Rizatriptan
Indications
Rizatriptan is used to treat a migraine attack once it has started, with or without aura (warning signs such as flashing lights before the headache). It relieves the headache and related symptoms such as nausea and sensitivity to light and sound. It does not prevent migraines and is not used for other types of headache.
How It Works
During a migraine, blood vessels around the brain widen and nerves release substances that cause pain and swelling. Rizatriptan is a triptan: it acts on serotonin (5-HT1B and 5-HT1D) receptors, which narrows these blood vessels and blocks the release of pain-causing substances, easing the attack.
Dosage and Administration
The usual adult dose is 10 mg taken as soon as the migraine headache begins. If the headache comes back, a second dose may be taken at least 2 hours after the first. Do not take more than 20 mg in 24 hours unless your doctor tells you otherwise. People taking Propranolol usually take 5 mg. Swallow the tablet with water; orally dissolving tablets are placed on the tongue and allowed to melt. If the first dose does not help at all, do not take a second dose for the same attack; talk to your doctor.
Interactions
Do not take rizatriptan within 24 hours of another triptan or ergot medicines such as Ergotamine. Do not use it with, or within 2 weeks of stopping, MAO inhibitor antidepressants. Propranolol raises rizatriptan levels, so a lower dose is used. Taking it with SSRI or SNRI antidepressants (for example Fluoxetine, Sertraline, Venlafaxine) can rarely cause serotonin syndrome.
Contraindications
Do not use rizatriptan if you have heart disease such as angina or a past heart attack, a past stroke or mini-stroke, uncontrolled high blood pressure, poor blood flow in the legs or gut, hemiplegic or basilar migraine, severe liver or kidney disease, or an allergy to rizatriptan.
Side Effects
Common side effects include dizziness, sleepiness, tiredness, dry mouth, nausea, and feelings of tingling, warmth, heaviness or tightness in the chest, throat, neck or jaw. These are usually mild and short-lived.
Get urgent medical help if you have chest pain or pressure that does not go away, a fast or irregular heartbeat, sudden weakness or numbness on one side, trouble speaking, severe stomach pain, signs of serotonin syndrome (agitation, fever, sweating, shaking, fast heartbeat), or signs of a serious allergic reaction.
Pregnancy and Lactation
There is limited information on use in pregnancy, so it should be used only if your doctor feels it is needed. Small amounts may pass into breast milk; avoiding breastfeeding for 24 hours after a dose reduces exposure. Ask your doctor for advice.
Precautions and Warnings
Make sure your headache is a migraine before treating it. If you have risk factors for heart disease (smoking, diabetes, high cholesterol, strong family history), your doctor may check your heart first. Using migraine medicines on 10 or more days a month can cause medication-overuse headache. Rizatriptan may make you drowsy or dizzy, so do not drive until you know how it affects you. Some orally dissolving tablets contain phenylalanine, which matters for people with phenylketonuria.
Overdose
Too much rizatriptan can cause dizziness, fainting, high blood pressure, slow heartbeat and chest symptoms. Seek medical help straight away if an overdose is suspected.
Therapeutic Class
Antimigraine agent, selective serotonin (5-HT1) receptor agonist (triptan).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep orally dissolving tablets in their blister until use.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Rizatriptan