What is rizatriptan?
Rizatriptan is a modern triptan for the treatment of acute migraine attacks. It is distinguished by rapid action and is especially available as a melt tablet which can be taken without water.
Rapid action (within 30 minutes) makes Rizatriptan a good choice when rapid relief is required. The melt tablet is also advantageous in case of nausea or if no water is available.
The known brand name is Maxalt®.
Active Ingredients & Mechanism of Action
Active ingredient: Rizatriptan
Rizatriptan acts on the same mechanism as other triptans:
Active mechanism:
- Activation of 5-HT1B/1D serotonin receptors
- constriction of extended cranial blood vessels
- Inhibition of the release of vasoactive peptides (CGRP)
- Blocking the trigeminal pain transfer
Special features:
- Fast action: 30 minutes
- High lipophilia – good CNS capability
- Melt tablet dissolves in seconds
Activity: The effect lasts about 24 hours. When the headache is returned, a second dose can be taken after 2 hours.
Who is it suitable for?
Rizatriptan is suitable for:
- Adults with acute migraine attacks
- Patients who need rapid action
- In case of nausea / vomiting (melting tablet)
- If no water is available
Special advantage:
- For severe migraine-related nausea
- For traveling
- On early intervention in the attack
Not suitable for:
- cardiovascular diseases
- Uncontrolled high blood pressure
- Propranolol therapy (dose reduction required!)
- Hemiplegic or Basilaris marshes
Available Dosages
Tablets:
- 5 mg
- 10 mg (standard dose)
Melt tablets (Maxalt lingua):
- 5 mg
- 10 mg
Recommended dosage:
- Adults: 10 mg at the start of attack
- If required, second dose after 2 hours
- Maximum: 20 mg in 24 hours
For Propranolol intake:
- Only 5 mg Rizatriptan (half dose!)
How to Take
Normal tablets:
- Suck with water
- At the start of headache, not at Aura
melting tablets:
- Put on the tongue
- Releases in seconds
- Swallow with saliva
- No water needed
Time:
- Taking first headaches
- Early intake is more effective
- Not during the aura phase
If first dose does not work: No second dose for the same attack. Try again at the next attack.
Contraindications
**Rizatriptan must not be taken at:* *
- coronary heart disease
- condition after heart attack, stroke, TIA
- Heavy or uncontrolled hypertension
- Peripheral arterial disease
- Heavy liver or kidney failure
- Hemiplegic or Basilaris marshes
- MAO inhibitor therapy (or < 2 weeks thereafter)
- Simultaneous ergotamine intake
Preview at:
- Propranolol therapy (half dose!)
- Cardiovascular risk factors
- Easier/medium liver / kidney failure
Possible Side Effects
Acid (1-10%):
- Squeeze
- Bemonia
- fatigue
- Asthenie (smooth)
- nausea
Triptane-specific sensations:
- Crawling, numbness
- Heat or cold feeling
- Pressure or constriction (breast, neck)
- Heavy in limbs
Occasionally:
- Heart palp
- Mouth dryness
- diarrhea
Selten:
- Allergic reactions
- Coronary seeds
- serotonin syndrome
Note to melt tablets: Can contain aspartame – Be careful with phenylketonuria.
Interactions
Important – Propranolol:
- Rizatriptan mirror rising to double
- Only 5 mg of rizatriptan with simultaneous propanolol intake!
Not combine with:
- ergotamine (24 hours distance)
- Other triptans on the same day
- MAO inhibitors
Preview at:
- SSRI/SNRI (Serotoninsyndrom risk)
- St. John's wort
- Lithium
Frequently Asked Questions
Similar Medications
Is rizatriptan right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.