Does maxalt make you sleepy

Rizatriptan

Easy-to-read medicine information about rizatriptan – what it is, how to take rizatriptan safely and possible side effects.

Type of medicine Also called
  • Migraine treatment
  • Triptan
  • Rizamelt®

What is rizatriptan?

Rizatriptan is used to ease the symptoms of migraine headaches. It works by releasing a chemical called serotonin, which causes the blood vessels around your brain to contract (narrow). This reverses the dilating (widening) of blood vessels that are believed to be part of the headache process. Rizatriptan belongs to a group of medicines called triptans. Rizatriptan only works when a migraine attack has already begun. It will not prevent a migraine. Do not take it before your headache begins, or during the aura phase, as it may be less effective. Read more about migraine headaches.

In New Zealand rizatriptan is available as tablets (10 mg). The tablet dissolves when you place it on your tongue. It may be useful if you find drinking water difficult during a migraine or you cannot swallow tablets. It is not useful if you are vomiting.

Dose

  • Take 1 tablet (10 mg) at the start of the migraine attack. Rizatriptan should work within 30 minutes.
  • If your migraine improves but then comes back, wait at least 2 hours before taking another tablet (10 mg).
  • Do not take more than 3 tablets (30 mg) in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.
  • If the first rizatriptan tablet does not relieve your symptoms or help your migraine, do not take another rizatriptan tablet for the same attack. It is unlikely to work.

Monthly limit

Do not use rizatriptan for more than 10 days per month. Using rizatriptan too frequently can cause medication overuse headache or rebound headache. This headache is caused by overuse of painkillers to treat headache, including the use of triptans for migraine. The symptoms include a tension-type headache or migraine-like attack. Headaches often improve within 7 to 10 days after rizatriptan has been stopped. Symptoms may be worse before an improvement is seen. To avoid this, do not use rizatriptan for more than 10 days per month.

How to take rizatriptan

  • Take rizatriptan as soon as you notice headache symptoms, or after a migraine has already begun.
  • Rizatriptan usually starts to work within 30 minutes of taking the tablet.
  • Open the packet with dry hands. Place the rizatriptan tablet on your tongue and allow it to dissolve then swallow with saliva. You do not need to drink water to take your rizatriptan tablet. It is only absorbed after swallowing.
  • It does not matter if you take rizatriptan with or without food.

Precautions – before taking rizatriptan

If you answer ‘yes’ to any of the following questions, it’s important that you tell your doctor or pharmacist before taking rizatriptan.

  • Do you have problems with your liver or kidneys?
  • Do you have problems with high blood pressure (hypertension)?
  • Have you had a heart attack or do you get angina (chest pain)?
  • Have you had a stroke or do you get transient ischemic attacks?
  • Are you pregnant?
  • Are you breastfeeding?
  • Are you taking medication for depression?

Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

Like all medicines, rizatriptan can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Feeling sleepy,
  • Dizziness
  • Tiredness
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Do not drink alcohol.
  • Feeling sick or vomiting
  • This may be due to the migraine attack
  • Avoid eating, until this feeling passes
  • Tell your doctor if this is troublesome
  • Pain or tightness in your chest, jaw or throat, tingling or feeling of heaviness.
  • This is quite common when you first start taking rizatriptan. It will usually pass after a while
  • If the pain is intense or does not go away tell your doctor immediately or ring HealthLine 0800 611 116
  • Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heart beat, headache, diarrhoea and rigid or twitching muscles
  • You are at increased risk of serotonin syndrome if you recently started taking rizatriptan or have increased the dose, or are taking other medicines that can cause serotonin syndrome.
  • Tell your doctor immediately or ring HealthLine 0800 611 116

Interactions

Rizatriptan interacts with a few medications and herbal supplements, so check with your doctor or pharmacist before starting rizatriptan or before starting any new medicines. It may also interact with some cold and flu preparations containing dextromethorphan such as Benadryl®.

Learn more

The following links provide further information on rizatriptan.

