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Generic Name: rizatriptan (ry zah TRIP tin)
Brand Names: Maxalt, Maxalt-MLT

What is rizatriptan?

Rizatriptan is a headache medicine. It is believed to work by narrowing the blood vessels around the brain. Rizatriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Rizatriptan is used to treat migraine headaches.

Rizatriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Rizatriptan may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about rizatriptan?

Before using rizatriptan, tell your doctor if you have coronary artery disease, or risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

Rizatriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

After taking a rizatriptan tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 30 mg of rizatriptan in 24 hours.

What should I discuss with my healthcare provider before using rizatriptan?

• a history of heart disease, angina (chest pain), blood circulation problems, or history of a heart attack or stroke;

• ischemic bowel disease;

• severe or uncontrolled high blood pressure; or

• a headache that is not like other headaches you have had.

• almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), or zolmitriptan (Zomig); or

• ergot medicine such as methysergide (Sansert), ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), methylergonovine (Methergine).

Before using rizatriptan, tell your doctor if you have:

• high blood pressure;

• liver disease;

• kidney disease;

• phenylketonuria (tablets may contain phenylalanine);

• coronary artery disease (or risk factors that include diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

If you have any of these conditions, you may not be able to use rizatriptan, or you may need a dosage adjustment or special tests during treatment.

Your name may need to be listed on a rizatriptan pregnancy registry when you start using this medication.

How should I use rizatriptan?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Take rizatriptan as soon as you notice headache symptoms, or after an attack has already begun.

Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to see if you have any serious side effects.

To take rizatriptan orally disintegrating tablets (Maxalt-MLT):

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

• Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet two (2) hours after the first. Do not take more than 30 mg of rizatriptan in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

Contact your doctor if you have more than four headaches in one month (30 days).

What happens if I miss a dose?

Since rizatriptan is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using rizatriptan.

After taking a rizatriptan tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 30 mg of rizatriptan in 24 hours.

What happens if I overdose?

Symptoms of a rizatriptan overdose may include severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure (convulsions), neck stiffness, tiredness, lack of coordination, feeling light-headed, or fainting.

What should I avoid while using rizatriptan?

Rizatriptan side effects

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, problems with vision, speech, or balance;

• fast heart rate, agitation, muscle stiffness, hallucinations, lack of coordination, with nausea, vomiting, or diarrhea;

• sudden and severe stomach pain and bloody diarrhea; or

• numbness or tingling and a pale or blue-colored appearance in your fingers or toes.

Continue using rizatriptan and talk with your doctor if you have any of these less serious side effects:

• dry mouth, upset stomach;

• mild headache (not a migraine);

• feeling too warm or too cold;

• tremors, confusion;

• warmth or redness under your skin;

• pressure or heavy feeling in any part of your body;

• feeling of pain or pressure in your neck and throat; or

• weakness, dizziness, sleepiness.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect rizatriptan?

Before using rizatriptan, tell your doctor if you are using any of the following drugs:

• propranolol (Inderal, InnoPran);

• an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor); or

• another migraine medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), or zolmitriptan (Zomig).

If you are using any of these drugs, you may not be able to use rizatriptan, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect rizatriptan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has more information about rizatriptan written for health professionals that you may read.

What does my medication look like?

Rizatriptan is available with a prescription under the brand name Maxalt. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Maxalt 5 mg-pale pink, capsule-shaped tablets

• Maxalt 10 mg-pale pink, capsule-shaped tablets

• Maxalt-MLT Orally Disintegrating Tablets 5 mg-white, round tablets

• Maxalt-MLT Orally Disintegrating Tablets 10 mg-white, round tablets

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.