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DRUG IMAGES
RIZATRIPTAN 5 MG TABLET
RIZATRIPTAN 10 MG TABLET
RIZATRIPTAN 5 MG ODT
The following indications for RIZATRIPTAN (rizatriptan benzoate) have been approved by the FDA:
Indications:
Migraine
Professional Synonyms:
None.
Indications:
Migraine
Professional Synonyms:
None.
The following dosing information is available for RIZATRIPTAN (rizatriptan benzoate):
Dosage of rizatriptan benzoate is expressed in terms of rizatriptan.
For the acute treatment of migraine attacks with or without aura in adults, the recommended initial oral dose of rizatriptan is a single dose of 5 or 10 mg. Single oral doses of 5 or 10 mg (conventional tablets or orally disintegrating tablets) were effective in clinical studies, although the 10-mg dose may provide a greater effect than the 5-mg dose. However, the 10-mg dose also may be associated with an increased risk of adverse effects.
Although efficacy of a second dose or subsequent doses has not been established in placebo-controlled trials, if the migraine headache recurs, a second dose of rizatriptan may be administered 2 hours after the first dose. The maximum dosage administered in any 24-hour period should not exceed 30 mg. The safety of treating an average of more than 4 headaches per 30-day period has not been established.
For the acute treatment of migraine attacks with or without aura in pediatric patients 6-17 years of age, the recommended dose of rizatriptan is a single dose of 5 mg in patients weighing less than 40 kg or 10 mg in those weighing 40 kg or more. Efficacy and safety of more than one dose within any 24-hour period have not been established in pediatric patients.
For the acute treatment of migraine attacks with or without aura in adults, the recommended initial oral dose of rizatriptan is a single dose of 5 or 10 mg. Single oral doses of 5 or 10 mg (conventional tablets or orally disintegrating tablets) were effective in clinical studies, although the 10-mg dose may provide a greater effect than the 5-mg dose. However, the 10-mg dose also may be associated with an increased risk of adverse effects.
Although efficacy of a second dose or subsequent doses has not been established in placebo-controlled trials, if the migraine headache recurs, a second dose of rizatriptan may be administered 2 hours after the first dose. The maximum dosage administered in any 24-hour period should not exceed 30 mg. The safety of treating an average of more than 4 headaches per 30-day period has not been established.
For the acute treatment of migraine attacks with or without aura in pediatric patients 6-17 years of age, the recommended dose of rizatriptan is a single dose of 5 mg in patients weighing less than 40 kg or 10 mg in those weighing 40 kg or more. Efficacy and safety of more than one dose within any 24-hour period have not been established in pediatric patients.
No enhanced Administration information available for this drug.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| RIZATRIPTAN 5 MG ODT | Maintenance | Adults place 1 tablet (5 mg) on top of tongue, allow to dissolve then swallow by translingual route once, may repeat every 2 hrs; max 30 mg/24 hrs |
| RIZATRIPTAN 10 MG ODT | Maintenance | Adults place 1 tablet (10 mg) on top of tongue, allow to dissolve then swallow by translingual route once, may repeat every 2 hrs; max 30 mg/24 hrs |
| RIZATRIPTAN 5 MG TABLET | Maintenance | Adults take 1 tablet (5 mg) by oral route once, may repeat at 2 hour intervals; do not exceed 30 mg in 24 hours |
| RIZATRIPTAN 10 MG TABLET | Maintenance | Adults take 1 tablet (10 mg) by oral route once, may repeat at 2 hour intervals; do not exceed 30 mg in 24 hours |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| RIZATRIPTAN 5 MG TABLET | Maintenance | Adults take 1 tablet (5 mg) by oral route once, may repeat at 2 hour intervals; do not exceed 30 mg in 24 hours |
| RIZATRIPTAN 10 MG TABLET | Maintenance | Adults take 1 tablet (10 mg) by oral route once, may repeat at 2 hour intervals; do not exceed 30 mg in 24 hours |
