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
Nurtec
Maxalt vs. Nurtec Dosage
Maxalt
Nurtec
| 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 |
| 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
| 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
| 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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