Medsafe Consumer Information Sheet: Rizamelt®

  1. Treatment of acute migraine New Zealand Formulary
  2. Diagnosing and managing headache in adults in primary care BPAC, 2017
  3. The role of triptans in the treatment of migraine in adults BPAC, 2014

About rizatriptan

Type of medicine 5HT1-receptor agonist (also known as a ‘triptan’)
Used for Treatment of acute migraine attacks
Also called Maxalt®
Available as Tablets, and wafers which dissolve in the mouth

It is not clear what causes migraine. It is thought that some chemicals in the brain increase in activity, and as a result parts of the brain then send out confused signals which result in the symptoms of migraine. Why people with migraine should develop these chemical changes is also not clear. Many migraine attacks occur for no apparent reason, but for some people there may be things which trigger an attack, like certain foods or drinks.

Rizatriptan belongs to a class of medicines known as 5HT1-receptor agonists. They are also known simply as triptans. Triptans work by stimulating the receptors of a natural substance in the brain called serotonin (or 5HT). This eases the symptoms of migraine.

Rizatriptan is effective in relieving migraine attacks once the headache phase has started. It does not help prevent migraine headaches from developing.

Before taking rizatriptan

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rizatriptan it is important that your doctor or pharmacist knows:

  • If you are aged over 65 years or under 18 years.
  • If you are pregnant or breast-feeding.
  • If you have heart problems such as angina, or if you have had a heart attack.
  • If you have high blood pressure.
  • If you have circulation problems.
  • If you have any problems with the way your liver works or with the way your kidneys work.
  • If you have ever had a stroke or a transient ischaemic attack (this is also referred to as a TIA, or ‘mini-stroke’).
  • If you have ever had an allergic reaction to a medicine.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

How to take rizatriptan

  • Before you start this treatment, read the manufacturer’s printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about rizatriptan and a full list of the side-effects which you may experience from taking it.
  • Take rizatriptan exactly as your doctor tells you to. It is usual to take one tablet as soon as you start to feel a migraine headache develop.
  • If you are taking a Maxalt® tablet, swallow the tablet with a drink of water. If you are taking a Maxalt® Melt wafer, this has been made so that you can place it on your tongue and allow it to dissolve in your mouth. Maxalt® Melt wafers are particularly helpful if drinking water to take a tablet would make you feel sick.
  • If you have recently had a meal, rizatriptan may take a little longer before it starts to work than if you had not eaten. This is because the food in your stomach can delay the absorption of the medicine. Although rizatriptan is better taken when your stomach is empty, you can still take it if you have had a meal.
  • If your migraine at first improves but then comes back again, you may take another tablet/wafer, providing it is at least two hours after you took the first one. If your migraine is not eased after taking the first dose, a further dose is unlikely to work, so do not take a second tablet/wafer.
  • Do not take more than two 10 mg tablets in 24 hours.

Getting the most from your treatment

  • Rizatriptan is meant to be used to treat headache pain during a migraine attack, not to stop the pain from coming on. You should wait until the pain is just beginning to develop, rather than taking it at the aura stage or when you feel that a migraine may be developing. Taking it earlier in a migraine attack will not stop the headache from developing.
  • You should not take other migraine treatments such as other triptans or ergotamine at the same time as rizatriptan.
  • Some people may benefit from taking a non-steroidal anti-inflammatory painkiller (such as naproxen) in addition to rizatriptan. Your doctor will advise you about this if it is recommended for you.
  • If you find that rizatriptan does not relieve your migraine, make an appointment to discuss this with your doctor, as a different ‘triptan’ medicine may be more effective for you.
  • If you buy any ‘over-the-counter’ medicines, check with your pharmacist which medicines are safe for you to take.
  • It may help to keep a migraine diary. Note down when and where each migraine attack started, what you were doing, and what you had eaten that day. A pattern may emerge, and it may be possible to avoid one or more things that trigger your migraine attacks.
  • Rizatriptan is used to treat migraine attacks, but there are other medicines that are available that may help to prevent you from having migraines. If you have migraines frequently, discuss this with your doctor.
  • Some people who get frequent migraine attacks are in fact getting medication-induced headache. Medication-induced headache (also called medication-overuse headache) is caused by taking painkillers or triptans too often. If you use rizatriptan or painkillers on more than two days a week on a regular basis, you may be at risk of this. You should talk to your doctor if you suspect it.

