Meds and you

30 September 2013


Rizatriptan is an anti-migraine drug. Anti-migraine drugs are drugs that are used to prevent or reduce the severity of migraine headaches.


Rizatriptan is the active ingredient of Maxalt tablets (Nappi code: 848271-009, 848298-004, -012), Maxalt RPD wafers (Nappi code: 848301-005, -013).

General information
Rizatriptan is an anti-migraine drug. Anti-migraine drugs are drugs that are used to prevent or reduce the severity of migraine headaches.

In South Africa rizatriptan is registered for the treatment of acute migraine attacks.

Migraine headaches often cause a throbbing headache on one side of the head and may be accompanied by increased sensitivity to light and sound, nausea, vomiting and dizziness. In many people the actual migraine headache is often preceded by an aura - an unusual sensation which may include seeing patterns of flashing light or a tingling sensation.

Although a single dose can relieve a migraine headache at any stage during an attack, treatment with this drug should be started as soon as possible after the onset of a headache. Although some sources state that treatment should start at the onset of an aura, it should best be taken only at the onset of a migraine headache, since not all auras lead to headaches.

It should be noted that rizatriptan is not effective against any other kind of pain or headache, and should also not be taken to prevent migraine headaches.

How does rizatriptan work?
Although the cause of migraine attacks is not fully understood, it is thought to be caused by electrical and chemical imbalances in certain parts of the brain. These imbalances affect the blood vessels in the brain — first tightening them up, and then widening them. This widening of the blood vessels is thought to cause the throbbing pain of migraine headaches.

Rizatriptan works by stimulating chemical receptors in the brain. This relieves the pain of migraine headache by causing the blood vessels in the brain to narrow.

Fast facts

Drug schedule: schedule 4
Available as: rizatriptan is available as tablets and wafers.
What does it do? Rizatriptan relieves migraine headaches.
Overdose risk: medium
Dependence risk: low
Is rizatriptan available as a generic? no
Is rizatriptan available on prescription only? yes

User information

Onset of effect: within 30 minutes
Duration of action: up to 3 hours
Stopping this medicine: treatment with this medication can be safely stopped when no longer needed.
Prolonged use: rizatriptan is not intended for chronic use. If the first dose of this medicine doesn't relieve your migraine headache, then you should not take another dose for the same attack, as research studies have shown that this is not effective. If the first dose however proves to be effective, but the headache returns, you may take a second dose, but not within 2 hours of the initial dose.

Special precautions
Consult your doctor before using this drug if:

  • you have heart disease
  • you have kidney or liver disease
  • you have a history of a heart attack or stroke
  • you have high blood pressure
  • you are a post-menopausal female
  • you are a male over the age of 40
  • you are taking any other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children.
The elderly: this medication should best be avoided in the elderly.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Consult your doctor

Only if severe
In all cases
sensation of tightness, pressure in the body












increased blood pressure




chest tightness


chest pain


change in heart rhythm




breathing difficulties


skin rash




Drug interactions

ergotamine prolonged vasospastic reactions. Wait at least 6 hours after taking rizatriptan, before taking ergotamine, or 24 hours before taking rizatriptan after taking ergotamine
lithium risk of increased central nervous system side effects
monoamine oxidase inhibitor antidepressants increased risk of rizatriptan toxicity. Do not take rizatriptan within 14 days of a MAOI antidepressant
Beta-blockers (e.g. propranolol) increased level of rizatriptan in blood. A dosage adjustment is needed in those patients taking beta-blockers
isosorbide dinitrate risk of coronary vasoconstriction
isosorbide mononitrate risk of coronary vasoconstriction
glyceryl trinitrate risk of coronary vasoconstriction
other medicines that enhance the activity of serotonin (fluoxetine, citalopram, venlafaxine, St John’s wort, etc.) risk of serotonin syndrome or migraine exacerbation

Disease interactions
Consult your doctor before using this drug if you have heart disease, kidney or liver disease, you have a history of a heart attack or stroke, high blood pressure, you have epilepsy or a history of seizures or if you are a male over the age of 40.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage
Adults, oral: 5 - 10mg which may be repeated every 2 hours if the headache returns. Daily dose (24 hours) should not exceed 30mg.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.


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