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Maxalt vs Amerge
Introduction
For patients with migraines, certain drugs that alter the concentrations of compounds in the brain linked to pain can provide relief and manage symptoms. Maxalt and Amerge are two such medications prescribed for migraine attacks. They each impact different processes in the brain but both have significant effects on alleviating migraine episodes. Maxalt, known as rizatriptan, works by narrowing blood vessels around the brain and affects serotonin levels, thereby reducing swelling that triggers headaches. On the other hand, Amerge or naratriptan has a similar mechanism but is absorbed more slowly into the body leading to a longer period of effect compared to Maxalt. Both belong to a class of drugs called triptans which work specifically on serotonin (5-HT) receptors located on blood vessels in your brain.
Maxalt vs Amerge Side By Side
| Attribute | Maxalt | Amerge |
|---|---|---|
| Brand Name | Maxalt | Amerge |
| Contraindications | Should not be taken with MAO inhibitors within the last 2 weeks. Risk of serotonin syndrome with SSRIs or SNRIs. | Should not be taken with MAO inhibitors within the last 2 weeks. Risk of serotonin syndrome with SSRIs or SNRIs. |
| Cost | Brand name: around $220 for 9 tablets of 10 mg. Generic: $1-$3 per day based on frequency and severity of migraines. | Brand name: around $200 for 9 tablets of 2.5 mg. Generic: Similar to Maxalt, can vary based on location and dosage requirements. |
| Generic Name | Rizatriptan | Naratriptan |
| Most Serious Side Effect | Signs of a heart attack or stroke, increased blood pressure, serotonin syndrome symptoms. | Signs of an allergic reaction, chest pain or pressure, sudden numbness or weakness, blood circulation problems. |
| Severe Drug Interactions | MAO inhibitors, SSRIs, SNRIs | MAO inhibitors, SSRIs, SNRIs |
| Typical Dose | 5-10 mg, up to three doses in any 24-hour period. Maximum dosage 30mg/day. | 1-2.5 mg, may take another dose after 4 hours if needed. Maximum daily dosage should not exceed 5 mg. |
What is Maxalt?
Rizatriptan (the generic name for Maxalt) was one of the early drugs in the class of triptans, a significant development over previous classes of migraine medications. Rizatriptan was first approved by the FDA in 1998. Maxalt reduces swelling that causes migraines and it does this without causing vasoconstriction, a major side effect associated with older generation treatments. It is prescribed for relieving acute migraine attacks.
Maxalt influences serotonin (5-HT1D receptors), resulting in narrowing blood vessels around the brain, which helps reduce pain signals sent from nerves to the brain. Naratriptan (Amerge), on the other hand, has a more gradual onset and longer duration than rizatriptan but might not provide as rapid relief from symptoms.
Both Maxalt and Amerge have proven efficacy against migraines; however, their impact can vary between individuals due to differences in absorption rates or how well an individual tolerates each medication's specific effects or possible side effects.
What conditions is Maxalt approved to treat?
Maxalt is approved for the treatment of different variations of migraines:
- Migraine with or without aura in adults
- Acute migraine attacks in adolescents aged 12 to 17 years old
Amerge, on the other hand, is used for:
- Acute treatment of migraine attacks with or without aura in adults
- It's not indicated for prevention of migraines nor for cluster headaches.
How does Maxalt help with these illnesses?
Maxalt (rizatriptan) helps to manage migraines by constricting the blood vessels around the brain. It does this by activating serotonin receptors in these blood vessels, leading them to narrow and reduce the inflammation that is thought to contribute to migraine headaches. Serotonin is a neurotransmitter, a chemical that acts as a messenger in the brain and throughout the body, playing important roles in mood, cognition, memory, sleep patterns amongst other things. Maxalt can therefore alleviate pain from migraines quickly.
Amerge (naratriptan), on the other hand works similarly but has a slower onset of action and longer half-life than rizatriptan. This makes Amerge more suitable for patients who experience prolonged migraines or have recurrent migraine attacks within 24 hours since it maintains its effect over an extended period.
