Generic name: rizatriptan (RYE za TRIP tan)
Brand name: Maxalt, Maxalt-MLT
Dosage forms: oral tablet (10 mg; 5 mg); oral tablet, disintegrating (10 mg; 5 mg)
Drug class: Antimigraine agents
Rizatriptan is a headache medicine that narrows the blood vessels around the brain. Rizatriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.
Rizatriptan is used to treat migraine headaches. Rizatriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.
Rizatriptan should not be used to treat a common tension headache, or a headache that causes loss of movement on one side of your body. Use rizatriptan only if your condition has been confirmed by a doctor as migraine headaches.
Rizatriptan may also be used for purposes not listed in this medication guide.
Warnings
You should not use this medicine if you have uncontrolled high blood pressure, heart problems, a history of heart attack or stroke, or circulation problems that cause a lack of blood supply within the body.
Do not take rizatriptan within 24 hours before or after using another migraine headache medicine.
Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Before taking this medicine
You should not use rizatriptan if you are allergic to it, or if you have:
- heart problems, or a stroke (including "mini-stroke");
- coronary artery disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;
- circulation problems affecting your legs, arms, stomach, intestines, or kidneys;
- uncontrolled high blood pressure;
- severe liver disease; or
- a headache that seems different from your usual migraine headaches.
Do not use rizatriptan if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor if you have ever had:
- liver or kidney disease;
- heart problems, chest pain;
- shortness of breath; or
- risk factors for coronary artery disease (such as high blood pressure, high cholesterol, diabetes, menopause, smoking, a family history of coronary artery disease, being overweight, or being older than 40 and a man).
Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with rizatriptan and cause a serious condition called serotonin syndrome.
Rizatriptan disintegrating tablets may contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).
Tell your doctor if you are pregnant or breastfeeding.
Rizatriptan is not approved for use by anyone younger than 6 years old.
How should I use rizatriptan?
Take rizatriptan as soon as you notice headache symptoms. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
You may receive your first dose in a hospital or clinic setting to quickly treat any serious side effects.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Take the regular tablet whole with a full glass of water.
Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet in your mouth and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves.
After taking a tablet (for adults): If your headache does not completely go away, or goes away and comes back, take a second tablet 2 hours after the first. If your symptoms have not improved, contact your doctor before taking any more tablets.
After taking a tablet (for children ages 6 to 17): If your headache does not completely go away, or goes away and comes back, contact your doctor before taking any more tablets.
Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks.
Call your doctor if your symptoms do not improve, or if you have more than 4 headaches in one month (30 days).
Rizatriptan can raise blood pressure to dangerous levels. Your blood pressure may need to be checked often while you are using rizatriptan. If you use rizatriptan long-term, your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Since rizatriptan is used when needed, it does not have a daily dosing schedule. Call your doctor if your symptoms do not improve after using this medicine.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while using rizatriptan?
Do not take rizatriptan within 24 hours before or after using another migraine headache medicine, including:
- almotriptan, eletriptan, frovatriptan, naratriptan, sumatriptan, zolmitriptan; or
- ergot medicine--dihydroergotamine, ergotamine, ergonovine, methylergonovine.
Avoid driving or hazardous activity until you know how rizatriptan will affect you. Your reactions could be impaired.
Rizatriptan side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using rizatriptan and call your doctor at once if you have:
- sudden and severe stomach pain and bloody diarrhea;
- cold feeling or numbness in your feet and hands;
- severe headache, blurred vision, pounding in your neck or ears;
- heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
- high levels of serotonin in the body--agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea; or
- signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.
Common side effects may include:
- dizziness, drowsiness, feeling tired; or
- pain or a feeling of pressure in your throat or chest.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Rizatriptan dosing information
Usual Adult Dose for Migraine:
Use only after a clear diagnosis of migraine has been established
Initial dose: 5 mg or 10 mg orally, once
-Provided there has been a response to first dose, a second dose may be administered at least 2 hours later if migraine returns
Maximum dose: 30 mg in a 24-hour period
Comments:
-The 10 mg dose may provide greater effect, however there may be a greater risk of adverse reactions.
-This drug should not be used to treat basilar or hemiplegic migraines because these patients are at a greater risk of stroke.
-The safety of treating an average of 4 or more migraine attacks in a 30-day period has not been established; the effectiveness of a second dose or subsequent doses has not been established in placebo-controlled trials.
Use: For the acute treatment of migraine with or without aura.
Usual Pediatric Dose for Migraine:
Use only after a clear diagnosis of migraine has been established
6 years or older and weight less than 40 kg:
-Initial dose: 5 mg orally once
6 years or older and weight 40 kg or greater:
-Initial dose: 10 mg orally once
Maximum: 1 dose in any 24-hour period
Comments:
-This drug should not be used to treat basilar or hemiplegic migraines because these patients are at a greater risk of stroke.
-The safety of treating an average of 4 or more migraine attacks in a 30-day period has not been established; the safety and effectiveness of more than 1 dose within 24 hours has not been established.
Use: For the acute treatment of migraine with or without aura in patients 6 years or older.
What other drugs will affect rizatriptan?
Tell your doctor about all your other medicines, especially:
- propranolol;
- an antidepressant; or
- medicine to treat a mood disorder.
This list is not complete. Other drugs may affect rizatriptan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Tell your doctor about all your other medicines, especially any type of antidepressant.
Other drugs may affect rizatriptan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.