Can rizatriptan cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with rizatriptan. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common rizatriptan side-effects (these affect less than 1 in 10 people) What can I do if I experience this?
Feeling tired, dizzy or sleepy If this happens, do not drive and do not use tools or machines
Feeling sick (nausea), indigestion, diarrhoea Stick to simple foods
Sore throat, tingling feelings, stiff or painful neck, feeling hot and flushed, dry mouth If troublesome, speak with your doctor
Some people feel tightness or pain in their throat or chest If the pain is intense, do not take any further tablets, and speak with your doctor about it

If you experience any other symptoms that you think may be due to the medicine, speak with your doctor or pharmacist for advice.

How to store rizatriptan

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine, ask your pharmacist.

Maxalt

What should I discuss with my healthcare provider before using rizatriptan (Maxalt, Maxalt-MLT)?

You should not use rizatriptan if you are allergic to it, or if you have:

  • severe or uncontrolled high blood pressure;
  • past or present heart problems;
  • a history of coronary artery disease, angina (chest pain), heart attack, or stroke, including “mini-stroke”;
  • a blood vessel disorder or circulation problems that cause a lack of blood supply within the body; or
  • a headache that seems different from your usual migraine headaches.

Do not use rizatriptan if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure rizatriptan is safe for you, tell your doctor if you have:

  • liver or kidney disease;
  • high blood pressure, a heart rhythm disorder;
  • a condition for which you take propranolol (Hemangeol, Inderal, InnoPran); or
  • coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having 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 disintegrating tablets may contain phenylalanine. Talk to your doctor before using this form of rizatriptan if you have phenylketonuria (PKU).

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether rizatriptan passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Rizatriptan is not approved for use by anyone younger than 6 years old.

How should I use rizatriptan (Maxalt, Maxalt-MLT)?

Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to quickly treat any serious side effects that occur.

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take rizatriptan as soon as you notice migraine symptoms.

Take the regular tablet whole with a full glass of water.

To take the orally disintegrating tablet (Maxalt-MLT):

  • Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet.
  • Use dry hands to remove the tablet and place it in your mouth.
  • Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

After taking a tablet (for adults): If your headache does not completely go away, or goes away and comes back, take a second tablet 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.

After taking a tablet (for children ages 6 to 17): If your headache does not completely go away, or goes away and comes back, contact your doctor before taking any more tablets.

Call your doctor if your headache does not go away at all after taking the first rizatriptan tablet.

Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse.

Contact your doctor if you have more than four headaches in one month (30 days). Do not take migraine headache medication for longer than 10 days per month. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks.

Rizatriptan can raise blood pressure to dangerous levels. Your blood pressure may need to be checked often while you are using this medicine. If you use rizatriptan long-term, your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).

Store at room temperature away from moisture and heat.

Consumer medicine information

Before you take MAXALT Wafers

When you must not take it

Do not take MAXALT Wafers if you have an allergy to MAXALT or any of the ingredients listed at the end of this leaflet.

Do not take MAXALT Wafers if you have or had:

  • high blood pressure that is not being treated
  • some heart diseases, including angina, or a previous heart attack
  • a stroke or transient ischaemic attack (TIA)
  • blood vessel problems, including ischaemic bowel disease

Do not take MAXALT Wafers if you are currently taking monoamine oxidase inhibitors (MAOIs) for depression, or have taken them within the last two weeks.

MAOIs include moclobemide, phenelzine, tranylcypromine and pargyline.

Do not take MAXALT Wafers if the packaging is torn or shows signs of tampering.

Do not take MAXALT Wafers if the expiry date on the pack has passed.

If you take this medicine after the expiry date has passed, it may not work.

If you are not sure whether you should start taking MAXALT Wafers, talk to your doctor.

Do not give MAXALT Wafers to children under 18 years of age.

The safety and effectiveness of MAXALT Wafers in children under 18 years have not been established.

Before you start to take it

Tell your doctor if:

  1. you are pregnant or intend to become pregnant
    Like most medicines, MAXALT Wafers are not recommended for use during pregnancy. If there is a need to consider MAXALT Wafers during pregnancy, your doctor will discuss with you the risks and benefits of taking them during pregnancy.
  2. you are breast-feeding or plan to breast-feed
    It is not known whether MAXALT Wafers pass into breast milk. Your doctor will discuss with you the risks and benefits of taking them while breast-feeding.
  3. you have any risks factors for heart or blood vessel disease, including:
  • high blood pressure
  • diabetes
  • smoking
  • a high cholesterol level
  • a family history of heart or blood vessel disease
  1. your headache is more severe than your ‘usual’ migraine, or it behaves differently
  2. you have a condition called phenylketonuria
    The 5mg wafer* contains 1.05mg phenylalanine (a component of aspartame) and the 10mg wafer contains 2.10mg phenylalanine.
  3. you have, or have had, any other medical conditions
  4. you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.

