Maxalt Rpd (Rizatriptan Benzoate)

• Rizatriptan acts on the trigeminal vascular system to relieve migraine symptoms.
• Migraine (with or without aura): provides rapid relief of headache pain and associated nausea, photophobia, and phonophobia.
• Acute migraine attack: reduces the intensity of throbbing head pain within two hours of administration.
• Migraine‑associated nausea: alleviates nausea and vomiting that accompany the headache.

• Rizatriptan selectively agonises serotonin 5‑HT1B and 5‑HT1D receptors located on cranial blood vessels and trigeminal nerve terminals. Activation of 5‑HT1B causes vasoconstriction of intracranial arteries, while 5‑HT1D stimulation inhibits release of pro‑inflammatory neuropeptides, thereby interrupting the pain signalling cascade responsible for migraine.

Rizatriptan may cause a range of adverse reactions, which are categorized by frequency.

Common Side Effects

• Chest tightness or pressure
• Tingling or numbness of fingers and toes
• Dizziness or light‑headedness
• Fatigue or drowsiness
• Dry mouth
• Nausea

Serious or Rare Side Effects

• Coronary vasospasm or myocardial infarction
• Serotonin syndrome, especially with other serotonergic agents
• Severe allergic reaction (anaphylaxis)
• Hypertension or hypertensive crisis
• Stroke or transient ischemic attack

Before prescribing Rizatriptan, clinicians should evaluate patient history and comorbid conditions.

• Cardiovascular disease: avoid use in patients with coronary artery disease, uncontrolled hypertension, or a history of myocardial infarction.
• Hemiplegic or basilar migraine: contraindicated due to increased risk of cerebrovascular events.
• Serotonergic agents: caution when combined with SSRIs, SNRIs, or MAO inhibitors because of serotonin syndrome risk.
• Hepatic or renal impairment: assess severity and adjust therapy if necessary.
• Pregnancy and lactation: safety not established; use only if potential benefit justifies potential risk.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and light.

Rizatriptan can interact with several drug classes, requiring careful review of concomitant medications.

Major Interactions (Avoid)

• MAO inhibitors: increase risk of serotonin syndrome.
• Other triptans or ergot derivatives: additive vasoconstrictive effects.
• SSRIs, SNRIs, or other serotonergic agents: heightened serotonin toxicity.

Moderate Interactions (Monitor Closely)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): may raise rizatriptan plasma levels.
• Antihypertensive agents: possible additive blood pressure effects.
• Oral contraceptives: may slightly increase migraine frequency; monitor response.