Nurtec vs. Rizatriptan for Migraine: Important Differences and Potential Risks.

Key takeaways

Rimegepant (Nurtec ODT) and rizatriptan (Maxalt) are both medications used to treat migraines with or without aura. However, they belong to different medication classes. Rimegepant is a calcitonin gene-related peptide (CGRP) receptor blocker, while rizatriptan is a triptan. Rimegepant can be used for both the prevention and treatment of migraines in adults, whereas rizatriptan is only used to treat migraine attacks in people ages 6 and older. Rimegepant is taken as a 75 mg orally disintegrating tablet every other day for prevention or as needed for treatment. Rizatriptan is available in 5 mg and 10 mg doses taken at the onset of a migraine, with a maximum of 30 mg in a 24-hour period for adults. Rimegepant is not available as a generic, but rizatriptan is. Common side effects of rimegepant include nausea and stomach pain, while rizatriptan can cause dizziness, sleepiness, and nausea. Rimegepant generally has fewer side effects than triptans. Rizatriptan can cause serious heart problems and serotonin syndrome, especially if taken with certain other medications.

Nurtec ODT

(rimegepant)

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Rizatriptan

(Maxalt)

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Summary for Nurtec

Prescription only

Nurtec ODT (rimegepant) is a type of migraine medication called a calcitonin gene-related peptide (CGRP) receptor antagonist. It helps treat migraine attacks with or without aura in adults. It can also help prevent migraines from happening in the long run. This medication is an orally disintegrating tablet (ODT). You put it on or under the tongue and let it dissolve. The dosage is 1 tablet each time. But how often you take the medication depends on if you're taking it to prevent or treat migraines. Side effects include nausea and stomach pain. Nurtec ODT (rimegepant) is a brand-name medication; there's no generic version yet.

Indications for Nurtec

Treatment of migraines with or without aura in adults
Prevention of migraines with or without aura in adults

Pros and Cons for Nurtec

Pros

A first-choice option for preventing migraines
Generally has fewer side effects than triptans
Can take without any foods or liquids
Dissolves on the tongue, so it's a good option for people who don't like to or can't swallow pills

Cons

Usually a second-choice option for treating migraines (after trying triptans)
Can interact with certain medications, like some antifungals and antiseizure medications
Might not be the best choice if you have serious liver or kidney problems
Not approved for children (but studies are ongoing)

Common Side Effects for Nurtec

Nausea (up to 3%)
Stomach pain or indigestion (up to 2%)

Warnings for Nurtec

Allergic reactions
High blood pressure
Raynaud's phenomenon

Summary for Rizatriptan

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 Rizatriptan

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

Pros and Cons for Rizatriptan

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 Rizatriptan

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

Warnings for Rizatriptan

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