

Nurtec covers both treatment and prevention with the same tablet, which simplifies things for people who need both. It has no generic version yet and its list price runs higher than Maxalt's, which matters for patients paying out of pocket.

Pros

  • Treats migraine attacks and prevents future ones

  • No cardiovascular contraindications like triptans have

  • Fewer common side effects reported in trials

  • Only oral CGRP drug approved for both acute and preventive use

Cons

  • No generic version available yet

  • Costs more than Maxalt, roughly $1,000-$1,376 vs $800-$935 per month

  • Can trigger serious hypersensitivity reactions

  • May worsen or cause high blood pressure

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