Rizatriptan

Soothe migraines with Rizatriptan (generic Maxalt) on prescription

Rizatriptan’s treatment purpose is to tackle acute migraine attacks, and it’s simply very good at that. As a common off-label use, it also treats cluster headaches.

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Information

Reviewed by Dr Yasmin Aghajan, MD

Information last reviewed 08/06/19

About

What is Rizatriptan?

Rizatriptan belongs to a class of drugs known as triptans, a group of medicines used to treat the symptoms of migraine headaches. The latter can manifest itself as severe, throbbing headaches which are sometimes accompanied by sensitivity to light and/or sound, and nausea (feeling sick). If you are known to suffer from migraine, doctors at Medzino can issue a prescription for Rizatriptan 5mg or 10mg.

How does Rizatriptan work?

Migraine is a common and debilitating brain disorder that affects approximately 3%-22% of women and 1%-16% of men. Triptans such as Rizatriptans work by modulating the neuro-transmitter substance serotonin in the brain, and reduce headache pain by several mechanisms. One is by reducing the swelling/dilation of the blood vessels in the brain. Another is by blocking release of pain signaling substances in the brain. Rizatriptan is not suitable as a preventive medicine for chronic migraine. Rather, it should be taken after a migraine attack has already begun and the symptoms have started showing. Rizatriptan is ineffective in preventing future migraines or reducing the frequency of migraine attacks you get.

How effective is Rizatriptan?

Rizatriptan has shown the following efficacy in clinical trials as reported by the manufacturer:
After 2 hours, the following proportion of patients experienced relief:

  • 62% of people experienced relief after 5mg tablet compared to just 35% after taking a placebo
  • 71% of people experienced relief after 10mg tablet compared to just 35% after taking a placebo
     

Ingredients

Active ingredients

The active ingredient in Rizatriptan is rizatriptan benzoate at a concentration of 5mg or 10mg.

Inactive ingredients

Rizatriptan also contains the following inactive ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, ferric oxide (red), and magnesium stearate

Please note: Inactive ingredients may vary between different manufacturers. 

Which ingredients can cause an allergic reaction?

Rizatriptan is not commonly associated with causing a severe allergic reaction in people. However, if you notice symptoms of a severe allergic reaction (hives, facial swelling, lightheadedness, tightening of the chest, finding it difficult to breathe) you should seek emergency medical help right away. 

Dosage

Rizatriptan Dosage

The dose of Rizatriptan varies from patient to patient. Use Rizatriptan exactly as prescribed by your doctor, and do not auto-medicate without consulting your doctor, or exceed the recommended dosage.

The recommended starting dose of Rizatriptan is either 5mg or 10mg. You may take a second dose two hours after the first dose if your headache returns. The maximum recommended dose within a period of 24h is 30mg. Do not exceed this.

How to take Rizatriptan

Do not take this medication if your headache is not a migraine. For efficient migraine relief, take Rizatriptan as soon as the headache pain begins. If you get warning signals of a coming migraine, only use the drug when the headache starts.

Swallow the tablet whole with a glass of water without crushing, breaking, or chewing it.

How to take Rizatriptan

Take either the 5mg or 10mg dose at the onset of a migraine; repeat the dose after 2 hours if significant relief is not achieved. Take with a glass of water, do not crush the pills.

What should I do if I miss a dose of Rizatriptan?

Rizatriptan should not be taken on a scheduled basis; rather, it must only be used on an as-needed basis at the start of a migraine. If the migraine started hours ago, you may still take Rizatriptan for some effect.

What should I do if I took too much Rizatriptan?

You should call the Poison Control Center at 1-800-222-1222 and seek immediate medical attention, such as going to the emergency department. An overdose of Rizatriptan could have severe consequences. Do not delay seeking medical care. 