| RIZATRIPTAN 5 MG ODT | Maintenance | Adults place 1 tablet (5 mg) on top of tongue, allow to dissolve then swallow by translingual route once, may repeat every 2 hrs; max 30 mg/24 hrs |
| RIZATRIPTAN 10 MG ODT | Maintenance | Adults place 1 tablet (10 mg) on top of tongue, allow to dissolve then swallow by translingual route once, may repeat every 2 hrs; max 30 mg/24 hrs |
The following drug interaction information is available for RIZATRIPTAN (rizatriptan benzoate):
There are 2 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| 5-HT1D Agonists/Ergot Alkaloids SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: The 5-HT1D agonists and ergot alkaloids can produce vasospastic reactions. CLINICAL EFFECTS: Concurrent therapy may produce additive vasospastic effects. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer states that sumatriptan should not be used within 24 hours of an ergotamine-containing or ergotamine-like medication (such as dihydroergotamine or methysergide).(1,2) The Australian(3) and UK(4,5) manufacturers state that 24 hours should elapse before sumatriptan is administered following an ergotamine-containing preparation and 6 hours should elapse before an ergotamine-containing preparation is administered following sumatriptan. The US manufacturer states that zolmitriptan should not be used within 24 hours of an ergotamine-containing or ergotamine-like medication.(6) The UK manufacturer states that zolmitriptan should not be used within 6 hours of an ergotamine-containing or ergotamine-like medication.(7) The The Australian manufacturer states that 24 hours should elapse before zolmitriptan is administered following an ergotamine-containing preparation and 6 hours should elapse before an ergotamine-containing medication is administered following zolmitriptan.(8) The US manufacturer states that the use of rizatriptan within 24 hours of an ergotamine-containing or ergot-type medication is contraindicated.(9) The US manufacturer states that the use of naratriptan within 24 hours of an ergotamine-containing or ergot-type medication is contraindicated.(10) The Australian manufacturer states that concurrent use of naratriptan and ergotamine or ergotamine derivatives is not recommended.(11) The US manufacturer states that the use of eletriptan within 24 hours of an ergotamine-containing or ergot-type medication is contraindicated.(12) The UK manufacturer states that the use of eletriptan within 24 hours of an ergotamine-containing or ergot-type medication is not recommended.(13) DISCUSSION: Because of the theoretical risk of additive vasospastic effects, the US manufacturer states that the use of sumatriptan within 24 hours of an ergotamine-containing or ergotamine-like medication is contraindicated.(1,2) The Australian(3) and UK(4,5) manufacturer states that 24 hours should elapse before sumatriptan is administered following an ergotamine-containing preparation and 6 hours should elapse before an ergotamine-containing medication is administered following sumatriptan. Although the pharmacokinetics of zolmitriptan were not affected by ergotamine, the UK manufacturer of zolmitriptan recommends that 6 hours should elapse between the administration of zolmitriptan and an ergotamine preparation.(7) The US manufacturer of zolmitriptan states under contraindications that zolmitriptan should not be used within 24 hours of an ergotamine-containing or ergot-type medication.(6) The Australian manufacturer states that 24 hours should elapse before zolmitriptan is administered following an ergotamine-containing preparation and 6 hours should elapse before an ergotamine-containing medication is administered following zolmitriptan.(8) Because of the additive risk of prolonged vasospastic reactions, the manufacturers of rizatriptan(9) and naratriptan(10) in the US state that the use of ergotamine-containing or ergot-type medications and these agents is contraindicated. The Australian manufacturer states that concurrent use of naratriptan and ergotamine or ergotamine derivatives is not recommended.(11) Administration of oral ergotamine one and two hours after eletriptan resulted in additive increases in blood pressure.(13) |
