Migraine Medication Selector
Find Your Best Match
Answer a few questions about your migraine pattern, health conditions, and preferences to see which medications might work best for you.
Recommended Medications
Medication Comparison
Key Takeaways
- Rizatriptan (Maxalt) works fast and is good for moderate‑to‑severe migraine attacks.
- Traditional triptans like Sumatriptan or Zolmitriptan are similar but differ in onset speed and cost.
- New‑generation drugs such as Ubrogepant and Lasmiditan avoid the vasoconstriction risk that triptans carry.
- Choosing the right option depends on attack pattern, cardiovascular health, and personal tolerance.
- Always discuss any switch with a healthcare professional to avoid drug interactions.
What is Rizatriptan (Maxalt)?
When you hear "Maxalt," most people think of a quick‑acting migraine pill. Rizatriptan is a prescription medication classified as a triptan - a serotonin 5‑HT1B/1D receptor agonist designed to stop migraine pain in its tracks. It was approved by the FDA in 1998 and quickly became a go‑to for patients who need relief within 30 minutes of symptom onset.
How does Rizatriptan work?
Rizatriptan binds to serotonin receptors located on the walls of cranial blood vessels and on pain‑signaling nerves. By activating these receptors, it does two things:
- Constricts the dilated vessels that are believed to cause migraine throbbing.
- Blocks the release of inflammatory neuropeptides like CGRP, which prolong the headache.
In plain English, it tells the brain "turn the alarm off" and the blood vessels "stop expanding." This double action explains why many patients report relief in as little as 15‑30 minutes.
Popular Triptan Alternatives
If Rizatriptan isn’t a perfect fit-maybe because of cost, side‑effects, or a personal health condition-there are several other triptans you can consider.
Sumatriptan
Sumatriptan is the original triptan, launched in 1991. It’s available as tablets, nasal spray, and injectable forms, giving flexibility for people who dislike swallowing pills. Onset is a bit slower than Rizatriptan (about 45 minutes), but the injectable version can work within 10 minutes.
Zolmitriptan
Zolmitriptan offers a mid‑range onset (about 30‑45 minutes) and comes in both oral and nasal spray formulations. It’s often chosen for patients who want a lower dose than Sumatriptan but still need a reliable rescue option.
Eletriptan
Eletriptan has one of the fastest oral onsets among triptans-around 20 minutes-making it a close competitor to Rizatriptan in speed. It can be a bit pricier, but many insurers cover it comparably.
Naratriptan
Naratriptan is known for its long half‑life, providing relief that can last up to 24 hours. It’s a solid choice for patients who experience a "double‑attack" (headache returning later in the day).
Almotriptan
Almotriptan balances fast onset (about 30 minutes) with a relatively low side‑effect profile. It’s often prescribed when patients have mild cardiovascular risk factors.
Non‑Triptan Options
For people who cannot take triptans-due to heart disease, hypertension, or personal preference-new classes of migraine drugs have emerged.
Ibuprofen (NSAID)
Ibuprofen is an over‑the‑counter non‑steroidal anti‑inflammatory drug that reduces inflammation and can blunt mild migraine attacks. It works slower than triptans (about 60‑90 minutes) and should be taken early in the headache phase.
Ubrogepant (CGRP Antagonist)
Ubrogepant blocks the calcitonin gene‑related peptide (CGRP) pathway, a key driver of migraine pain. It’s taken as a single oral dose and avoids the vasoconstriction that triptans cause, making it safe for most cardiovascular patients.
Lasmiditan (Ditans)
Lasmiditan activates the serotonin 5‑HT1F receptor, providing migraine relief without narrowing blood vessels. It’s a later‑line option for people who have tried triptans and CGRP antagonists without success.
Comparison Table: Rizatriptan vs Common Alternatives
| Medication | Onset (minutes) | Duration of Relief | Typical Dose | Common Side Effects | Cost (US$) Approx. |
|---|---|---|---|---|---|
| Rizatriptan (Maxalt) | 15‑30 | 4‑6 hours | 10 mg tablet | Dizziness, dry mouth, chest tightness | 30‑45 |
| Sumatriptan | 30‑45 (tablet), 10 (injection) | 5‑8 hours | 50‑100 mg tablet / 6 mg injection | Nausea, tingling, fatigue | 25‑40 |
| Zolmitriptan | 30‑45 | 4‑6 hours | 5‑10 mg tablet | Dry mouth, drowsiness | 28‑42 |
| Ubrogepant | 60‑90 | 8‑12 hours | 50 mg tablet | Nausea, fatigue, constipation | 150‑200 |
| Lasmiditan | 30‑45 | 6‑12 hours | 50‑200 mg tablet | Drowsiness, paresthesia | 250‑300 |
Choosing the Right Medication: Factors to Consider
Switching from Rizatriptan to another drug isn’t just about price. Use this quick checklist before you discuss options with your doctor:
- Cardiovascular health: If you have heart disease, avoid any triptan and consider CGRP antagonists or ditans.
- Attack timing: Need relief within 15 minutes? Rizatriptan or Eletriptan are top picks.
- Frequency of use: For chronic migraines (≥15 days/month), a medication with a longer half‑life (Naratriptan) or a preventive therapy may be better.
- Side‑effect tolerance: If you’re sensitive to chest tightness, try a non‑vasoconstricting option.
- Insurance coverage: Check your formulary; many plans treat triptans similarly, but newer CGRP drugs often have higher copays.
Potential Side Effects and Safety Tips
All migraine medicines carry risks. Here’s a quick safety rundown:
- Triptans (Rizatriptan, Sumatriptan, etc.): Chest pressure, serotonin syndrome if combined with SSRIs, medication overuse headache if taken >10 days/month.
- NSAIDs (Ibuprofen): Stomach ulcers, kidney strain-avoid if you have chronic kidney disease.
- CGRP antagonists (Ubrogepant): Generally safe for heart patients but watch for liver enzyme changes.
- Ditans (Lasmiditan): Strong sedation; don’t drive or operate machinery for 8 hours after dosing.
Always keep a medication list handy and let your prescriber know about any over‑the‑counter drugs you use.
Frequently Asked Questions
Can I take Rizatriptan with ibuprofen?
Yes, many doctors recommend a “combo” of a triptan and an NSAID because ibuprofen can boost pain relief without increasing triptan side‑effects. Still, avoid exceeding the maximum daily dose of ibuprofen.
What if I have high blood pressure?
Triptans can raise blood pressure slightly, so talk to your doctor. CGRP antagonists like ubrogepant are usually safer for hypertensive patients.
Is Rizatriptan effective for chronic migraine?
Rizatriptan works well for acute attacks but does not prevent future episodes. For chronic migraine, preventive medications such as topiramate or CGRP monoclonal antibodies are needed.
How does Ubrogepant differ from a triptan?
Ubrogepant blocks the CGRP pathway instead of constricting blood vessels. This means it can be used by people who can’t take triptans, though it may take longer to work.
Can I use more than one triptan in a day?
The standard limit is 30 mg of Rizatriptan per day (two 10‑mg tablets). Exceeding this raises the risk of serious side effects, so stick to the prescribed maximum.