What is Amerge?
Amerge, with its generic name being naratriptan, is a type of drug known as a triptan which serves to treat migraines. Similar to maxalt (rizatriptan), it works by stimulating serotonin receptors in the brain which can cause the blood vessels in the brain to constrict and subsequently alleviate migraine symptoms. It was first approved by FDA in 1998.
Unlike Maxalt, Amerge does not influence dopamine or norepinephrine levels within the body. This means that while both drugs work on serotonin receptors for migraine relief, their side-effect profiles differ quite significantly due to this distinction. Amerge tends not to have a strong sedative effect compared with many other types of anti-migraine medications and is less likely than some others (including some SSRI antidepressants) to cause weight gain or sexual dysfunction—common side effects associated with those classes of medication.
The impact on serotonin alone can be highly beneficial for alleviating acute migraines, especially among patients who don't respond well or have adverse reactions related to typical treatments such as Maxalt.
What conditions is Amerge approved to treat?
Amerge, a triptan drug class member, is FDA-approved for the treatment of:
- Acute migraine attacks with or without aura in adults
- Other severe headache disorders
It's beneficial for those who need a longer acting migraine medication or cannot tolerate other more immediate treatments.
How does Amerge help with these illnesses?
Amerge is a medication that targets serotonin, a neurotransmitter involved in various processes within the body including the regulation of mood, appetite, and sleep. It functions as a selective serotonin receptor agonist which helps to narrow blood vessels around the brain thereby relieving headaches and other symptoms associated with migraines such as nausea, vomiting, and sensitivity to light or sound. Unlike Maxalt which acts rapidly but has a short duration of action, Amerge works slower but its effects last longer making it beneficial for patients who experience prolonged migraine attacks. As with norepinephrine in depression management where Wellbutrin increases its levels when typical SSRIs are ineffective or contraindicated; Amerge can be utilized effectively when quick relief from migraine symptoms isn't necessary but long-lasting effect is desired.
How effective are both Maxalt and Amerge?
Both rizatriptan (Maxalt) and naratriptan (Amerge) are commonly prescribed to treat migraines, having been approved by the FDA within a few years of each other in the late 1990s. As they belong to the same class of medications called triptans, they work similarly by stimulating serotonin receptors in the brain which causes blood vessels in the brain to constrict, thereby relieving migraine.
The effectiveness of both drugs was compared directly in several studies; one double-blind clinical trial from 2001 noted that while both were effective at alleviating acute migraine symptoms, patients taking rizatriptan had a faster onset of pain relief than those on naratriptan. However, naratriptan has been observed to have a longer half-life than rizatriptan and may be more suitable for preventing recurrence or prolongation of a migraine attack.
A review study published in 2012 found that across multiple trials comparing different triptans, including Maxalt and Amerge, most demonstrated similar efficacy levels overall. It highlighted though that individual response can vary significantly between patients due to factors such as side effect tolerance or specific symptom severity.
In terms of safety profiles, both medicines are well-tolerated but come with potential side effects like dizziness or sleepiness. Rizatriptan might be more likely to cause chest tightness or pressure. Neither drug is recommended as first-line therapy for individuals with coronary artery disease due its vasoconstrictive properties.
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At what dose is Maxalt typically prescribed?
Oral dosages of Maxalt typically range from 5-10 mg, taken as needed at the onset of a migraine. However, clinical studies have indicated that a 10mg dose is often sufficient for most adults suffering from migraines. Adolescents and individuals with kidney or liver problems may commence treatment on a lower dose of 5 mg. If there is insufficient response to the initial dose within two hours, an additional dose can be considered but should not exceed three doses in any 24-hour period. The maximum dosage that should not be exceeded in any case is 30mg/day.
In comparison, Amerge (Naratriptan) oral dosages commonly start at a single dose of 1-2.5mg taken when migraine symptoms begin to surface. It has been observed that a repeat dosage may be consumed after four hours if symptoms persist but should not surpass five tablets (12.5mg total) within a span of twenty-four hours.