DIHYDROERGOTAMINE MESYLATE, ERGOLOID MESYLATES, ERGOMAR, ERGOTAMINE TARTRATE, ERGOTAMINE-CAFFEINE, METHYLERGONOVINE MALEATE, METHYSERGIDE MALEATE, MIGERGOT, MIGRANAL, TRUDHESA |
| Selected 5-HT1D Agonists/MAO Inhibitors SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: MAOIs inhibit the metabolism of rizatriptan,(1) sumatriptan,(2-9) and zolmitriptan.(10-11) CLINICAL EFFECTS: Concurrent use of MAOIs may result in increased levels and effects of rizatriptan, sumatriptan or zolmitriptan.(1-11) PREDISPOSING FACTORS: Patients with a history of cardiovascular disease, e.g., coronary artery disease (CAD), transient ischemic attack (TIA), stroke, cardiac conduction disorders or poorly controlled hypertension are not considered candidates for 5-HT1D agonist therapy and would be at greater risk for toxicity due to this interaction. PATIENT MANAGEMENT: Concurrent administration of rizatriptan and a MAOI or administration of rizatriptan within two weeks of the discontinuation of a MAOI is contraindicated according to product labeling for rizatriptan.(1) Concurrent administration of sumatriptan and a MAOI or administration of sumatriptan within two weeks of the discontinuation of a MAOI is contraindicated according to the Australian, Canada, UK, and US product labeling for these agents.(2-9) Concurrent administration of zolmitriptan and a MAO-A inhibitor or the administration of zolmitriptan within two weeks of discontinuation of a MAO-A inhibitor is contraindicated according to US labeling.(10) The UK manufacturer states that a maximum of 7.5 mg of zolmitriptan should be administered within 24 hours of a MAO-A inhibitor.(11) Eletriptan and frovatriptan are not metabolized by MAO-A(12, 13) and may be an alternative in patients who require treatment with an MAO-A inhibitor. DISCUSSION: Rizatriptan is metabolized by the 'A' subtype of monoamine oxidase. In a study with 12 subjects, the concurrent administration of rizatriptan (10 mg) with moclobemide (450 mg daily, a selective, reversible MAO-A inhibitor) resulted in increases in the rizatriptan area-under-curve (AUC) and maximum concentration (Cmax) by 119% and 41%, respectively. The AUC of the active metabolite, N-monodesmethyl rizatriptan, increased over 400%. Plasma concentrations of rizatriptan may be increased by selective MAO-A inhibitors or by nonselective MAO-A and MAO-B inhibitors, although the interaction is expected to be greater with selective MAO-A inhibitors. The manufacturer also states that no interaction is expected with selective MAO-B inhibitors.(1) Sumatriptan oral bioavailability is approximately 15%, primarily due to presystemic clearance by MAO-A in the gut and liver. A small study found an approximately 7-fold increase in systemic sumatriptan exposure when an MAO-A inhibitor was given prior to a 25 mg oral dose of sumatriptan.(4) In another study, pretreatment with an MAO-A inhibitor prior to administration of injectable sumatriptan resulted in a 2-fold increase in sumatriptan AUC and a 40% increase in elimination half-life.(8) Pretreatment with a MAO-B inhibitor did not produce any significant changes in sumatriptan pharmacokinetics. The effect of a MAOI on nasal sumatriptan systemic absorption is expected to be less than that seen with oral sumatriptan but greater than that seen with injectable sumatriptan.(6) Administration of moclobemide, a MAO-A inhibitor, for one week (150 mg twice daily) resulted in a 25% increase in zolmitriptan AUC and a three-fold increase in Cmax and AUC for zolmitriptan's active N-desmethyl metabolite.(10,11) Administration of selegiline for one week at a dosage of 10 mg daily had no effect on the pharmacokinetics of zolmitriptan or its metabolite.(10) At daily doses of 10 mg, selegiline is primarily a selective MAO-B inhibitor; however, at higher doses, selegiline is capable of inhibiting MAO-A. Hypertensive reactions to the addition of either tyramine or a sympathomimetic to recommended dosages of selegiline have been reported.