Rizatriptan

Sounds like 'rye-za-trip-tan'

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®

References

  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
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 14 Feb 2019