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
Ubrelvy
Maxalt vs. Ubrelvy Dosage
Maxalt
Ubrelvy
| 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 |
| 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
| 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
| 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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