Side Effects

Rizatriptan side effects

Common side effects of Rizatriptan include:

  • Dizziness
  • Somnolence (feeling sleepy)
  • Paresthesia (skin sensation such as tingling, pricking, chilling, burning, or numbness)
  • Headache
  • Tremor
  • Confusion/disorientation
  • Hot flushes and sweating
  • Sore throat
  • Difficulty breathing
  • Nausea (feeling sick)
  • Dry mouth
  • Vomiting
  • Diarrhea
  • Chest pain
  • Fatigue (feeling tired)


Get immediate medical help if you experience any of the following rare but serious side effects:If any of these side effects persist or cause discomfort, talk to your physician.

  • Blue fingers/toes/nails, cold hands/feet, hearing changes, mental/mood changes
  • Symptoms of a heart attack including chest/jaw/left arm pain, shortness of breath, or unusual sweating
  • Fast/irregular heartbeat
  • Fainting
  • Severe stomach/abdominal pain
  • Bloody diarrhea
  • Signs of stroke such as weakness on one side of the body, trouble speaking, sudden vision changes, and confusion
  • Symptoms of serotonin syndrome such as fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness

Drug Interactions

Certain drugs will interact with Rizatriptan or even cause harmful effects if taken simultaneously. Always inform your doctor of the medications and/or herbal supplements you use. In any case, do not mix Rizatriptan with the following drugs:

  • Propranolol and other beta-blockers (drugs to treat high blood pressure and irregular heartrate)
  • Ergot-containing drugs
  • Other triptans to treat migraine
  • MAOIs (Monoamine Oxidase Inhibitors) to treat depression

Contraindications

In the following cases, taking Rizatriptan is contraindicated:

  • If you are allergic to rizatriptan or any of its other ingredients: Lactose monohydrate, microcrystalline cellulose, magnesium stearate, Iron oxide red (E 172), pregelatinised starch (maize). Symptoms of an allergic reaction include swelling of the face/tongue/throat, rash, severe dizziness, and trouble breathing. Seek immediate help if this occurs.
  • If you take anti-depressants such as monoamine oxidase (MAO) inhibitors at the same time as Rizatriptan, or use Rizatriptan within two weeks of termination of MAO inhibitors therapy.
  • If you suffer from severe hepatic (relating to the liver) or renal (relating to the kidneys) insufficiency
  • If you have previously suffered from a cerebrovascular accident (a stroke) or transient ischemic attack (a “mini stroke”)
  • If you suffer from moderately severe to severe hypertension or untreated mild hypertension
  • If you have a heart problem including ischaemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischaemia), signs and symptoms of ischaemic heart disease, or Prinzmetal's angina.
  • If you suffer from peripheral vascular disease
  • If you are taking ergotamine (used to treat migraine) or ergotamine derivatives including methysergide, or other or other 5 HT1B/1D receptor agonists (e.g. sumatriptan, zolmitriptan, naratriptan). Do not use any of these in combination with Rizatriptan as this might increase the risk of coronary artery vasoconstriction and hypertensive effects.

Q&A

Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

  1. WebMB, ‘Rizatriptan’, [website], https://www.webmd.com/drugs/2/drug-8425-3051/rizatriptan-oral/rizatriptan-tablet-oral/details [last accessed 15 May 2019]
  2. Medline Plus, ‘Rizatriptan’, [website], 15 November 2015, https://medlineplus.gov/druginfo/meds/a601109.html [last accessed 15 May 2019]
  3. Migraine.com, ‘Maxalt (Rizatriptan Benzoate), [website], March 2019, https://migraine.com/migraine-treatment/maxalt/ [last accessed 15 May 2019]
  4. Health Navigator, ‘Rizatriptan’, [website], 14 February 2019, https://www.healthnavigator.org.nz/medicines/r/rizatriptan/ [last accessed 15 May 2019]
  5. Rxlist, ‘Maxalt’, [website], 11 March 2019, https://www.rxlist.com/maxalt-drug.htm#description [last accessed 15 May 2019]
  6. Katsarava Z, Fritsche G, Muessig M, Diener HC, Limmroth V. Clinical features of withdrawal headache following overuse of triptans and other headache drugs. Neurology. 2001 Nov 13;57(9):1694-8. [PubMed: 11706113]

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