(14) Therefore, patients receiving selegiline at dosages of greater than 10 mg daily should be considered to be receiving a MAO-A inhibitor. It would also be prudent to monitor patients receiving selegiline at recommended dosages for this interaction. Methylene blue, when administered intravenously, has been shown to reach sufficient concentrations to be a potent inhibitor of MAO-A.(15) Metaxalone is a weak inhibitor of MAO.(17,18) One or more of the drug pairs linked to this monograph have been included in a list of interactions that should be considered "high-priority" for inclusion and should not be inactivated in EHR systems. This DDI subset was vetted by an expert panel commissioned by the U.S. Office of the National Coordinator (ONC) for Health Information Technology. |
EMSAM, FURAZOLIDONE, MARPLAN, MATULANE, METAXALONE, METHYLENE BLUE, NARDIL, PARNATE, PHENELZINE SULFATE, PROCARBAZINE HCL, PROVAYBLUE, SELEGILINE HCL, TRANYLCYPROMINE SULFATE, XADAGO, ZELAPAR |
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Selected 5-HT1D Agonists/Linezolid SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Monoamine oxidase inhibitors (MAOIs) inhibit the metabolism of rizatriptan,(1) sumatriptan,(2-9) and zolmitriptan.(10) Linezolid is a weak, reversible, nonselective MAOI.(12) CLINICAL EFFECTS: Concurrent use of linezolid may result in increased levels and effects of rizatriptan, sumatriptan or zolmitriptan.(1-11) PREDISPOSING FACTORS: Patients with a history of cardiovascular disease, e.g. coronary artery disease (CAD), transient ischemic attack (TIA), stroke, cardiac conduction disorders or poorly controlled hypertension, are not considered candidates for 5-HT1D agonist therapy and would be at greater risk for toxicity due to this interaction. PATIENT MANAGEMENT: Concurrent administration of rizatriptan and a MAOI or administration of rizatriptan within two weeks of the discontinuation of a MAOI is contraindicated according to product labeling for rizatriptan.(1) Concurrent administration of sumatriptan and a MAOI within two weeks of the discontinuation of a MAOI is contraindicated according to the Australian, Canada, UK, and US product labeling for these agents.(2-9) Concurrent administration of zolmitriptan and a MAO-A Inhibitor or the administration of zolmitriptan within two weeks of discontinuation of a MAO-A Inhibitor is contraindicated according to US labeling.(10) The UK manufacturer states that a maximum of 7.5 mg of zolmitriptan should be administered within 24 hours of a MAO-A inhibitor.(11) The manufacturer of linezolid does not contraindicated the use of 5-HT1D agonists but states that they should not be coadministered unless clinically appropriate and patients are carefully observed for signs and symptoms of serotonin syndrome.(12) Eletriptan and frovatriptan are not metabolized by MAO-A(13,14) and may be an alternative in patients who require treatment with linezolid. DISCUSSION: The combination of linezolid and 5-HT1D agonists has not been studied. Other MAOIs have been reported to interact with 5-HT1D agonists. Rizatriptan is metabolized by the 'A' subtype of monoamine oxidase. In a study with 12 subjects, the concurrent administration of rizatriptan (10 mg) with moclobemide (450 mg daily, a selective, reversible MAO-A inhibitor) resulted in increases in the rizatriptan area-under-curve (AUC) and maximum concentration (Cmax) by 119% and 41%, respectively. The AUC of the active metabolite, N-monodesmethyl rizatriptan, increased over 400%. Plasma concentrations of rizatriptan may be increased by selective MAO-A inhibitors or by nonselective MAO-A&B inhibitors, although the interaction is expected to be greater with selective MAO-A inhibitors. The manufacturer also states that no interaction is expected with selective MAO-B inhibitors.(1) Sumatriptan oral bioavailability is approximately 15%, primarily due to presystemic clearance by MAO-A in the gut and liver. A small study found an approximately 7-fold increase in systemic sumatriptan exposure when an MAO-A inhibitor was given prior to a 25 mg oral dose of sumatriptan.(4) In another study, pretreatment with an MAO-A inhibitor prior to administration of injectable sumatriptan resulted in a 2-fold increase in sumatriptan AUC and a 40% increase in elimination half-life.(8) Pretreatment with a MAO-B inhibitor did not produce any significant changes in sumatriptan pharmacokinetics. The effect of a MAOI on nasal sumatriptan systemic absorption is expected to be less than that seen with oral sumatriptan but greater than that seen with injectable sumatriptan.(6) Administration of moclobemide, a MAO-A inhibitor, for one week (150 mg twice daily) resulted in a 25% increase in zolmitriptan AUC and a three-fold increase in Cmax and AUC for zolmitriptan's active N-desmethyl metabolite.(10,11) |
