Rizatriptan is used to treat migraines. It helps to relieve headaches, pain and other symptoms of migraines, including sensitivity to light/sound, nausea, and vomiting. Prompt treatment allows you to get back to your normal routine and may decrease your need for other pain medications. Rizatriptan does not prevent future migraines or reduce how often you may get a headache.

Rizatriptan belongs to a group of drugs called triptans. It affects a certain natural chemical (serotonin) that constricts blood vessels in the brain. It may also block other pain pathways in the brain.

Read the Patient Information Leaflet available from your pharmacist before you start using rizatriptan and each time you get a refill. Ask your doctor or pharmacist if you have any questions.

Take this medication by mouth at the first sign of a migraine, or as directed by your doctor. It may be taken with or without food, although faster relief may occur when it is taken on an empty stomach. Do not take rizatriptan to prevent a migraine. If there is no improvement in your symptoms, do not take any more doses of this medication before talking to your doctor.

If your symptoms are only partly relieved, or if your headache comes back, you may take a second dose after 2 hours or as directed by your doctor. Do not take more than 30 milligrams (3 doses) in a 24-hour period. If you also take propranolol, do not take more than 15 milligrams of rizatriptan in a 24-hour period. For the Canadian product: according to the drug manufacturer, do not exceed 20 milligrams in a 24 hour period.

If you have never taken this medication before and you have risk factors for heart disease (see Precautions), you may be advised to take your first dose in your doctor's office in order to monitor for rare but serious heart problems (e.g., heart attack).

Your dosage is based on your medical condition and response to therapy. Tell your doctor if your condition does not improve or if it worsens.

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What is Maxalt (Rizatriptan)?

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

Maxalt is used to treat migraine headaches.

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

Maxalt may also be used for other purposes not listed in this medication guide.

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

Maxalt can cause serious side effects on the heart, including heart attack or stroke. Although these side effects are rare, do not use this medication if you have a history of heart disease, angina (chest pain), blood circulation problems, ischemic bowel disease, severe or uncontrolled high blood pressure, or history of a heart attack or stroke.

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).

Do not use rizatriptan if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or phenelzine (Nardil) in the past 14 days. Do not use rizatriptan within 24 hours after taking almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), 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 taking rizatriptan, tell your doctor if you are also taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Maxalt 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?

Do not use this medication if you are allergic to rizatriptan, or if you have:

• 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.

Do not use rizatriptan if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or phenelzine (Nardil) in the past 14 days. Do not use rizatriptan within 24 hours after taking any of the following medicines:

• 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 need a dose adjustment or special tests to safely take rizatriptan.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

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

It is not known whether rizatriptan passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. This medicine should not be given to anyone younger than 18 years old.

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.

Take one rizatriptan tablet whole with a full glass of water.

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).

Store rizatriptan at room temperature away from moisture and heat.

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?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms 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?

Maxalt can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Maxalt side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using rizatriptan and call your doctor at once if you have any of these serious 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.

Less serious side effects may include:

• dry mouth, upset stomach;
• mild headache (not a migraine);
• feeling too warm or too cold;
• tremors, confusion;
• warmth, redness, or tingling under your skin;
• feeling of pain or pressure in your neck and throat; or
• weakness, dizziness, sleepiness.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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).

This list is not complete and there may be other drugs that can interact with 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.