Warnings
Rizatriptan (Maxalt) Risks, Warnings, and Complications
Rizatriptan can cause serious adverse effects and health problems in some people. Talk to your doctor or pharmacist about other options for acute treatment of migraine if you are at increased risk of complications from rizatriptan use.
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Precautions Before Starting Rizatriptan (Maxalt)
Do not use rizatriptan to treat occasional or mild headache pain that is not migraine. Make sure you have received a diagnosis of migraine before starting treatment with rizatriptan. Your doctor will evaluate your headache symptoms and ensure they are not some other type of headache, such as hemiplegic or basilar migraine, common tension headache, or cluster headache.
Tell your doctor if you are allergic to rizatriptan, any of the active or inactive ingredients in rizatriptan formulations, any other triptans, or any other medications. Your pharmacy can give you a list of ingredients.
If you have phenylketonuria (PKU), don’t take the orally disintegrating tablets of rizatriptan (Maxalt MLT) because they contain aspartame, which can form into phenylalanine in the body.
Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions.
Give your doctor a complete medical history. Rizatriptan may not be safe for people with certain medical conditions such as heart disease, heart attack, angina (chest pain), arrhythmias (irregular heartbeats), stroke, transient ischemic attack, or mini-stroke, circulation problems, peripheral vascular disease, blood clots in the legs, varicose veins, Raynaud's disease, and ischemic bowel disease (decreased blood flow to the intestines). Also, tell your doctor if you are overweight, postmenopausal, or have high blood pressure, high cholesterol, diabetes, liver or kidney disease, or a family history of heart disease or stroke.
Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding. If you are sexually active, discuss appropriate birth control with your provider before starting rizatriptan.
Precautions During Use of Rizatriptan (Maxalt)
Keep all your medical appointments while on rizatriptan. Your doctor may adjust your dose and will monitor you for side effects and medication overuse headaches.
Rizatriptan can cause drowsiness and dizziness. Do not drive or do anything that requires your full concentration until you know how this medicine affects you.
Tell your doctor if you become pregnant while on rizatriptan.
Rizatriptan (Maxalt) Drug Interactions
Certain other drugs can affect how rizatriptan works. Possible interactions between rizatriptan and other medicines can increase the risk of severe adverse effects. Your doctor may adjust the dose of your medicines, switch you over to another migraine headache medicine, or monitor you carefully for side effects if there are known interactions between rizatriptan and your other medications.
Do not take rizatriptan if you have taken any of these medications within the last 24 hours:
- Other migraine headache medicines (triptans or selective serotonin receptor agonists) such as eletriptan (Relpax), sumatriptan (Imitrex, in Treximet), almotriptan (Axert), naratriptan (Amerge), or zolmitriptan (Zomig)
- Ergot-type medications such as cabergoline, bromocriptine (Parlodel), dihydroergotamine (Migranal, D.H.E. 45), ergonovine (Ergotrate), ergoloid mesylates (Hydergine), ergotamine (Cafergot, Ergomar), methysergide (Sansert), methylergonovine (Methergine), and pergolide (Permax)
Do not take rizatriptan if you have taken monoamine oxidase inhibitors such as phenelzine (Nardil), isocarboxazid (Marplan), or tranylcypromine (Parnate) in the past 2 weeks.
The following medications can also have drug interactions with rizatriptan:
- Acetaminophen (Tylenol)
- Aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve)
- Tricyclic antidepressants such as amitriptyline (Elavil), nortriptyline (Aventyl, Pamelor), clomipramine (Anafranil), imipramine (Tofranil), amoxapine (Asendin), doxepin (Adapin, Sinequan), desipramine (Norpramin), protriptyline (Vivactil), and trimipramine (Surmontil)
- Selective serotonin reuptake inhibitors such as sertraline (Zoloft), fluoxetine (Prozac, Sarafem, in Symbyax), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and fluvoxamine
- Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), and sibutramine (Meridia)
- Beta-blockers such as propranolol (Inderal)
The above list does not describe all the adverse reactions that can occur if you take rizatriptan with certain other drugs. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC medications, dietary supplements, and herbal remedies. Also, tell your doctor or pharmacist if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.
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