Rizatriptan

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Molecule Description

Rizatriptan is primarily used to treat migraine headaches of recent origin. It belongs to a class of medicines known as ‘Triptans’ or ‘Selective Serotonin Receptor Agonists’ and is available in the form of hard tablets, soft tablets (to be placed under the tongue) or dispersible tablets (to be dissolved in water).

Uses

Short-term relief in patients with migraine (severe headache) attacks, with or without aura (seeing dazzling or flashing lights).

Contraindications

When should one not use Rizatriptan

Allergy to Rizatriptan or any of the ingredients of the medicine
Uncontrolled blood pressure, history of chest pain or heart attacks
Severe liver or kidney problems
Blocked arteries (leading to pain in the legs or heart disease)
Brain stroke (rupture of blood vessels in the brain)
Specific class of antidepressants called Monoamine Oxidase (MAO) inhibitors (Moclobemide, Phenelzine, Tranylcypromine, Paragyline), etc.
Patients using these medicines or an antibiotic called Linezolid can take Rizatriptan only after 14 days after they stopped taking the treatment
Taking other medicines to treat migraine such as ‘Ergot Alkaloids’ or other ‘Triptans’

Side effects

Common side effects of this drug are:

Common & Serious:
Decreased sensitivity of skin, tingling, reduced alertness, sleep problems
Irregular or pounding heartbeats
Redness of skin (flushing), throat problems, feeling sick (nausea), vomiting, loose motions, dry mouth, indigestion, stomach or chest pain, heaviness in the body, neck pain and stiffness
Taste disturbances, unable to walk steadily, head spinning, tremors, fainting, blurry vision, confusion, feeling nervous, sweating, high blood pressure, abnormal ECG, tightness in the body, pain in the face and muscles, weakness (uncommon)
Severe allergic reaction causing swelling of the face, lips and throat, swallowing and breathing difficulties, with or without itching, rashes, skin peeling and blisters (serious but rare)

Precautions and Warnings

Pregnancy

No evidence is available to confirm that Rizatriptan is harmful when taken during pregnancy — recommended to be used only if other alternatives are not available.

Breast Feeding

Rizatriptan is secreted in breast milk. It is advisable not to take this medicine if you are breastfeeding. If other alternatives are unavailable, take care that there is at least a 24-hour gap between taking the tablet and giving breast milk.

Driving

Rizatriptan can make you sleepy or dizzy. Driving should be attempted only in the absence of such symptoms.

Alcohol

Rizatriptan and alcohol cause similar side effects such as feeling sick (nausea), dizziness, headache, dry mouth, etc. and when taken together, these side effects can become severe. Hence, it is advised to avoid alcohol.

Other General Warnings

Talk to your doctor if

High blood pressure, diabetes, smoking, kidney or liver problems, heart rhythm problems
Headache with light-headedness, walking, coordination and balance problems
A certain class of anti-depressants called Selective Serotonin Reuptake Inhibitors (SSRIs) (Sertraline, Escitalopram, Venlafaxine, Duloxetine)
Chest tightness and pain

Mode of Action

How Does It Work?

Rizatriptan works by increasing the levels of a useful chemical called ‘serotonin’ whose levels are low in migraine. Low levels of this substance which also transmit signals in the brain (neurotransmitter) are thought to be the main reason behind severe pain in migraine attacks. By regulating its levels, this medicine provides relief from pain.

Interactions

Interactions with other medicines

Avoid specific class of antidepressants called Monoamine Oxidase (MAO) inhibitors (Moclobemide, Phenelzine, Tranylcypromine, Paragyline), etc.
Linezolid (antibiotic)
Other medicines to treat migraine (other Triptans, Ergot derivatives, Methysergide)
You should wait for 14 days in case of MAO inhibitors and Linezolid and 24 hours in case of Ergot derivatives before taking Rizatriptan
Use with caution:
Propanolol (used to treat chest pain or high blood pressure)
A specific class of antidepressants called Selective Serotonin Reuptake Inhibitors (SSRIs) (Sertraline, Escitalopram, Venlafaxine, Duloxetine)
Inform the doctor about all the products you use (including prescription, non-prescription, and herbal medicines, vitamins or diet supplements)

Interactions with food items

Rizatriptan will act slowly if it is taken with food.

Dosage

Overdose

Take medication exactly as prescribed. If you are taking higher doses than prescribed, it will lead to severe headaches. Seek medical attention if you experience symptoms of overdose such as feeling dizzy, drowsiness, fainting, vomiting, etc.

Missed a Dose

If you missed any dose, take it as early as you remember
If it is time for the next dose, skip the missed dose and continue your regular dosing schedule
Do not take a higher or a double dose of medicine to compensate for the missed dose
A minimum gap of 2 hours is required between two dosages and do not take more than two doses in 24 hours

Frequently Asked Questions (FAQs)

Migraines, in general, are headaches on either side of the head, which may change sides during different attacks. But when they come, the pain is only one side of the head. This headache may be associated with or without an ‘aura.’ Aura is nothing but feeling a sensation of dazzling or flashing lightsMigraine with ‘aura’ is also known as classical migraine. More than 10% of population worldwide suffer from migraine attacks and it is one of the most common neurological disordersThe patterns of headache and triggering factors for migraine differ from patient to patient and cannot be pinpointed. Migraines of different origins and patterns respond to varying types of treatmentThe most common reason for migraine is thought to be a highly sensitive brain which reacts to the slightest excitation or irritation, which results in the release of chemicals that irritate the nerves and cause pain. In the process, the levels of a vital substance that transmits signals in the brain (neurotransmitter) called Serotonin decreases, resulting in a longer duration of action of the harmful chemicals‘Triptans’ or Rizatriptan acts by increasing the levels of Serotonin which regulates the levels of other substances in the brain and normalizes the activity in the brain, thus relieving the painThere are a total of 7 ‘Triptans’ that are in use to treat migraine headaches – Sumatriptan, Zolmitriptan, Naratriptan, Rizatriptan, Almotriptan, Eletriptan and FrovatriptanMigraine has no cure but if the triggering factors can be assessed, keeping away from the factors that cause these headaches can keep migraine away

Rizatriptan gives faster relief compared to some other medicinesYou can experience significant pain relief within 2 hours of taking this medicineOverall quality of life is said to be much better with Rizatriptan, and is commonly used by people who go to workThis medicine does not produce the same effect in all patients but is of particular benefit in some kinds of migraines (which are Serotonin dependent)Rizatriptan is well tolerated in children alsoThe maximum dose of Rizatriptan should not exceed 30 mg in 24 hours, and there should be a gap of 2 hours between two dosagesRizatriptan has to be taken with a valid prescription under the supervision of a physician