Rizatriptan (patient information)

# Why is this medication prescribed
Rizatriptan is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound and light). Rizatriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels in the brain, stopping pain signals from being sent to the brain, and stopping the release of certain natural substances that cause pain, nausea, and other symptoms of migraine. Rizatriptan does not prevent migraine attacks.

# How should this medicine be used
Rizatriptan comes as a tablet and an orally disintegrating tablet to take by mouth. It should be taken at the first sign of a migraine headache. If you are at risk for heart disease and you have never taken rizatriptan before, you may need to take the first dose in your doctor's office. Usually only one dose is needed. If pain is not relieved with the first dose, your doctor may prescribe a second dose to be taken 2 hours after the first dose. Do not take more than 30 mg of rizatriptan in any 24-hour period. If you are also taking propranolol (Inderal), you should not take more than 15 mg of rizatriptan in any 24-hour period. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rizatriptan exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.
The orally disintegrating tablet should not be removed from the package until just before it is taken. The packet should be opened with dry hands, and the orally disintegrating tablet should be placed on the tongue, where it will dissolve and be swallowed with saliva.

# Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before taking rizatriptan:
- tell your doctor and pharmacist if you are allergic to rizatriptan, naratriptan (Amerge), sumatriptan (Imitrex), zolmitriptan (Zomig), or any other drugs.
- do not take rizatriptan if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam, Eldepryl), and tranylcypromine (Parnate) during the last two weeks or if you have taken another medication for migraine headaches such as dihydroergotamine (D.H.E. 45, Migranal), methysergide (Sansert), almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), sumatriptan (Imitrex), or zolmitriptan (Zomig) during the past 24 hours.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, or herbal products you are taking or plan to take. Be sure to mention any of the following: selective serotonin reuptake inhibitors such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft); and selective serotonin/norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects..
- tell your doctor if you smoke, if you have a strong family history of heart disease, if you are postmenopausal, or if you are a man over 40. Also tell your doctor if you have or have ever had high blood pressure; phenylketonuria; angina (recurring chest pain); a heart attack; diabetes; high cholesterol; obesity; stroke; transient ischemic attack (mini-stroke); ischemic bowel disease; coronary artery disease; seizures; or blood vessel, kidney, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking rizatriptan, call your doctor.
- you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how rizatriptan will affect you.
- remember that alcohol can add to the drowsiness caused by this drug. Do not drink alcohol while taking this medication.
- tell your doctor if you use or have ever used tobacco products. A history of tobacco use or cigarette smoking while taking rizatriptan may increase the risk associated with taking rizatriptan.
- plan to avoid unnecessary or prolonged exposure to sunlight and sun lamps and to wear protective clothing, sunglasses, and sunscreen. Rizatriptan may make your skin sensitive to sunlight.

# What should I do if I forget a dose
Rizatriptan is not for routine use. Use it only to relieve a migraine headache as soon as symptoms appear.

# Side effects

## Mild side effects
Rizatriptan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- drowsiness
- dizziness
- fatigue
- tingling or numb feeling
- upset stomach
- stomach pain
- vomiting
- diarrhea
- muscle pain or cramps
- tremors
- chills
- flushing (feeling of warmth)
- dry mouth

## Severe side effects
If you experience any of the following symptoms, call your doctor immediately:
- chest pain, tightness, or heaviness
- fast or irregular heartbeats
- throat pain or tightness
- difficulty breathing
- redness, swelling, or itching of the eyelids, face, or lips
- rash
- changes in vision

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Do not remove tablets from the blister pack until just before use. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# What other information should I know
Keep all appointments with your doctor and the laboratory.
Read the patient information that comes with your prescription before you begin to take rizatriptan, and read it again every time you have your prescription filled in case the patient information changes.
Call your doctor if you continue to have migraine headache symptoms after the first dose.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Maxalt
- Maxalt-MLT