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.
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.