LINEZOLID, LINEZOLID-0.9% NACL, LINEZOLID-D5W, ZYVOX |
There are 2 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Rizatriptan/Propranolol SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The exact mechanism is unknown. CLINICAL EFFECTS: Concurrent administration of rizatriptan and propranolol may increase the levels of rizatriptan.(1,2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: For adult patients receiving propranolol, the manufacturer of rizatriptan states that the 5 mg dose of rizatriptan should be used and that a maximum of three doses (15 mg) should be administered in a 24 hour period.(1) For pediatric patients receiving propranolol who weigh less than 40 kg (88 lb), rizatriptan should not be given.(1) For pediatric patients receiving propranolol who weigh at least 40 kg (88 lb), a single 5 mg dose of rizatriptan is recommended (maximum dose of 5 mg in a 24 hour period).(1) DISCUSSION: In a study in 11 subjects, the concurrent use of rizatriptan (10 mg) with propranolol (240 mg daily) resulted in an increase in the area-under-curve (AUC) of rizatriptan by 70%. A 4-fold increase was observed in one subject. The AUC of the rizatriptan N-monodesmethyl metabolite was not affected by the concurrent administration of propranolol.(1,2) In a study in 12 healthy subjects, concurrent use of propranolol (80 mg twice daily) with almotriptan (12.5 mg) resulted in statistically significant changes in almotriptan AUC; however, the change was less than 7% and considered unlikely to be clinically significant.(3) In a study in 10 healthy subjects, concurrent propranolol (80 mg twice daily) with sumatriptan (300 mg) had no effects on the pharmacokinetics or pharmacodynamics of sumatriptan.(4) In a study in 12 healthy subjects, concurrent use of propranolol (160 mg daily) with zolmitriptan (10 mg) increased the AUC and maximum concentration (Cmax) of zolmitriptan by 56% and 37%, respectively. Propranolol had no effect on the pressor response to zolmitriptan. The authors stated that the effects are unlikely to be clinically significant and that no dosage adjustment is required during concurrent therapy.(5) |
HEMANGEOL, INDERAL LA, INDERAL XL, INNOPRAN XL, PROPRANOLOL HCL, PROPRANOLOL HCL ER, PROPRANOLOL-HYDROCHLOROTHIAZID |
| Selected 5-HT1D Agonists/Rasagiline SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Rasagiline may inhibit the monamine oxidase-A (MAO-A) mediated metabolism of rizatriptan,(2) sumatriptan,(3-10) and zolmitriptan.(11-12) At concentrations associated with recommended recommended doses of 0.5 mg to 1 mg daily, rasagiline has a high specificity for MAO-B. Mild hepatic impairment, concomitant use of strong CYP1A2 inhibitors, or use of higher than recommended doses may substantially increase rasagiline systemic exposure and could result in MAO-A inhibition. CLINICAL EFFECTS: Systemic concentrations of rizatriptan, sumatriptan or zolmitriptan may be increased.(2-12) PREDISPOSING FACTORS: Rasagiline concentration may be increased 2-fold or more in patients also receiving a strong CYP1A2 inhibitor (e.g. ciprofloxacin, fluvoxamine).(1) Rasagiline plasma concentrations are higher in patients with any degree of hepatic impairment. Rasagiline should not be used in patients with moderate or severe hepatic impairment.