At what dose is Amerge typically prescribed?
Amerge therapy typically begins with a dosage of 1-2.5 mg taken orally, as soon as the patient starts experiencing migraine symptoms. If some relief is achieved but the migraine hasn't completely resolved within 4 hours, another dose can be taken, spacing it out at least by that time period. The maximum daily dosage should not exceed 5 mg in any given 24-hour period. This may be adjusted if there is no significant improvement after a few attempts or weeks of treatment under this regimen.
What are the most common side effects for Maxalt?
Common side effects of Maxalt and Amerge (naratriptan) might include:
- Dizziness or vertigo
- Sleepiness/drowsiness (somnolence)
- Sensations of tingling, prickling, or numbness (paresthesia)
- General weakness and fatigue
- Nausea and vomiting
- Dry mouth
- Tightness or pressure in the chest, throat, neck, and jaw
- Flushing or feeling warm/hot
-Sweating
-Unusual taste sensation
-Difficulty falling asleep or staying asleep (insomnia)
But remember that not everyone experiences these side effects. If any of them persist or worsen while taking either medication, it's important to consult your healthcare provider immediately.
Are there any potential serious side effects for Maxalt?
While both Maxalt and Amerge are effective in treating migraines, their potential side effects can differ:
- Signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.
- Increased blood pressure leading to severe headaches, blurred vision, pounding in your neck or ears.
- Serotonin syndrome symptoms such as agitation, hallucinations, fever, sweating, shivering, fast heart rate (tachycardia), muscle stiffness or twitching; loss of coordination; nausea vomiting and diarrhea.
- Allergic reactions including hives; difficulty breathing due to throat swelling
- Unusual changes in mood or behaviors - feeling anxious agitated high-fever confusion rapid heartbeat fainting.
If you experience any of these symptoms while taking either Maxalt or Amerge for migraines treatment immediately seek medical attention. Keep in mind that this is not an exhaustive list and there may be other side effects associated with each drug so always consult with your healthcare provider if you have concerns.
What are the most common side effects for Amerge?
Amerge, also known as Naratriptan, can cause some side effects similar to Maxalt but with varying degrees of intensity. These may include:
- Sensations of tingling or numbness
- Dizziness
- Dry mouth
- Feeling warm or flushed
- Unusual feeling in the throat
- Weakness or heaviness sensation in certain parts of the body
- Nausea and stomach discomforts
In rare cases, Amerge can cause a fast heartbeat and feelings of anxiety. It's important to note that while these are potential side effects not everyone will experience them. If you do encounter any unusual symptoms after taking Amerge, it is advisable to consult your healthcare provider promptly for guidance.
Are there any potential serious side effects for Amerge?
While Amerge is generally well-tolerated, it can have a few significant side effects in some patients. These include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of the face, lips, tongue or throat.
- Chest pain or pressure, tight feeling in your neck or jaw, sweating and pain spreading to your arm or shoulder.
- Sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech and problems with vision or balance.
- Blood circulation problems in legs and feet such as cramping and burning when you walk, wound that won't heal, skin color changes (pale blue-to-purple).
- High levels of serotonin leading to agitation hallucinations fever fast heart rate overactive reflexes nausea vomiting diarrhea loss of coordination fainting If any such symptoms are experienced after taking Amerge immediately seek medical attention.
Contraindications for Maxalt and Amerge?
Both Maxalt and Amerge, like most migraine medications, may exacerbate symptoms in some individuals. If you notice your migraines worsening or an increase in frequency or severity of headaches, please seek immediate medical attention.
Neither Maxalt nor Amerge should be taken if you are taking or have been taking monoamine oxidase (MAO) inhibitors within the last 2 weeks. Always inform your physician about all medications that you are currently taking; MAOIs will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with Maxalt and Amerge.
These drugs can also cause serotonin syndrome when used with certain antidepressants called selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Symptoms include hallucinations, rapid heartbeat, fever, loss of coordination and severe nausea/vomiting/diarrhea. Seek immediate help if these symptoms occur.
