Emgality vs. Maxalt for Migraine: Important Differences and Potential Risks.

Key takeaways

Emgality (galcanezumab) and Maxalt (rizatriptan) are both used to manage migraines, but they work differently and are used in different ways. Emgality is a monoclonal antibody that prevents migraines and treats cluster headaches by blocking a protein called calcitonin-gene related peptide (CGRP). It is given as a monthly injection under the skin. Common side effects include pain and rash at the injection site. On the other hand, Maxalt is a triptan that treats migraines by tightening blood vessels and reducing inflammation. It is taken as an oral tablet or an orally disintegrating tablet (ODT) when a migraine starts. Maxalt can cause dizziness and sleepiness and is available as a lower-cost generic. Emgality is not available in a generic form. Emgality is used for prevention, while Maxalt is used for immediate relief during a migraine attack.

Emgality

(galcanezumab)

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Rizatriptan

(Maxalt)

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Summary for Emgality

Prescription only

Emgality (galcanezumab or galcanezumab-gnlm) is an injectable medication that can help prevent migraine attacks in adults. It can also help treat cluster headaches in adults. This medication is a monoclonal antibody that works as a CGRP antagonist. It blocks the CGRP protein in the brain that can cause migraine and headache pain. Emgality (galcanezumab) comes as a prefilled pen and syringe. You inject one dose of the medication under the skin monthly. Some common side effects include pain, itching, and redness at the injection site.

Indications for Emgality

Prevention of migraines in adults
Treatment of episodic (occasional) cluster headaches in adults

Pros and Cons for Emgality

Pros

Only needs to be given once a month
Good option for people who have a hard time taking medications by mouth
Generally well tolerated

Cons

Not a good option for people who don't like needles
Need to store in a refrigerator
Not known if the medication works well or is safe in children, during pregnancy, or while breastfeeding

Common Side Effects for Emgality

Pain, itching, warmth, and other injection site reactions (18%)

Warnings for Emgality

Serious allergic reactions
High blood pressure
Raynaud's phenomenon

Summary for Maxalt

Prescription only

Rizatriptan (Maxalt) is used to treat migraines with or without aura in people ages 6 years and older. Rizatriptan (Maxalt) is available as a lower-cost generic tablet and an orally disintegrating tablet (ODT) that's placed on the tongue. Common side effects include dizziness, headache, and sleepiness. It can interact with antidepressants and other similar migraine medications.

Indications for Maxalt

Treatment of migraine attacks with or without aura in people ages 6 years and older

Pros and Cons for Maxalt

Pros

First-choice option for treating migraines
Can be used by children ages 6 years and older
Orally disintegrating tablet (ODT) a possible option for people who have problems swallowing
Works within 30 minutes

Cons

Can't use to prevent migraines
Is short-acting, so it might not last as long
Not clear if taking a second dose (adults only) is actually helpful
Your migraines can get worse if you use this medication too often.

Common Side Effects for Maxalt

Dizziness (4-9%)
Sleepiness (4-8%)
Tiredness (4-7%)
Nausea (4-6%)

Warnings for Maxalt

Heart problems and high blood pressure
Stroke or other brain injury
Extreme narrowing of blood vessels
Taking too much rizatriptan (Maxalt)
Serotonin syndrome
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only