Generic Name: Rizatriptan Brand Name(s): Generics only. No brands available.

Uses

What is Rizatriptan used for?

Rizatriptan is used to treat migraines. It helps to relieve headache, pain, and other migraine symptoms (including nausea, vomiting, sensitivity to light/sound). Prompt treatment helps you return to your normal routine and may decrease your need for other pain medications. Rizatriptan belongs to a class of drugs known as triptans. It affects a certain natural substance (serotonin) that causes narrowing of blood vessels in the brain. It may also relieve pain by affecting certain nerves in the brain.

Rizatriptan does not prevent future migraines or lessen how often you get migraine attacks.

How should I take Rizatriptan?

Take this medication by mouth as directed by your doctor, at the first sign of a migraine. It may be taken with or without food, but may work faster when it is taken on an empty stomach. The dosage is based on your medical condition, age, response to treatment, and other drugs you may be taking. For children, the dosage is also based on weight. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If there is no improvement in your symptoms, do not take more doses of this medication before talking to your doctor. If your symptoms are only partly relieved, or if your headache comes back, adults may take another dose at least 2 hours after the first dose. Children should not take more than one dose, or 5 milligrams in a 24-hour period. For adults, the US manufacturer recommends a maximum dose of 30 milligrams in a 24-hour period. The Canadian manufacturer recommends a maximum dose of 20 milligrams (for adults) in a 24-hour period.

If you have a higher risk for heart problems, your doctor may perform a heart exam before you start taking rizatriptan. He/she may also direct you to take your first dose of this medication in the office/clinic to monitor for serious side effects (such as chest pain). Talk to your doctor for details.

If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Tell your doctor if you need to use this medication more often, or if the medication is not working as well, or if your headaches get worse.

How do I store Rizatriptan?

Rizatriptan is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Rizatriptan in the bathroom or the freezer. There may be different brands of Rizatriptan that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Rizatriptan down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Rizatriptan?

Before using rizatriptan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood circulation problems (for example, in your legs, arms/hands, or stomach), certain types of headaches (hemiplegic or basilar migraine), heart problems (such as chest pain, irregular heartbeat, previous heart attack), liver disease, seizure, stroke or “mini-stroke” (transient ischemic attack).

Certain conditions can increase your risk for heart problems. Tell your doctor if you have any of these conditions, including: high blood pressure, high cholesterol, diabetes, family history of heart disease, overweight, smoker, postmenopausal (women), age more than 40 years (men).

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

The risk of heart disease, liver disease, and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Rizatriptan during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Rizatriptan. Rizatriptan is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Rizatriptan?

Flushing, feelings of tingling/numbness/prickling/heat, tiredness, weakness, drowsiness, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: blue fingers/toes/nails, cold hands/feet, hearing changes, mental/mood changes.

Rizatriptan can commonly cause chest/jaw/neck tightness, pain, or pressure that is usually not serious. However, these side effects are like symptoms of a heart attack, which may include chest/jaw/left arm pain, shortness of breath, or unusual sweating. Get medical help right away if these or other seriousfast/irregular heartbeat, fainting, severe stomach/abdominal pain, bloody diarrhea, signs of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes, confusion).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Rizatriptan?

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

If you also take any ergotamine medication (such as dihydroergotamine) or other “triptan” drugs (such as sumatriptan, zolmitriptan), you will need to separate your rizatriptan dose at least 24 hours apart from your dose of these other medications to lessen the chance of serious side effects.

Rizatriptan may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Rizatriptan?

Rizatriptan may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Rizatriptan?

Rizatriptan may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Rizatriptan.

What is the dose of Rizatriptan for an adult?

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.

Liver Dose Adjustments

Use with caution; dose adjustment may be considered in patients with severe hepatic impairment, however, no specific guidelines have been suggested.

Dose Adjustments

CONCOMITANT USE WITH PROPRANOLOL:

Adults:

-Initial dose: 5 mg orally once

-Maximum dose: 3 doses (15 mg) in any 24-hour period

Pediatrics:

-Weight less than 40 kg: Use is not recommended

-Weight 40 kg or greater: Maximum dose: 5 mg in any 24-hour period

ELDERLY: Dose selection should be cautious, generally starting at the low end of the dosing range.

Other Comments

Administration advice:

Oral tablets:

-Take orally with or without food

Orally Disintegrating Tablets (ODT):

-Remove ODT from foil pouch at time of use

-Peel open blister pack with dry hands and place ODT on tongue; do not push tablet through the blister

-ODT will dissolve on tongue and can be swallowed with saliva, no additional liquid is needed.

General:

-This drug should be used only where a clear diagnosis of migraine has been established; if a patient does not respond, the diagnosis of migraine should be reconsidered before treating subsequent attacks.

-This drug is not intended to treat cluster headaches, hemiplegic, or basilar migraines or for the prophylactic treatment of migraines.

-For patients with coronary artery disease (CAD) risk factors, a cardiovascular evaluation should be performed prior to initiating therapy; for patients who have satisfactorily completed a cardiovascular evaluation, consider administering first dose in a medically supervised setting and performing an ECG immediately following administration.

-Medication overuse headaches may present as migraine-like headaches or as a marked increase in migraine frequency; for patients using acute migraine medications (e.g. ergotamine, triptans, opioids) for 10 or more days per month consider withdrawal of the overused drugs and treatment of withdrawal symptoms.

Monitoring:

-ECG monitoring should be considered in the interval following the first dose in patients with risk factors for coronary artery disease (CAD) who have satisfactorily completed a cardiovascular evaluation, consider periodic cardiovascular evaluation in intermittent long-term users with cardiovascular risk factors.

-Monitor blood pressure.

-Monitor for serotonin syndrome if concomitant use of selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs) are necessary, particularly when starting therapy or with a new or increased dose of a serotonergic medication.

Patient advice:

-Phenylketonurics should be aware that the orally disintegrating tablets contain phenylalanine.

-Patients should be advised to talk with their doctor or pharmacist before taking any new medications or supplements.

-Patients should be aware of the risk of serious cardiovascular side effects and the importance of seeking medical advice promptly if they occur.

-Patients experiencing no relief from a first dose of this medication should be instructed not to take a second dose without first talking to their healthcare provider.

-Patients should be informed of the possibility of developing medication overuse headaches.

-This drug may impair judgment, thinking, or motor skills; have patient avoid driving or operating machinery until adverse effects are determined.

-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.

What is the dose of Rizatriptan for a child?

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.

Precautions

Safety and efficacy have not been established in patients younger than 6 years.

How is Rizatriptan available?

Rizatriptan is available in the following dosage forms and strengths:

  • Oral tablet,
  • Oral tablet, disintegrating.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Rizatriptan, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: April 26, 2018 | Last Modified: April 26, 2018

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