How much do Maxalt and Amerge cost?
For the brand name versions of these drugs:
- The price of 9 tablets of Maxalt (10 mg) averages around $220, which works out to approximately $24/day per attack.
- The price for Amerge (2.5 mg), also sold as a pack of 9 tablets, is about $200, translating to roughly $22/day per migraine episode.
Thus, if you are using medication for each migraine occurrence and they happen frequently, then brand-name Amerge might be less expensive on a per-day treatment basis. However, remember that cost should not be your primary consideration in determining which of these drugs is more suitable for you.
For the generic version equivalents - rizatriptan (Maxalt) and naratriptan (Amerge):
- Rizatriptan comes in packs starting from 9 up to many more tablets with costs averaging between $1-$3 per day based on frequency and severity of migraines.
- Naratriptan starts off at around similar prices but can go lower if bought in bulk or higher depending upon location and dosage requirements.
It's crucial to discuss with your healthcare provider about both medications considering their efficacy along with their cost-effectiveness.
Popularity of Maxalt and Amerge
Rizatriptan, commonly known by its brand name Maxalt, was estimated to have been prescribed to about 1.2 million people in the United States in 2020. Rizatriptan accounted for approximately 17% of all triptan prescriptions used for treating migraines in the US. It has seen a steady increase in use since it first became available.
Naratriptan, sold under the brand name Amerge among others, is another option for migraine treatment and prevention. In comparison to rizatriptan, naratriptan was prescribed less frequently with around 400 thousand prescriptions filled across the US during the same year. Despite this difference in prescription numbers, both drugs are part of the class of medications called triptans and work similarly – they narrow blood vessels around the brain. Naratriptan's slower onset but longer duration compared to rizatriptan makes it more suitable as a preventive measure rather than an acute remedy.
Conclusion
Both Maxalt (rizatriptan) and Amerge (naratriptan) have proven track records in the management of migraine headaches. They are both part of a class of drugs known as triptans, which work by constricting cranial blood vessels and blocking transmission of pain signals to nerve endings. Extensive clinical trials validate their effectiveness over placebo treatments.
The two medications differ slightly in their onset and duration of action, with Maxalt generally providing faster relief but having a shorter half-life than Amerge. Therefore, while Maxalt might be preferred for rapid treatment of acute migraines, Amerge could be more suitable for those who experience longer-lasting or recurring migraines due to its extended effect.
Both drugs are available in generic form offering cost savings particularly beneficial for patients paying out-of-pocket. Both may require an adjustment period as effects may not be immediate after initial administration.
Side effects between the two are fairly similar; however, they can vary from person to person ranging from minor side-effects like dizziness or nausea to severe ones such as chest tightness or shortness of breath. As with any medication regimen it's crucial that patients closely monitor their responses especially when initiating these therapies.
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Refrences
- Bomhof, M., Paz, J., Legg, N., Allen, C., Vandormael, K., & Patel, K. (1999). Comparison of Rizatriptan 10 mg vs. Naratriptan 2.5 mg in Migraine. European Neurology. S. Karger AG.http://doi.org/10.1159/000008094
- Dahlof, C., & Lines, C. (1999, May). Rizatriptan: a new 5-HT1B/1D receptor agonist for the treatment of migraine. Expert Opinion on Investigational Drugs. Informa Healthcare.http://doi.org/10.1517/13543784.8.5.671
- Pascual, J., Bussone, G., Hernandez, J. F., Allen, C., Vrijens, F., & Patel, K. (2001). Comparison of Preference for Rizatriptan 10-mg Wafer versus Sumatriptan 50-mg Tablet in Migraine. European Neurology. S. Karger AG.http://doi.org/10.1159/000052143
- Dahlof, C. G. H., Rapoport, A. M., Sheftell, F. D., & Lines, C. R. (1999, November). Rizatriptan in the treatment of migraine. Clinical Therapeutics. Elsevier BV.http://doi.org/10.1016/s0149-2918(00)86731-4