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Maxalt vs Frova
Introduction
For patients suffering from migraines, certain medications that influence the dilation and inflammation of blood vessels in the brain can provide relief. Maxalt (rizatriptan) and Frova (frovatriptan) are two such drugs commonly prescribed for acute migraine attacks. They both belong to a class of drugs called triptans which work by stimulating serotonin receptors in the brain, causing vasoconstriction or narrowing of blood vessels around the brain. Maxalt is known for its fast action onset, usually providing relief within 2 hours while Frova has a slower action onset but provides longer-lasting effects due to its extended half-life compared to other triptans. Essentially, while they function similarly overall, their differences lie in speed and duration of efficacy.
Maxalt vs Frova Side By Side
Attribute | Maxalt | Frova |
---|---|---|
Brand Name | Maxalt | Frova |
Contraindications | Should not be taken with certain antidepressants like SSRIs, SNRIs, or MAO inhibitors | Should not be taken with certain antidepressants like SSRIs, SNRIs, or MAO inhibitors |
Cost | Brand: ~$540 for 9 tablets (10 mg), Generic: $20-$70 per pack | Brand: ~$600 for 6 tablets (2.5mg), Generic: $30-$90 per package |
Generic Name | Rizatriptan | Frovatriptan |
Most Serious Side Effect | Signs of allergic reaction, vision changes, heart-related issues, abnormal sensations, possible serotonin syndrome symptoms | Signs of a serious allergic reaction, chest pain or tightness, severe headache, blurred vision, rapid heartbeats, sudden numbness or weakness, confusion and problems with speech, unusual sweating and nausea |
Severe Drug Interactions | MAO inhibitors, SSRIs, SNRIs | MAO inhibitors, SSRIs, SNRIs |
Typical Dose | 5–10 mg per dose, up to twice a day | 2.5 mg taken as soon as symptoms appear, repeat after 4 hours if needed, no more than three doses in 24 hours |
What is Maxalt?
Rizatriptan (the generic name for Maxalt) and Frovatriptan (the generic name for Frova) are both members of the triptan class of drugs, which were a significant advancement from the earlier non-specific serotonin receptor agonists. They were developed to specifically target migraines. Rizatriptan was first approved by the FDA in 1997 and is noted for its rapid onset of action, providing relief within two hours of administration. It works by stimulating serotonin receptors in the brain to reduce inflammation and constrict blood vessels, thereby relieving migraine symptoms.
Frovatriptan, on the other hand, was approved later in 2001 and stands out due to its long half-life; it offers sustained relief over a longer period but might not provide immediate relief as quickly as rizatriptan does. Both drugs have selective influence on serotonin with negligible effects on dopamine or norepinephrine receptors which results in fewer side-effects compared to older generation migraine medications.
What conditions is Maxalt approved to treat?
Maxalt is approved for the treatment of acute migraine attacks with or without aura:
- In adults
- In pediatric patients 6 to 17 years of age
On the other hand, Frova is used for:
- The acute treatment of migraines with or without aura in adults
- Prevention of menstrual migraine (short-term) in adult women who have a clear pattern of migraines that occur exclusively on two consecutive days each month.
How does Maxalt help with these illnesses?
Maxalt helps to manage migraines by constricting the blood vessels around the brain. It does this by stimulating serotonin (5-HT1) receptors in the brain which causes vasoconstriction, thereby reducing headache pain. Serotonin is a neurotransmitter, a chemical that acts as a messenger in the brain and throughout the body, that plays an important role in mood, cognition, memory, sleep patterns and hunger among other things. Maxalt also blocks the release of substances from nerve endings that can cause more pain and other symptoms like nausea or sensitivity to light and sound. Therefore, by increasing serotonin activity at specific receptors and blocking certain nerve signals, Maxalt can limit negative effects of migraines and help patients manage their condition better.
