Pediatric migraine: Neurodevelopmental mechanisms, clinical phenotypes, and modern therapeutics

Table 4 The different Food and Drug Administration-approved triptans used to treat childhood migraine

Medication	Age group (FDA)	Age group (EMA)	Key features
Rizatriptan (Maxalt)	6-17 years	≥ 18 years1	Currently the only triptan FDA-approved for children as young as 6. Available as an ODT
Zolmitriptan nasal spray	12-17 years	12-17 years	First nasal-delivered triptan approved for adolescents. Offers rapid absorption and high efficacy for associated symptoms
Almotriptan	12-17 years	12-17 years	Often cited for having a superior tolerability profile with fewer “triptan sensations” (chest/neck tightness)
Sumatriptan/naproxen	12-17 years		A fixed-dose combination (Treximet) that targets both the neural (triptan) and inflammatory (NSAID) pathways

¹While European regulators (European Medicines Agency) often defer to national approvals for younger ages, sumatriptan nasal spray is the most widely approved pediatric triptan across Europe for those > 12 years.

EMA: European Medicines Agency; FDA: Food and Drug Administration; ODT: Orally disintegrating tablet; NSAID: Non-steroidal anti-inflammatory drugs.