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

Key takeaways

Rizatriptan (Maxalt) and Ergotamine (Ergomar) are both used to treat migraines, but they have some key differences. Rizatriptan (Maxalt) is a triptan that works by tightening blood vessels and lowering inflammation in the brain. It is available as a generic and comes in both oral and orally disintegrating tablet (ODT) forms. Ergotamine (Ergomar), on the other hand, is an ergot derivative that also tightens blood vessels but works more slowly and lasts longer. It is taken sublingually (under the tongue) and does not have a generic form. Rizatriptan (Maxalt) can be used by children ages 6 and older, while Ergotamine (Ergomar) is not typically a first-choice medication and is not recommended for children. Both medications can cause severe side effects, such as the risk of poor blood flow to the hands and feet. Ergotamine is not safe for use during pregnancy, while the safety of using Rizatriptan during pregnancy is unknown. Both medications should not be used together or within 24 hours of each other due to the risk of serious side effects.

Rizatriptan

(Maxalt)

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Ergomar

(ergotamine)

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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

Summary for Ergotamine

Prescription only

Ergomar (ergotamine) treats migraines. It's an ergot medication. It works by lessening inflammation in the brain and calming certain parts of the brain. Ergomar (ergotamine) is a brand-name medication that comes as sublingual tablets for adults. You place it under the tongue to dissolve as soon as you feel like you're about to have a migraine or headache. Side effects include nausea and vomiting.

Indications for Ergotamine

Treatment of migraines

Pros and Cons for Ergotamine

Pros

Dissolves under the tongue, so it's easy to take
Can take a second tablet 30 minutes after you first take it if you need more relief
Can take on an as-needed basis