Rizatriptan

What is Rizatriptan?

• Rizatriptan is taken once the migraine (or its aura) has started
• It can be used if paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen have not worked
• Rizatriptan usually works within 30 to 60 minutes
• Rizatriptan is part of the triptan family of medications
• Rizatriptan is also known by its brand name Maxalt
• Rizatriptan does not work on tension headaches
• It is important to read the patient leaflet for a full list of side effects and cautions.

How Does Rizatriptan Work?

Rizatriptan is a serotonin (5-HT1) agonist. It works on the receptors at blood vessels and nerve endings within the brain.

Rizatriptan is thought to work in three ways to reduce the pain of a migraine headache once it has started.

1. Blood vessel dilation (widening) is responsible for some of the pain of a migraine headache. Rizatriptan causes constriction (narrowing) of the vessels within the head to reduce the pain of a migraine.
2. Rizatriptan prevents the release of neuropeptides that would cause vessels to dilate. This also reduces the pain associated with blood vessel dilation.
3. The medication reduces the transmission of pain signals along the nerves within the brain, reducing your perception of the pain of the migraine.

How is Rizatriptan Taken?

Rizatriptan Tablets

Rizatriptan tablets should be swallowed whole with some water.

It is best to take rizatriptan on an empty stomach where possible. Taking it with, or shortly after food, can delay how quickly rizatriptan starts working.

What is the proper dosage of Rizatriptan?

Rizatriptan 10mg

The usual dose of rizatriptan is 10mg.

If the tablet works but the headache then starts to come back, a second dose of rizatriptan can be taken two hours after the first. No further doses should be taken in a 24 hour period.

If the first tablet does not reduce the pain of the migraine, a second tablet should not be taken. Even if the tablet doesn’t work for one migraine, rizatriptan may still work for subsequent migraines that occur in future.

If you have kidney disease, liver disease, or take propranolol, you may be prescribed the lower dose of 5mg rizatriptan.

Are there any side effects to Rizatriptan?

Like all medications, rizatriptan can have some side effects. The most common side effects include:

• Insomnia (difficulty sleeping)
• Dizziness
• Sleepiness in the daytime
• Headache
• Tingling or altered sensation in the skin
• Difficulty concentrating
• Palpitations (feeling your heart racing)
• Throat discomfort
• Nausea or vomiting (feeling sick or being sick)
• Dry mouth
• Diarrhoea
• Flushing
• Neck pain or stiffness
• Muscular aches and pains.

These side effects are likely to settle down, but if they persist or become troublesome you should speak to your doctor for further advice.

Serious allergic reactions happen very rarely. If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip swelling or tongue swelling, call 999 immediately.

Are there any warnings for Rizatriptan?

Rizatriptan may not be suitable for everyone. You should tell your prescriber if you:

• Are aged over 65
• Have liver disease
• Have kidney disease
• Have had a previous stroke or mini stroke (CVA or TIA)
• Have ischaemic heart disease including angina or a previous heart attack
• Have coronary artery disease
• Have Prinzmetal’s angina
• Have peripheral vascular disease
• Are pregnant, trying to conceive, or breastfeeding – your doctor may prescribe a different medication in these circumstances.

Your prescriber can then advise whether rizatriptan is a suitable medication for you.

Some medications can interact with rizatriptan. You may be advised that rizatriptan will not suit you if you already take:

• Another medication for migraine
• Certain antidepressant medications
• Medications for high blood pressure including beta blockers – if you take propranolol for migraine prevention you may be prescribed the lower 5mg dose of rizatriptan
• St John’s Wort (hypericum perforatum).