Maxalt vs. Ubrelvy

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

Key Takeaways

  • Maxalt is a triptan approved for adults and children as young as 6, while Ubrelvy is a gepant approved only for adults.

  • Maxalt carries cardiovascular contraindications that Ubrelvy, a non-triptan gepant, does not share.

  • Both drugs treat migraine attacks once they start, but neither is approved to prevent migraines.

Maxalt vs. Ubrelvy Drug Summary

Maxalt

Maxalt (rizatriptan) is a triptan that treats acute migraine attacks by narrowing blood vessels and blocking pain signals in the brain. It comes as a standard tablet or an orally disintegrating tablet, with a repeat dose allowed two hours later if the migraine returns. It is approved for adults and children ages 6 to 17.

Ubrelvy

Ubrelvy (ubrogepant) is a CGRP receptor antagonist, or gepant, that treats acute migraine attacks by blocking a protein involved in migraine pain. It is taken as an oral tablet, with a second dose allowed at least two hours after the first if needed. It is approved only for adults.

Maxalt vs. Ubrelvy Side Effects

Maxalt

Most common
somnolence (up to 8.3%)
nausea (up to 4%)

Ubrelvy

Most common
somnolence (3% vs 1% placebo)
nausea (4% vs 2% placebo)

Maxalt vs. Ubrelvy Dosage

Maxalt

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once as needed At the start
Maximum dose 5 mg or 10 mg repeat dose If needed
Dose changes 2 increases As tolerated

Ubrelvy

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 50 mg or 100 mg orally At the start
Maximum dose 50 mg or 100 mg (2nd dose) If needed
Dose changes 1 increase As tolerated

Maxalt vs. Ubrelvy Indications

Maxalt

Maxalt is FDA-approved to treat migraine attacks, with or without aura, once they start. It is approved for both adults and children ages 6 to 17, making it one of the few triptans with pediatric approval. It is not approved to prevent migraines or to treat cluster headaches.

  • Acute treatment of migraine with or without aura

  • Approved for adults and children ages 6-17

  • Available as tablet and orally disintegrating tablet

  • Not approved for migraine prevention

  • Limit of about 4 treated headaches per 30 days

Ubrelvy

Ubrelvy is FDA-approved to treat migraine attacks, with or without aura, once they start in adults. It is not approved for children or for migraine prevention. Its CGRP-blocking mechanism gives it a different side effect and interaction profile than triptans like Maxalt.

  • Acute treatment of migraine with or without aura

  • Approved for adults only, not children

  • Available as oral tablet only

  • Not approved for migraine prevention

  • No monthly headache-frequency limit in labeling

Maxalt vs. Ubrelvy Pros and Cons

Maxalt

Maxalt has decades of real-world use and is available as a generic, which can make it more accessible for many patients. Its cardiovascular contraindications mean it is not an option for people with heart disease or uncontrolled vascular risk factors. It also cannot be combined with other triptans or ergotamines within 24 hours.

Pros

  • Available as an orally disintegrating tablet for patients who have trouble swallowing pills

  • Approved for children as young as 6, unlike Ubrelvy

  • Generic rizatriptan is widely available

  • Decades of clinical use and safety data since 1998

Cons

  • Contraindicated in patients with ischemic or vasospastic heart disease

  • Cannot be taken within 24 hours of another triptan or an ergotamine

  • Contraindicated with MAO-A inhibitors

  • Carries warnings for cardiac risks like heart attack and coronary vasospasm

Ubrelvy

Ubrelvy works through a different mechanism than triptans, so it avoids the cardiovascular contraindications that limit Maxalt's use. It requires dose adjustments with certain drug interactions, including CYP3A4 inhibitors and grapefruit juice, and carries its own rare risk of hypersensitivity reactions. It is only approved for adults.

Pros

  • No cardiovascular contraindications, so it may suit patients who cannot take triptans

  • Can potentially be combined with a triptan since it works through a different pathway

  • No restriction on how many headaches per month it can treat

  • Fewer common side effects reported in clinical trials than Maxalt

Cons

  • Not approved for use in children

  • Requires dose adjustments with CYP3A4 inhibitors, inducers, and grapefruit juice

  • Carries a rare risk of hypersensitivity reactions including anaphylaxis

  • May cause new or worsening high blood pressure or Raynaud's phenomenon

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