Rizatriptan

Triptan (5-HT1B/1D agonist), Antimigraine medicine, Analgesic

Rizatriptan (benzoate)

Maxalt (tablet), Maxalt-MLT (orally disintegrating tablet)

Experience

👥 No personal reports yet

⚕ No clinical reports yet

Log in to add your own experience.

Problems

No problems yet. Be the first to suggest one.

+ Add a problem

Titration strategies

No titration strategies yet. Be the first to suggest one.

+ Add a titration strategy

Effects

No effects listed yet. Be the first to suggest one.

+ Add an effect

Relevant anecdote

No anecdotes yet. Share a relevant one.

+ Add an anecdote

Relevant Literature

No literature entries yet.

Log in to submit relevant literature.

Summary

Classes

Triptan (5-HT1B/1D agonist), Antimigraine medicine, Analgesic

Common uses

Acute migraine with or without aura (FDA; adult and pediatric ages 6+)▲0▼

Pharmacy

Starting dose

5-10 mg PO at migraine onset; may repeat after 2 hours, maximum 30 mg/24 hours

Preparations

Tablets 5, 10 mg; ODT (Maxalt-MLT) 5, 10 mg

US FDA Max

30 mg/24 hours

Pharmacology

Routes

Oral

Onset

30 minutes for migraine relief

Duration

4-6 hours; headache recurrence is common

Half-life

2-3 hours

Bioavailability

~45% (oral; substantially higher than sumatriptan's ~14%)

Pregnancy

Limited human data; pregnancy registry data have been broadly reassuring across the triptan class.^{[citation needed]}

Legal status

Rx-only in US

Purported mechanism

Selective 5-HT1B and 5-HT1D receptor agonist (the triptan-class signature). Compared to sumatriptan, oral bioavailability is substantially higher (~45% vs ~14%) and onset is faster, with similar headache-recurrence rates. The 5-HT1B effect produces cranial vasoconstriction reversing the neurogenic vasodilation of migraine; the 5-HT1D effect inhibits CGRP release at trigeminal nerve terminals.▲0▼ Propranolol substantially raises rizatriptan exposure (~70% increase) via MAO-A inhibition of rizatriptan metabolism; the 5 mg dose is required when used with propranolol. Same triptan-class contraindications: coronary artery disease, vasospastic angina, uncontrolled hypertension, ischemic stroke history, hemiplegic or basilar migraine.