(1) Patients with a history of cardiovascular disease, e.g. coronary artery disease (CAD), transient ischemic attack (TIA), stroke, cardiac conduction disorders or poorly controlled hypertension, are not considered candidates for 5-HT1D agonist therapy and would be at greater risk for toxicity due to this interaction. PATIENT MANAGEMENT: Evaluate patient for predisposing risk factors, e.g. concomitant use with CYP1A2 inhibitors, cardiovascular disease, and hepatic impairment. Patients with mild hepatic impairment or receiving concurrent therapy with a CYP1A2 inhibitor (e.g. ciprofloxacin, fluvoxamine) should be receiving a maximum rasagiline dose of 0.5 mg daily. DISCUSSION: Triptan interaction studies with other MAO inhibitors: Rizatriptan is metabolized by the 'A' subtype of monoamine oxidase. In a study with 12 subjects, the concurrent administration of rizatriptan (10 mg) with moclobemide (450 mg daily, a selective, reversible MAO-A inhibitor) resulted in increases in the rizatriptan area-under-curve (AUC) and maximum concentration (Cmax) by 119% and 41%, respectively. The AUC of the active metabolite, N-monodesmethyl rizatriptan, increased over 400%. Plasma concentrations of rizatriptan may be increased by selective MAO-A inhibitors or by nonselective MAO-A&B inhibitors, although the interaction is expected to be greater with selective MAO-A inhibitors. The manufacturer also states that no interaction is expected with selective MAO-B inhibitors.(2) Sumatriptan oral bioavailability is approximately 15%, primarily due to presystemic clearance by MAO-A in the gut and liver. A small study found an approximately 7-fold increase in systemic sumatriptan exposure when an MAO-A inhibitor was given prior to a 25 mg oral dose of sumatriptan.(5) In another study, pretreatment with an MAO-A inhibitor prior to administration of injectable sumatriptan resulted in a 2-fold increase in sumatriptan AUC and a 40% increase in elimination half-life.(9) Pretreatment with a MAO-B inhibitor did not produce any significant changes in sumatriptan pharmacokinetics. The effect of a MAOI on nasal sumatriptan systemic absorption is expected to be less than that seen with oral sumatriptan but greater than that seen with injectable sumatriptan.(6) Administration of moclobemide, a MAO-A inhibitor, for one week (150 mg twice daily) resulted in a 25% increase in zolmitriptan AUC and a three-fold increase in Cmax and AUC for zolmitriptan's active N-desmethyl metabolite.(11,12) Administration of selegiline for one week at a dosage of 10 mg daily had no effect on the pharmacokinetics of zolmitriptan or its metabolite.(11) At daily doses of 10 mg, selegiline is primarily a selective MAO-B inhibitor; however, at higher doses, selegiline is capable of inhibiting MAO-A. Hypertensive reactions to the addition of either tyramine or a sympathomimetic to recommended dosages of selegiline have been reported.(15) Therefore, patients receiving selegiline at dosages of greater than 10 mg daily should be considered to be receiving a MAO-A inhibitor. It would also be prudent to monitor patients receiving selegiline at recommended dosages for this interaction. |
AZILECT, RASAGILINE MESYLATE |
The following contraindication information is available for RIZATRIPTAN (rizatriptan benzoate):
Drug contraindication overview.
Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction, documented silent ischemia), coronary artery vasospasm (e.g., Prinzmetal variant angina), uncontrolled hypertension, or other serious underlying cardiovascular disease. History of stroke or transient ischemic attack, peripheral vascular disease, or ischemic bowel disease. Basilar or hemiplegic migraine.
Treatment within the previous 24 hours with another 5-HT1 receptor agonist or with an ergot alkaloid (e.g., ergotamine, dihydroergotamine, methysergide (no longer commercially available in the US)). Concurrent or recent (within 2 weeks) treatment with a monoamine oxidase-A (MAO-A) inhibitor. Known hypersensitivity to rizatriptan or any ingredient in the formulation.
Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction, documented silent ischemia), coronary artery vasospasm (e.g., Prinzmetal variant angina), uncontrolled hypertension, or other serious underlying cardiovascular disease. History of stroke or transient ischemic attack, peripheral vascular disease, or ischemic bowel disease. Basilar or hemiplegic migraine.