On the other hand Frova works similarly but has a longer half-life compared to Maxalt meaning it remains active within your system for longer periods; hence preferred for those with prolonged migraine attacks.
What is Frova?
Frova, which is a brand name for frovatriptan, works as a serotonin receptor agonist specifically for the 5HT1B/1D receptors. This means it mimics the action of serotonin on these receptors in certain brain cells, leading to constrictions of blood vessels that are dilated during migraines and reduction of inflammation-associated substances implicated in migraine pain.
Frovatriptan was first approved by the FDA in 2001. Although both Maxalt and Frova belong to the same class of medications called triptans, they have some differences. Unlike other triptans such as Maxalt (rizatriptan), Frovatriptan does not act on any other subtypes of serotonin receptors that could lead to side effects like chest discomfort or tightness.
The longer half-life of Frovatriptan compared with other drugs from its class makes it particularly effective at preventing migraines known for lasting longer than usual or those that reoccur within short time periods after initial treatment – attributes not typically found with many medications similar to Prozac or Wellbutrin. The side-effect profile also differs; common potential adverse effects include nausea, dry mouth, flushing and dizziness.
What conditions is Frova approved to treat?
Frova is approved for the treatment of:
- Acute migraines with or without aura in adults
- It's also used as a preventive measure to reduce the frequency and intensity of menstrual-related migraines.
It's important to note that Frova is not intended for the routine prevention of migraines, nor is it designed to treat cluster headaches.
How does Frova help with these illnesses?
Frovatriptan, commonly known as Frova, is a medication that plays crucial roles in the treatment of migraines. It functions by inducing vasoconstriction - narrowing of blood vessels in the brain - to counteract vasodilation which occurs during migraines. This helps reduce pain and other symptoms like sensitivity to light and sound associated with migraine episodes. As with serotonin (5-HT), abnormal levels have been implicated in migraines due to its role on vascular tone and sensory pain pathways. Frova works primarily by stimulating 5-HT receptors located on intracranial blood vessels and sensory nerves of the trigeminal system, thereby relieving some of the symptoms of a migraine attack. Its longer half-life compared to Maxalt makes it particularly useful for patients who experience prolonged or recurrent migraines or those who do not respond well to other triptans such as Maxalt.
How effective are both Maxalt and Frova?
Both rizatriptan (Maxalt) and frovatriptan (Frova) have proven efficacy in treating migraines, with their initial FDA approval coming within a few years of each other. Since they act on different serotonin receptors, they may be prescribed under distinct situations. The effectiveness of Maxalt and Frova for alleviating migraine was examined directly in a double-blind clinical trial in 2001; the two drugs showed similar effectiveness in managing symptoms of migraines as well as comparable safety profiles. In this study, no significant differences were found when comparing various metrics used to measure efficacy between patients receiving Maxalt or Frova.
A 2005 review analyzing several studies demonstrated that Maxalt starts providing relief from migraines within two hours after administration, has a favorable side effect profile compared to many other triptans, and is generally well-tolerated by most populations including adults and adolescents. It has become one of the most frequently prescribed triptans worldwide due to its quick onset action and high success rates among users.
In contrast, while a review conducted in 2012 indicated that Frova seems to be more effective than placebo at reducing migraine pain intensity over extended periods (up to 48 hours), it tends not to provide immediate relief like some other common triptans do such as Maxalt. As such, Frova is typically considered only after first-line treatments fail or are unsuitable for specific cases involving prolonged aura or menstrually associated migraines where long-lasting effects might be beneficial.
At what dose is Maxalt typically prescribed?
Oral dosages of Maxalt typically range from 5–10 mg per dose, and it can be taken up to twice a day for treating migraines. Adolescents aged 12-17 are usually started on the lower end at 5 mg per dose, and may take up to two doses in a 24-hour period if needed. Adults can start with either dosage depending upon severity of their symptoms but should not exceed two doses in any single day. On the other hand, Frova is administered at a standard dose of 2.5 mg once every 12 hours as required for migraine treatment; its usage should not exceed three tablets (7.5mg) within any given day.
