Maxalt vs Axert

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For patients experiencing migraine attacks, certain drugs that interact with specific receptors in the brain can help to alleviate symptoms. Maxalt and Axert are two such medications often prescribed for this purpose. Both these drugs belong to a class of medicines known as triptans, which work by stimulating serotonin (a neurotransmitter) receptors in the brain, causing blood vessels there to constrict and thus relieving headache pain. Maxalt specifically is classified as a selective 5-hydroxytryptamine1B/1D (5-HT1B/1D) receptor agonist affecting levels of serotonin while also reducing inflammatory substances in the body that can trigger head pain, nausea, sensitivity to light and sound, and other migraine symptoms. On the other hand, Axert also stimulates 5-HT1B/1D receptors but has its unique pharmacological properties which make it effective for some individuals where others might not be.

What is Maxalt?

Rizatriptan (the generic name for Maxalt) is a triptan drug first approved by the FDA in 1998. It was developed after the initial class of migraine medications called ergotamines. Rizatriptan works by constricting blood vessels around the brain to relieve migraine headaches. Like Prozac, it has a selective influence on serotonin receptors with minimal impact on dopamine or norepinephrine receptors, resulting in fewer side effects compared to other drugs that affect these neurotransmitters more strongly.

On the other hand, Almotriptan (marketed under Axert and other names) also belongs to this same family of triptans and shares similar properties with Rizatriptan. Approved by FDA in 2001, its primary use is in treating acute migraines both with and without aura in adults and adolescence aged 12 or older. While it also targets serotonin receptors selectively, individual responses may vary between patients taking either medication.

What conditions is Maxalt approved to treat?

Maxalt is approved for the management of acute migraine attacks with or without aura in adults:

On the other hand, Axert is also indicated for treating acute migraines in both adults and adolescents (12 years of age and older):

  • Acute treatment of migraine headache pain
  • Not intended for the prophylactic therapy of migraines

How does Maxalt help with these illnesses?

Maxalt aids in mitigating migraines by stimulating the serotonin (5-HT1) receptors in the brain. It achieves this through constricting the dilated blood vessels, which is considered a major source of migraines. Serotonin or 5-HT is a neurotransmitter that transmits signals between nerve cells and regulates their intensity. When it comes to migraines, it's believed that individuals may have unbalanced levels of serotonin. By stimulating serotonin receptors, Maxalt can limit migraine symptoms and help patients manage their condition.

Just like Maxalt, Axert also targets serotonin (5-HT1B/1D) receptors to alleviate migraine symptoms by causing vasoconstriction of these dilated blood vessels. While both drugs perform similar functions, they differ slightly in terms of dosage amounts and frequency as well as side effects profile which could influence patient preference.

What is Axert?

Axert, known generically as almotriptan, is a serotonin receptor agonist specifically used in the treatment of migraines. It operates by activating 5-HT1 receptors located on intracranial arteries and sensory nerves of the trigeminal system which results in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release. Axert was first approved by the FDA in 2001. As an antimigraine agent, it does not inhibit reuptake of norepinephrine or dopamine like some antidepressants do. This unique mechanism of action means that its side-effect profile differs from those drugs; for instance, it doesn't typically cause sedation, weight gain or sexual dysfunction (common side effects with SSRIs such as Prozac). The effect on serotonin receptors can be particularly beneficial for migraine relief especially in patients who don’t respond well to other treatments such as Maxalt.

What conditions is Axert approved to treat?

Axert, an FDA-approved medication for the treatment of acute migraine attacks with or without aura in adults and pediatric patients aged 12 years and older. It is effective for:

  • Relieving moderate to severe migraines, including those accompanied by visual and sensory symptoms known as auras.
  • Managing recurrent headaches characterized by intense, throbbing pain usually on one side of the head.

How does Axert help with these illnesses?

Serotonin is a neurotransmitter that plays roles in many processes in the body, affecting mood regulation, memory recall, and our sense of well-being. It also influences the dilation and constriction of blood vessels. Axert (almotriptan) works by stimulating serotonin (or 5-HT) receptors in the brain which causes the muscles surrounding the blood vessels in the brain to contract and narrow. This aids in relieving migraine symptoms such as headache pain, nausea, and sensitivity to light or sound.

Like Maxalt (rizatriptan), it belongs to a class of drugs known as 'triptans'. However, Axert may have fewer side effects compared with other triptans due its selective action on certain serotonin receptors. Moreover, it has been proven effective even when taken after migraine symptoms start appearing. Therefore, it might be preferred if a patient does not respond well to other typical migraine treatments like Maxalt or can't take them early enough at onset.