Treatment within the previous 24 hours with another 5-HT1 receptor agonist or with an ergot alkaloid (e.g., ergotamine, dihydroergotamine, methysergide (no longer commercially available in the US)). Concurrent or recent (within 2 weeks) treatment with a monoamine oxidase-A (MAO-A) inhibitor. Known hypersensitivity to rizatriptan or any ingredient in the formulation.
There are 12 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Acute myocardial infarction |
| Angina |
| Cerebral ischemia |
| Cerebrovascular accident |
| Coronary artery disease |
| Hemiplegic migraine |
| Ischemic bowel disease |
| Myocardial ischemia |
| Peripheral vascular disease |
| Prinzmetal angina |
| Serotonin syndrome |
| Severe uncontrolled hypertension |
There are 1 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Cardiac arrhythmia |
There are 3 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Chronic kidney disease stage 5 (failure) GFr<15 ml/min |
| Disease of liver |
| Hypertension |
The following adverse reaction information is available for RIZATRIPTAN (rizatriptan benzoate):
Adverse reaction overview.
Adverse effects occurring in 2% or more of adults receiving rizatriptan and occurring more frequently with rizatriptan than with placebo include pain/pressure sensations (i.e., chest pain (tightness/pressure, heaviness), pain/tightness/pressure in neck/throat/jaw, regional pain (tightness/pressure/heaviness), pain at location not specified), asthenia/fatigue, dizziness, headache, somnolence, dry mouth, nausea, and paresthesia.
Adverse effects occurring in 2% or more of adults receiving rizatriptan and occurring more frequently with rizatriptan than with placebo include pain/pressure sensations (i.e., chest pain (tightness/pressure, heaviness), pain/tightness/pressure in neck/throat/jaw, regional pain (tightness/pressure/heaviness), pain at location not specified), asthenia/fatigue, dizziness, headache, somnolence, dry mouth, nausea, and paresthesia.
There are 22 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Dyspnea Palpitations |
Bradycardia Cardiac arrhythmia Chest pain Chest tightness Paresthesia Tachycardia |
| Rare/Very Rare |
|---|
|
Acute myocardial infarction Anaphylaxis Angina Angioedema Cerebrovascular accident Hearing loss Hypersensitivity drug reaction Intracerebral hemorrhage Serotonin syndrome Subarachnoid intracranial hemorrhage Tongue swelling Toxic epidermal necrolysis Ventricular arrhythmias Wheezing |
There are 56 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Dizziness Drowsy Fatigue General weakness Vomiting |
Acute cognitive impairment Arthralgia Constipation Depression Diarrhea Dry eye Dyspepsia Dysphagia Euphoria Flatulence Flushing Hyperhidrosis Hypertension Hypoesthesia Irritability Muscle rigidity Muscle spasm Myalgia Nausea Neck stiffness Ocular irritation Pain Pruritus of skin Sensation of cold Sensation of warmth Tremor Xerostomia |
| Rare/Very Rare |
|---|
|
Acute abdominal pain Agitation Ataxia Blurred vision Chills Disturbance of attention Drug-induced hot flash Dysgeusia Edema Erythema Facial edema Gait abnormality Hallucinations Medication overuse headache Memory impairment Periorbital edema Polydipsia Polyuria Skin rash Symptoms of anxiety Syncope Tinnitus Urticaria Vertigo |
The following precautions are available for RIZATRIPTAN (rizatriptan benzoate):
Safety and efficacy have not been established in children younger than 6 years of age. Adverse effects in pediatric patients are expected to be similar to those reported in adults.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Category C. (See Users Guide.) The manufacturer has established a pregnancy registry to facilitate assessment of fetal outcomes in women who received rizatriptan during pregnancy. Clinicians are encouraged to report prenatal exposures to rizatriptan by calling 800-986-8999.
Rizatriptan is distributed into milk in rats. Caution is advised if used in nursing women.
Pharmacokinetic profile is similar to that in younger adults. Clinical studies of rizatriptan did not include sufficient numbers of patients 65 years of age and older to determine whether they respond differently than younger patients. While other clinical experience has not revealed age-related differences in response, dosage should be selected with caution in geriatric patients.