If you have not told your doctor about any of the above, tell them before you take any MAXALT Wafers.

Taking other medicines

Tell your doctor if you are taking any other medicines, herbal products, or dietary supplements, including those that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines should not be taken with MAXALT Wafers. These include:

  • monoamine oxidase inhibitors (MAOIs) used to treat depression, including moclobemide, tranylcypromine, phenelzine, pargyline
  • sumatriptan, another similar medicine used to treat migraine

Some medicines, herbal products, or dietary supplements, and MAXALT Wafers may interfere with each other. These include:

  • propranolol, a medicine used to treat high blood pressure
  • ergotamine, dihydroergotamine, other medicines used to treat migraine
  • methysergide, a medicine used to prevent migraine
  • St. John’s wort (Hypericum perforatum), a herbal product sold as a dietary supplement, or products containing St. John’s wort

These medicines, herbal products, or dietary supplements may be affected by MAXALT Wafers, or may affect how well it works. You may need different amounts of your medicine, you may need to take different medicines or you may need to be careful of the timing of some of these medicines.

Ask your doctor for instructions about taking MAXALT Wafers if you are also taking selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram oxalate, and fluoxetine or serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, and duloxetine for depression.

Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking MAXALT Wafers.

  • tell your doctor and pharmacist if you are allergic to rizatriptan, any other medications, or any of the ingredients in rizatriptan tablets or orally disintegrating tablets. Ask your pharmacist for a list of the ingredients.
  • do not take rizatriptan if you have taken any of the following medications in the past 24 hours: other selective serotonin receptor agonists such as almotriptan (Axert), eletriptan (Relpax), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), or zolmitriptan (Zomig); or ergot-type medications such as bromocriptine (Parlodel), cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), ergotamine (Cafergot, Ergomar), methylergonovine (Methergine), methysergide (Sansert), and pergolide (Permax).
  • do not take rizatriptan if you are taking a monoamine oxidase A (MAO-A) inhibitor such as isocarboxazid (Marplan), phenelzine (Parnate), or tranylcypromine (Nardil) or if you have taken one of these medications in the past 2 weeks.
  • 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: acetaminophen (Tylenol); antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); propranolol (Inderal); 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 desvenlafaxine (Pristiq), duloxetine (Cymbalta), sibutramine (Meridia), 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 have or have ever had heart disease; a heart attack; angina (chest pain); irregular heartbeats; stroke or ‘mini-stroke’; or circulation problems such as varicose veins, blood clots in the legs, Raynaud’s disease (problems with blood flow to the fingers, toes, ears, and nose), or ischemic bowel disease (bloody diarrhea and stomach pain caused by decreased blood flow to the intestines). Your doctor may tell you not to take rizatriptan.
  • tell your doctor if you smoke or are overweight; if you have or have ever had high blood pressure, diabetes, high cholesterol, or kidney or liver disease; if you have gone through menopause (change of life); or if any family members have or have ever had heart disease or stroke.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you plan to be sexually active while you are taking this medication, talk to your doctor about effective methods of birth control. If you become pregnant while taking rizatriptan, call your doctor.
  • you should know that rizatriptan may make you drowsy. Do not drive a car or operate machinery until you know how this medication will affect you.
  • talk to your doctor about your headache symptoms to make sure they are caused by migraine. Rizatriptan should not be used to treat hemiplegic or basilar migraine or headaches caused by other conditions (such as cluster headaches).
  • if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the orally disintegrating tablets contain aspartame that forms phenylalanine.

What is Maxalt used for?

  • Relieving migraine headaches.

Maxalt tablets and Maxalt melt tablets both contain the active ingredient rizatriptan, which is a type of medicine called a serotonin (or 5HT) agonist. This type of medicine is also commonly known as a ‘triptan’. It is a painkiller specifically used to relieve migraine attacks.