How effective are both Maxalt and Axert?

Both rizatriptan (Maxalt) and almotriptan (Axert) have established histories of success in treating patients with migraines, and they were initially approved by the FDA only a few years apart. Since they act on similar neurotransmitters, specifically serotonin receptors, they are often prescribed under similar circumstances. The effectiveness of rizatriptan and almotriptan in alleviating migraine symptoms was directly studied in several clinical trials; both drugs exhibited comparable efficacy in managing symptoms of migraines as well as similar safety profiles.

A 2001 review demonstrated that Maxalt is effective in relieving migraine symptoms within two hours after administration for most people. Its side effect profile is favorable over many other older class migraine medications due to its more specific action on serotonin receptors involved in triggering migraines without affecting other parts of the body. It has become one of the most widely used triptans worldwide for acute treatment of migraines.

On the other hand, a 2010 meta-analysis indicated Axert seems to be just as effective as Maxalt at providing relief from moderate to severe headaches within two hours following ingestion, but it may provide better sustained relief over 24 hours than some other triptans including Maxalt. Significant research involves using Axert alongside typical analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs), which can enhance its pain-relieving effect for more severe or refractory migraines. Due to its slightly longer half-life than rizatriptan, almotriptan may be an optimal treatment choice if fast symptom resolution is not achieved with shorter-acting drugs like Maxalt.

abstract image of a researcher studying a bottle of drug.

At what dose is Maxalt typically prescribed?

Oral dosages of Maxalt range from 5–10 mg/dose, but research shows that a dose of 5 mg is often enough to treat an acute migraine episode in most people. For those with renal or hepatic impairment and for adults over the age of 65, it's recommended not to exceed a total daily dosage of 5mg. Adolescents aged between 12-17 years old may be started on a lower dose of around 5 mg per treatment session. If there is no response after two hours, another dose can be taken as long as the maximum dosage does not go beyond two doses in any given day (24-hour period). The maximum single dose should not exceed more than 30mg in any case.

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At what dose is Axert typically prescribed?

The treatment with Axert (almotriptan) usually begins at a dosage of 6.25–12.5 mg per dose, taken orally as soon as the migraine symptoms become apparent. If relief isn't achieved within two hours, another dose can be taken, but the total daily dosage should not exceed 25 mg in any given 24-hour period. The doses should be spaced apart by at least two hours to ensure safety and efficacy of the medication. In some cases where there is no response to initial treatments, your healthcare provider may consider increasing or adjusting the regimen after a thorough evaluation.

What are the most common side effects for Maxalt?

Some of the potential side effects for Maxalt include:

  • Dizziness
  • Fatigue, sleepiness/drowsiness
  • Paresthesia (tingling or numbness in your skin)
  • Nausea and vomiting
  • Pain or tight feeling in the chest, throat, jaw, or neck
  • Feeling weak, fainting
  • Fast heartbeats

On the other hand possible side effects for Axert are:

  • Nausea and vomiting
  • Dry mouth
  • Headache
  • Altered sense of taste
  • Abdominal discomfort and pain.

Bear in mind that while these lists outline some common side-effects they may not include all possible ones. Always consult with a healthcare provider for complete information about any medication you are considering.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Maxalt?

Maxalt, like most medications, has potential side effects. Although rare, some serious ones may include:

  • Symptoms of heart attack: chest pain or pressure; pain spreading to your jaw or shoulder; nausea; sweating.
  • Serotonin syndrome symptoms: agitation, hallucinations, fever, fast heart rate, overactive reflexes.
  • Stroke symptoms: sudden numbness or weakness (especially on one side of the body), severe headache, slurred speech.
  • High levels of serotonin in the body - hallucination(s), rapid heartbeat/pulse rate
  • An allergic reaction that can cause hives and difficulty breathing along with swelling involving face/throat/tongue
  • Severe stomach/abdominal pain

On the other hand Axert also has potential side effects such as:

  • Signs of high blood pressure like very bad headache or dizziness
  • Unusual bleeding or bruising
  • Heart beat irregularities

If you experience any of these symptoms after taking Maxalt or Axert contact your healthcare provider immediately. Your healthcare provider will help you decide if it is safe for you to continue taking these medications based on your specific health condition and history.

What are the most common side effects for Axert?

Axert, also known as Almotriptan, can potentially cause side effects such as:

  • Dry mouth or an unusual taste in the mouth
  • Nausea and vomiting
  • Sensations of tingling, warmth or heaviness
  • Dizziness and fatigue
  • Slight discomfort in throat or chest area.