At what dose is Frova typically prescribed?
Frova treatment typically begins with a dosage of 2.5 mg taken by mouth as soon as migraine symptoms appear. If the headache returns, the dose can be repeated after 4 hours; however, no more than three doses should be taken in a 24-hour period. The maximum recommended dose is 7.5 mg within any given day. It's important to note that if you do not experience relief from your initial migraine attack after taking Frova, you should consult with your healthcare provider before continuing to use it for subsequent attacks.
What are the most common side effects for Maxalt?
Common side effects of Maxalt (Rizatriptan) include:
- Tiredness/drowsiness
- Sensation of pressure or tightness in the chest, throat, jaw, and/or neck
- Dizziness
- Nausea or vomiting
- Warm/cold sensations
On the other hand, common side effects associated with Frova (Frovatriptan) are:
- Headache (other than a migraine headache)
- Dizziness
- Fatigue
- Dry mouth
- Hot flashes -Nausea or vomiting
Remember to always consult with your healthcare provider about any concerns relating to side effects.
Are there any potential serious side effects for Maxalt?
When comparing Maxalt to Frova, it's important to note that both medications have potential side effects. However, the severity and frequency of these can vary from person to person.
- Signs of allergic reaction or severe skin reaction: rashes, difficulty breathing, swelling in your face or throat
- Vision changes such as seeing halos around lights or blurred vision
- Heart-related issues such as fast heartbeats, chest discomfort or tightness; feeling lightheaded like you might pass out
- Abnormal sensations including tingling and numbness (paresthesia), dry mouth
- Possible serotonin syndrome symptoms which include restlessness, hallucinations, rapid heartbeat, fever, loss of coordination nausea and vomiting
It is crucial if you encounter any of these severe side effects when taking Maxalt or Frova to seek immediate medical help.
What are the most common side effects for Frova?
Frova, like many medications, can have some potential side effects. These can include:
- Hot or cold sensations
- Dry mouth and changes in the sense of taste
- Nausea or stomach discomfort
- Mild dizziness or fatigue
- Feeling of heaviness in parts of the body
- Insomnia and other sleep disturbances Some people might also experience muscle weakness or a prickling sensation under the skin. It's important to remember that not everyone will experience these side effects, and they often subside as your body adjusts to Frova. However, if any persist or become troublesome, it is always best to consult with your healthcare provider.
Are there any potential serious side effects for Frova?
Frova, like any medication, can occasionally cause severe side effects. If you notice the following symptoms after taking Frova, seek immediate medical attention:
- Signs of a serious allergic reaction: rash; hives; swelling of the face, lips or tongue; difficulty breathing
- Chest pain or tightness that may spread to your jaw or shoulder
- Severe headache, blurred vision, pounding in your neck or ears
- Rapid heartbeats
- Sudden numbness or weakness (especially on one side of the body)
- Confusion and problems with speech
- Unusual sweating and nausea.
These symptoms could indicate a serious condition such as serotonin syndrome which requires urgent medical help. Always consult with your healthcare provider if you experience any unusual reactions after taking this medication.
Contraindications for Maxalt and Frova?
Both Maxalt and Frova, along with most other medications aimed at treating migraines, may exacerbate certain symptoms in some people. If you notice an increase in the frequency or severity of your headaches, or if your headache becomes different or worsens after taking these medications, please seek immediate medical attention.
Neither Maxalt nor Frova should be taken if you are using certain types of antidepressants like selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), or monoamine oxidase (MAO) inhibitors. Always inform your physician about all the medications you are currently taking; MAO inhibitors especially will require a period of about 2 weeks to clear from the system before starting treatment with either Maxalt or Frova to prevent potentially serious interactions.
How much do Maxalt and Frova cost?