Although the cause of migraine attacks is not fully understood, it is thought that widening of blood vessels in the brain causes the throbbing pain of migraine headaches. Rizatriptan relieves this pain by causing the blood vessels in the brain to narrow.

Rizatriptan works by stimulating receptors called serotonin (or 5HT) receptors that are found in the brain. A natural substance called serotonin normally acts on these receptors, causing blood vessels in the brain to narrow. Rizatriptan mimics this action of serotonin by directly stimulating the serotonin receptors in the brain. This narrows the blood vessels and so relieves the pain of migraine headaches.

How do I take Maxalt?

  • Your dose of rizatriptan should be taken as soon as possible after your migraine headache has started, though it is also effective if taken at a later stage during the migraine attack. It should not be taken during the aura, or warning phase that can occur before a migraine headache, as the safety and effectiveness of the medicine have not been established during this period, and the medicine will not prevent the headache.
  • Maxalt melt tablets are designed to melt on the tongue in your saliva so they can be taken without needing a drink of water. They may be particularly useful for people who feel sick or vomit during their migraine attack and are unable to drink, as well as for people who can’t swallow conventional tablets.
  • This medicine should preferably be taken on an empty stomach, because the presence of food in the stomach can delay the effect of the medicine for approximately an hour.
  • 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 this has not been shown to be effective. (You can still take Maxalt for your next attack.)
  • If the first dose does initially relieve your migraine, but the headache then comes back, you can take a second dose. However, if you need a second dose because your migraine has returned, you should NOT take it within two hours of your first dose. Do not take more than two doses in 24 hours.
  • Do not exceed the recommended dose.

Important information about Maxalt

  • This medicine should not be used to prevent migraines.
  • This medicine should only be used by people with a clear diagnosis of migraine from their doctor.
  • Using any painkillers for headaches too often or for too long can actually make the headaches worse. If you find you need to use this medicine frequently you should consult your doctor for advice.
  • This medicine can cause feelings of warmth, heaviness, pressure, tightness, tingling or pain in certain parts of the body, including the chest or throat. Although sometimes very strong, these feelings usually only last a few minutes. If they continue or are particularly severe (especially chest pain), you should not take any more tablets and consult your doctor immediately.
  • This medicine may cause drowsiness. If affected do not drive or operate machinery.

Maxalt should be used with caution in

  • People with mild to moderately decreased kidney or liver function.
  • People with risk factors for coronary heart disease, such as smoking, high cholesterol levels, high blood pressure (hypertension), diabetes, obesity, or a family history of heart disease.
  • Men over 40 years of age.
  • Post-menopausal women.
  • People who suffer from phenylketonuria should be aware that Maxalt melt tablets contain aspartame, which is a source of phenylalanine.

Maxalt should not be used in

  • People with severely decreased kidney or liver function.
  • People who have had a heart attack.
  • People with heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or a severe form of angina that occurs even at rest (Prinzmetal’s angina).
  • People who have poor blood circulation in the legs or arms due to narrowing of blood vessels (peripheral vascular disease).
  • Uncontrolled or moderate to severe high blood pressure (hypertension).
  • People who have had a stroke or mini-stroke (transient ischaemic attack).
  • A form of migraine associated with temporary paralysis of one side of the body (hemiplegic migraine).
  • A type of migraine where there is a disturbance in brain function which initially presents with total blindness followed by dizziness, speach disturbances, ringing in the ears and double vision (basilar migraine).
  • Maxalt tablets contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (this doesn’t apply to Maxalt melt tablets).
  • This medicine is not recommended for children and adolescents aged under 18 years, or people aged over 65 years, as there is no information available regarding its safety and effectiveness in these age groups.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
  • This medicine may pass into breast milk. It is not recommended for use during breastfeeding unless considered essential by your doctor. If you are breastfeeding and your doctor recommends you to take this medicine, you should avoid breastfeeding for 24 hours after taking the medicine, and any milk expressed during this time should be discarded. Seek further medical advice from your doctor.

