Maxalt (Rizatriptan) vs Other Migraine Medicines: Pros, Cons & When to Use
Stuart Moore 24 October 2025 15

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Key Takeaways

  • Maxalt is a fast‑acting triptan that works for many migraine sufferers but isn’t the only option.
  • Sumatriptan, Zolmitriptan, Naratriptan and Eletriptan share the same mechanism but differ in speed, duration and side‑effect profile.
  • Newer classes such as CGRP antagonists and Lasmiditan provide alternatives for patients who can’t tolerate triptans.
  • Choosing the right drug depends on attack frequency, timing of dose, comorbid conditions and insurance coverage.
  • Always discuss head‑to‑head comparisons with a pharmacist or physician before switching.

What is Maxalt (Rizatriptan)?

When building a migraine toolkit, Maxalt is a rapid‑acting oral triptan whose active ingredient is rizatriptan. Approved by the FDA in 2001, it’s designed to abort migraine attacks once the pain begins. The tablet dissolves quickly, reaching peak blood levels in 45‑60 minutes, which is why many patients label it the "fast‑acting" option.

How Maxalt Works

Rizatriptan belongs to the triptan class, which targets serotonin (5‑HT1B/1D) receptors around cranial blood vessels. By binding to these receptors, the drug narrows dilated vessels and blocks the release of inflammatory neuropeptides. The result: reduced pain, less nausea, and a quicker return to normal activity.

Benefits and Typical Use

  • Onset of relief in under an hour for most users.
  • Effective for moderate to severe migraine attacks.
  • Available in 5 mg and 10 mg tablets, making dose titration simple.
  • Can be combined with an anti‑nausea medication if needed.
Various migraine medicines displayed as colorful offerings on a DĂ­a de los Muertos altar.

Common Side Effects

About 10‑15 % of patients report mild side effects such as:

  • Chest tightness or pressure (usually transient).
  • Dizziness or light‑headedness.
  • Fatigue and dry mouth.

Serious adverse events are rare, but anyone with heart disease should avoid triptans unless cleared by a cardiologist.

Alternative Migraine Medications

While Maxalt works well for many, several alternatives fill the gaps where it falls short.

Sumatriptan

Sumatriptan is the first FDA‑approved triptan, available as tablets, nasal spray, and injection. It’s slower to act orally (30‑60 minutes) but the injectable form provides relief within 10‑15 minutes-useful for severe attacks.

Zolmitriptan

Zolmitriptan is a medium‑duration triptan that offers a quick onset and an oral spray formulation. The spray can be handy for those who dislike swallowing pills during a migraine.

Naratriptan

Naratriptan is a longer‑acting triptan, often chosen for chronic migraine sufferers. Its slower onset (up to 2 hours) can be a downside, but the extended relief helps when attacks linger.

Eletriptan

Eletriptan is one of the most potent triptans, delivering strong pain relief for tough attacks. It carries a slightly higher risk of cardiovascular side effects, so screening is essential.

CGRP Antagonists

CGRP antagonists are a newer drug class that blocks calcitonin gene‑related peptide, a key migraine trigger. Examples include erenumab and galcanezumab, administered via monthly injection. They’re ideal for patients who can’t tolerate any triptan.

Lasmiditan

Lasmiditan is a serotonin 5‑HT1F receptor agonist that avoids vasoconstriction. This makes it safe for those with cardiovascular disease, though it may cause drowsiness.

Aspirin & NSAIDs

Aspirin is a non‑prescription analgesic that can lessen migraine pain when taken early. It’s less effective for severe attacks but can be combined with a triptan for a synergistic effect.

Head‑to‑Head Comparison Table

Maxalt vs Common Migraine Meds
Drug Onset (oral) Duration of Relief Typical Dose Key Contra‑indication
Maxalt 45‑60 min 4‑6 hrs 5 mg or 10 mg Uncontrolled heart disease
Sumatriptan (tablet) 30‑60 min 4‑8 hrs 25 mg, may repeat after 2 hrs Severe CAD
Zolmitriptan 30‑45 min 3‑5 hrs 5 mg Hypertension uncontrolled
Naratriptan 1‑2 hrs 6‑12 hrs 2.5 mg History of stroke
Eletriptan 30‑45 min 6‑12 hrs 40 mg Ischemic heart disease
CGRP antagonist (erenumab) N/A (preventive) Monthly dosing 70 mg SC Pregnancy (no data)
Lasmiditan 1‑2 hrs 4‑6 hrs 50‑200 mg Severe liver disease
Skeleton guide pointing to different migraine treatment paths on a festive background.

How to Decide Which Medication Fits You

Think of the choice as a short decision tree:

  1. If you have any heart‑vascular disease, skip all triptans. Consider CGRP antagonists or Lasmiditan.
  2. If you need rapid relief within an hour, Maxalt, Sumatriptan (tablet) or Zolmitriptan are the front‑runners.
  3. If you experience frequent attacks (>8 per month), a longer‑acting triptan like Naratriptan or a preventive CGRP blocker may be smarter.
  4. Check insurance coverage. Some newer drugs have higher out‑of‑pocket costs.
  5. Trial a single drug for at least two attacks before switching; keep a headache diary to record onset, relief time, and side effects.

Safety, Interactions, and When to Call Your Doctor

All migraine meds can interact with other prescriptions. Triptans, for instance, should not be combined with monoamine oxidase inhibitors (MAOIs) or certain antidepressants (SSRIs/SNRIs) because of serotonin syndrome risk.

Ask your pharmacist about:

  • Potential bleed risk when mixing triptans with blood thinners.
  • Impact on birth control hormones, especially for women in the "Women's Health" category.
  • Whether your over‑the‑counter pain relievers (ibuprofen, naproxen) are safe to pair with a triptan.

If you notice chest pain, severe shortness of breath, or an allergic reaction, seek emergency care immediately-these are rare but serious signals.

Bottom Line

Maxalt remains a solid first‑line option for many migraineurs who need a quick fix, but it’s not a one‑size‑fits‑all. Understanding the nuances of other triptans, the newer CGRP antagonists, and non‑triptan choices lets you personalize treatment and avoid unnecessary side effects. Talk to a pharmacist or your neurologist to test‑drive a couple of options and lock in the best fit for your lifestyle.

How fast does Maxalt work compared to other triptans?

Maxalt typically starts relieving pain in 45‑60 minutes, which is a bit faster than oral Sumatriptan (30‑60 min) and similar to Zolmitriptan. Injectable Sumatriptan can be faster (10‑15 min), but the oral route is most convenient for most users.

Can I take Maxalt with ibuprofen?

Yes, many doctors recommend a combo of a triptan and a non‑steroidal anti‑inflammatory drug (NSAID) like ibuprofen to boost pain relief. Just avoid exceeding the maximum daily dose of ibuprofen and watch for stomach upset.

What if I have high blood pressure?

Uncontrolled hypertension is a red flag for any triptan, including Maxalt. Talk to your doctor about safer alternatives like Lasmiditan or a CGRP antagonist, which don’t cause vessel constriction.

Is Maxalt effective for menstrual migraines?

Many women find Maxalt works well for hormonal migraines because the rapid onset matches the quick escalation of pain. Keep a diary to see if the timing fits your cycle, and consider preventive options if attacks are frequent.

How many Maxalt tablets can I take in a day?

The usual limit is 30 mg per day (either two 10 mg tablets or three 5 mg tablets). Exceeding this increases the risk of cardiovascular side effects.