For the brand name versions of these drugs:
- The price for 9 tablets of Maxalt (10 mg) averages around $540, which works out to about $60/day, considering it is an as-needed medication.
- The cost for 6 tablets of Frova (2.5mg) averages around $600, working out to approximately $100/day on an as-needed basis.
Thus, if you are in need of frequent migraine relief therapy and use more than one tablet a day, then branded Maxalt is less expensive on a per-day treatment basis than Frova. Please note that cost should not be the primary consideration in determining which drug is right for your condition.
As for generic versions; rizatriptan (generic Maxalt) and frovatriptan (generic Frova), costs are significantly lower:
- Rizatriptan costs between $20-$70 per pack depending on the number of doses included with approximate daily costs ranging from $2-$8 based off typical usage.
- Frovatriptan costs between $30-$90 per package also depending on quantity provided with average daily expenditures falling between approximately $5-$15.
Popularity of Maxalt and Frova
Rizatriptan, also known by the brand name Maxalt, was prescribed to approximately 2.5 million people in the US in 2020. Rizatriptan is part of a class of medications called triptans which are used specifically for treating migraines. It accounted for around 16% of all triptan prescriptions.
Frovatriptan, sold under the brand name Frova, had a significantly lower prescription rate with about 250 thousand prescriptions filled in the same year in the USA. This accounts for roughly 2% of all triptan prescriptions. Frovatriptan has a longer half-life than rizatriptan and other triptans, making it particularly useful for managing prolonged or menstruation-related migraines.
The prescription rates for both drugs have remained fairly steady over recent years but rizatriptan tends to be more commonly chosen due to its faster onset of action despite frovatriptan's advantage of longer duration effect.
Conclusion
Both Maxalt (rizatriptan) and Frova (frovatriptan) have long-standing records of usage in patients with migraines, supported by numerous clinical studies demonstrating their effectiveness. They belong to a class of drugs known as triptans, which work by narrowing blood vessels around the brain to provide relief from migraine headaches. While both drugs can be used alone, they are not typically combined due to potential overuse or rebound headache risks.
Maxalt is often chosen for its faster onset of action—it takes effect within 2 hours—making it suitable for treating acute migraine attacks that require quick relief. On the other hand, Frova has a slower onset but longer duration of action—lasting up to 26 hours—and may be preferred when prolonged pain control is desired or for menstrual-related migraines.
Both medications are available in generic form offering cost savings especially for those paying out-of-pocket. The effects of these drugs might not be noticeable immediately after starting treatment and some patients might need an adjustment period before experiencing full benefits.
The side effect profiles between Maxalt and Frova are similar; both being generally well-tolerated but with common side effects like dizziness, fatigue, tingling sensation or flushing reported among users. As always, if any adverse reactions occur during treatment with either drug—or if there's worsening symptoms—the patient should consult their healthcare provider promptly.
Refrences
- 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
- Comer, M. B., & Hons. (2002, April). Pharmacology of the Selective 5‐HT<sub>1B/1D</sub> Agonist Frovatriptan. Headache: The Journal of Head and Face Pain. Wiley.http://doi.org/10.1046/j.1526-4610.42.s2.2.x
- Goldstein, J., Keywood, C., & On Behalf Of The 251/96/14 Study Group. (2002, January). Frovatriptan for the Acute Treatment of Migraine: A Dose‐Finding Study. Headache: The Journal of Head and Face Pain. Wiley.http://doi.org/10.1046/j.1526-4610.2002.02012.x
- Rapoport, A. M. (2001, January). Frovatriptan: Pharmacological Differences and Clinical Results. Current Medical Research and Opinion. Informa Healthcare.http://doi.org/10.1185/0300799039117006
- Balbisi, E. A. (2004, July 21). Frovatriptan succinate, a 5-HT1B/1D receptor agonist for migraine. International Journal of Clinical Practice. Hindawi Limited.http://doi.org/10.1111/j.1368-5031.2004.00218.x
- 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