Possible side effects of Maxalt

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

  • Dizziness.
  • Sleepiness.
  • Feeling weak or fatigued.
  • Pins and needles, tingling or numb sensations.
  • Difficulty concentrating.
  • Neck pain.
  • Feeling of tightness or heaviness in the throat or chest (see important information above).
  • Flushing.
  • Chest pain (see important information above).
  • Awareness of your heartbeat (palpitations).
  • Headache.
  • Nausea and vomiting.
  • Dry mouth.
  • Diarrhoea.
  • Indigestion.
  • Difficulty sleeping (insomnia)

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Blurred vision.
  • Nervousness.
  • Feeling disorientated.
  • Increased heart rate.
  • Increase in blood pressure.
  • Feeling short of breath.
  • Sensation of spinning (vertigo).
  • Tremor.
  • Unpleasant taste.
  • Thirst.
  • Sweating.
  • Rash or itching.
  • Allergic reaction involving swelling of the face, tongue or throat (angioedema).

The side effects listed above may not include all of the side effects reported by the medicine’s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it’s necessary they’ll report it for you.

You can also report side effects yourself using the yellow card website: www.mhra.gov.uk/yellowcard.

Can I take Maxalt with other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

Do not take this medicine if you have taken ergotamine or its derivatives, eg dihydroergotamine or methysergide, in the previous 24 hours. These medicines should not be taken within six hours of taking rizatriptan.

If your first dose of rizatriptan does not work to relieve your migraine, it is fine to take a painkiller containing aspirin, paracetamol, or a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen. However, as noted above, you should not take ergotamine, dihydroergotamine or methysergide for at least six hours after taking rizatriptan.

This medicine must not be taken in combination with other 5HT agonists (triptans), eg sumatriptan, zolmitriptan, frovatriptan, naratriptan, eletriptan, almotriptan.

There may be an increased risk of a rare side effect called the serotonin syndrome if rizatriptan is taken by people taking other medicines that enhance the activity of serotonin in the central nervous system, such as the following. You should not take this medicine if you are taking any of these:

  • dapoxetine (don’t take rizatriptan if you’ve taken this in the last week)
  • duloxetine
  • linezolid
  • lithium
  • monoamine oxidase inhibitor antidepressants (MAOIs), eg phenelzine, tranylcypromine, isocarboxazid or moclobemide (don’t take rizatriptan if you’ve taken one of these in the last two weeks)
  • selective serotonin re-uptake inhibitor antidepressants (SSRIs), such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine or sertraline
  • selegiline (don’t take rizatriptan if you’ve taken this in the last two weeks)
  • the herbal remedy St John’s wort (Hypericum perforatum)
  • venlafaxine.

The beta-blocker propranolol may increase the level of rizatriptan in the blood, increasing the risk of its side effects. Your doctor should prescribe you a lower dose of rizatriptan if you are taking propranolol. In addition, a dose of rizatriptan should not be taken within two hours of taking propranolol.

Other medicines containing the same active ingredient

Rizatriptan tablets and melt tablets are also available without a brand name, ie as the generic medicine.

Further reading

For background information about our medicine factsheets, including the references used to produce them, .

Last updated 19.01.2016

SIDE EFFECTS: Flushing, feelings of tingling/numbness/prickling/heat, tiredness, weakness, drowsiness, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: blue fingers/toes/nails, cold hands/feet, hearing changes, mental/mood changes.Chest/jaw/neck tightness can commonly occur soon after using rizatriptan. Only rarely are these signs of a serious condition. However, you may not be able to tell it apart from a serious reaction due to a lack of blood flow to the heart, brain, or other parts of the body. Get medical help right away if you have any very serious side effects, including: chest pain, jaw/left arm pain, fainting, fast/irregular/pounding heartbeat, vision changes, weakness on one side of the body, confusion, slurred speech, sudden or severe stomach/abdominal pain, bloody diarrhea, change in the amount of urine.This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using rizatriptan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood circulation problems (for example, in your legs, arms/hands, or stomach), certain types of headaches (hemiplegic or basilar migraine), heart problems (such as chest pain, irregular heartbeat, previous heart attack), liver disease, seizure, stroke or “mini-stroke” (transient ischemic attack).Certain conditions can increase your risk for heart problems. Tell your doctor if you have any of these conditions, including: high blood pressure, high cholesterol, diabetes, family history of heart disease, overweight, smoker, postmenopausal (women), age more than 40 years (men).This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).The risk of heart disease, liver disease, and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

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