While less common, some individuals may experience sleep issues (insomnia), increased heartbeat and sweating. It's important to note that most people using Axert do not have serious side effects. However, if you feel agitated, confused or hostile after taking it; develop a rash; notice changes in your weight; encounter increased urination; suffer from persistent headaches or muscle/joint pain - please consult your healthcare provider immediately.

Are there any potential serious side effects for Axert?

While Axert is generally well-tolerated, it can occasionally cause serious side effects. Some of the potential adverse reactions to be aware of are:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat
  • Heart attack symptoms including chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating and a feeling of general ill-being
  • Serotonin syndrome symptoms like agitation, hallucinations, fever, sweating excessively and a faster heart rate
  • Stroke-like symptoms for instance sudden numbness or weakness (especially on one side of the body), sudden severe headache and slurred speech
  • High levels of serotonin in the body - shivering sensation down your spine along with diarrhea and loss appetite

It's crucial that if you experience any above mentioned signs while taking Axert immediately seek medical attention.

Contraindications for Maxalt and Axert?

Both Maxalt and Axert, as with most other migraine medications, may cause certain side effects such as dizziness, sleepiness or fatigue. If you notice these symptoms becoming significantly worse or if they persist for a prolonged period after taking either of these drugs, please seek immediate medical attention.

Neither Maxalt nor Axert should be taken if you are currently using or have recently discontinued monoamine oxidase (MAO) inhibitors. As with many other medications, MAOIs can lead to dangerous interactions; thus it is important to inform your doctor about any medicines you're currently taking. You'll need approximately two weeks without an MAOI before starting treatment with either Maxalt or Axert to prevent possible drug interactions.

How much do Maxalt and Axert cost?

For the brand name versions of these drugs:

  • The price of 6 tablets of Maxalt-MLT (10 mg) averages around $120, which works out to $20/day, depending on your dose.
  • The price of 6 tablets of Axert (12.5 mg) is about $140, working out to approximately $23/day.

Thus, if you are in the higher dosage range for Maxalt (i.e., 20 mg/day), then brand-name Axert is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.

For the generic versions:

  • Rizatriptan Benzoate (the active ingredient in Maxalt; available as a tablet or orally disintegrating tablet - ODT) can run between one and two dollars per pill ($30-$60/ month).

  • Almotriptan Malate (the active ingredient in Axert) may also cost between one and two dollars per pill ($30-$60/month).

Prices may vary significantly based on location and pharmacy choice. It's also important to remember that while generics have the same active ingredients as their branded counterparts, they may differ slightly due to fillers and other non-active components.

Popularity of Maxalt and Axert

Rizatriptan, available under the brand name Maxalt, and almotriptan, sold as Axert, are both medications used for acute treatment of migraines. These selective serotonin receptor agonists work by narrowing blood vessels around the brain.

In 2019 it was estimated that rizatriptan was prescribed to approximately 1.4 million people in the US. This accounted for just over 19% of triptans prescriptions in the country. The use of rizatriptan has been steadily increasing since its approval by FDA in 1998.

Almotriptan on the other hand was prescribed to about half a million people in America during the same year. It made up roughly 6% of all triptans prescriptions in the US market which is considerably less than rizatriptan's share but this might be due to a later introduction into market (2001) compared to Rizatripan (1998). Despite these numbers, both medications have comparable effectiveness and safety profiles.


Both Maxalt (rizatriptan) and Axert (almotriptan) have an established history of use in managing migraine headaches, with a wealth of clinical studies supporting their efficacy over placebos. At times, these medications may be used together, but this decision should only be made under the careful guidance of a healthcare professional due to contraindications. The drugs function differently; Maxalt works by narrowing blood vessels around the brain and reducing substances that can trigger headache pain and other symptoms like sensitivity to light/sound, whereas Axert works on serotonin receptors in the brain which helps reduce nerve inflammation.

Maxalt is often considered as one of the primary treatment options for migraines while Axert is usually recommended when other triptans do not work or cause bothersome side effects.

Both are available as generic medications which could provide substantial cost savings for patients who must pay out-of-pocket. Both rizatriptan and almotriptan take effect relatively quickly but it's important to remember that response rates can vary from person to person.

The side-effect profiles are somewhat similar between both drugs, generally well-tolerated with potential side effects including dizziness, nausea, dry mouth etc., although Maxalt has been shown in some studies to have slightly fewer gastrointestinal side effects than Axert. As with all medication use for conditions such as migraines, patients should carefully monitor their symptoms post-administration and seek immediate medical attention if they experience worsening headaches or any signs of allergic reactions.