The following prioritized warning is available for RIZATRIPTAN (rizatriptan benzoate):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for RIZATRIPTAN (rizatriptan benzoate)'s list of indications:
| Migraine | |
| G43 | Migraine |
| G43.0 | Migraine without aura |
| G43.00 | Migraine without aura, not intractable |
| G43.001 | Migraine without aura, not intractable, with status migrainosus |
| G43.009 | Migraine without aura, not intractable, without status migrainosus |
| G43.01 | Migraine without aura, intractable |
| G43.011 | Migraine without aura, intractable, with status migrainosus |
| G43.019 | Migraine without aura, intractable, without status migrainosus |
| G43.1 | Migraine with aura |
| G43.10 | Migraine with aura, not intractable |
| G43.101 | Migraine with aura, not intractable, with status migrainosus |
| G43.109 | Migraine with aura, not intractable, without status migrainosus |
| G43.11 | Migraine with aura, intractable |
| G43.111 | Migraine with aura, intractable, with status migrainosus |
| G43.119 | Migraine with aura, intractable, without status migrainosus |
| G43.4 | Hemiplegic migraine |
| G43.40 | Hemiplegic migraine, not intractable |
| G43.41 | Hemiplegic migraine, intractable |
| G43.7 | Chronic migraine without aura |
| G43.70 | Chronic migraine without aura, not intractable |
| G43.701 | Chronic migraine without aura, not intractable, with status migrainosus |
| G43.709 | Chronic migraine without aura, not intractable, without status migrainosus |
| G43.71 | Chronic migraine without aura, intractable |
| G43.711 | Chronic migraine without aura, intractable, with status migrainosus |
| G43.719 | Chronic migraine without aura, intractable, without status migrainosus |
| G43.8 | Other migraine |
| G43.80 | Other migraine, not intractable |
| G43.801 | Other migraine, not intractable, with status migrainosus |
| G43.809 | Other migraine, not intractable, without status migrainosus |
| G43.81 | Other migraine, intractable |
| G43.811 | Other migraine, intractable, with status migrainosus |
| G43.819 | Other migraine, intractable, without status migrainosus |
| G43.82 | Menstrual migraine, not intractable |
| G43.821 | Menstrual migraine, not intractable, with status migrainosus |
| G43.829 | Menstrual migraine, not intractable, without status migrainosus |
| G43.83 | Menstrual migraine, intractable |
| G43.831 | Menstrual migraine, intractable, with status migrainosus |
| G43.839 | Menstrual migraine, intractable, without status migrainosus |
| G43.9 | Migraine, unspecified |
| G43.90 | Migraine, unspecified, not intractable |
| G43.901 | Migraine, unspecified, not intractable, with status migrainosus |
| G43.909 | Migraine, unspecified, not intractable, without status migrainosus |
| G43.91 | Migraine, unspecified, intractable |
| G43.911 | Migraine, unspecified, intractable, with status migrainosus |
| G43.919 | Migraine, unspecified, intractable, without status migrainosus |
| G43.B | Ophthalmoplegic migraine |
| G43.B0 | Ophthalmoplegic migraine, not intractable |
| G43.B1 | Ophthalmoplegic migraine, intractable |
| G43.C | Periodic headache syndromes in child or adult |
| G43.C0 | Periodic headache syndromes in child or adult, not intractable |
| G43.C1 | Periodic headache syndromes in child or adult, intractable |
| G43.D | Abdominal migraine |
| G43.D0 | Abdominal migraine, not intractable |
| G43.D1 | Abdominal migraine, intractable |
| G43.E | Chronic migraine with aura |
| G43.E0 | Chronic migraine with aura, not intractable |
| G43.E01 | Chronic migraine with aura, not intractable, with status migrainosus |
| G43.E09 | Chronic migraine with aura, not intractable, without status migrainosus |
| G43.E1 | Chronic migraine with aura, intractable |
| G43.E11 | Chronic migraine with aura, intractable, with status migrainosus |
| G43.E19 | Chronic migraine with aura, intractable, without status migrainosus |
Formulary Reference Tool