How it works
Although no clear cause has been established, one thought is that migraines are caused by the dilation (widening) of blood vessels, creating swelling and pressure, causing pain and neurological symptoms. Another possible cause maybe that certain chemicals in the brain increase in activity and parts of the brain may then send out confusing signals which cause the symptoms.
Rizatriptan constricts these blood vessels as well reducing the release of certain brain chemicals that occurs during a migraine attack which can relieve the symptoms.
Your migraine symptoms should improve within two hours of taking Rizatriptan.
The following treatments can be taken with Rizatriptan for maximum relief. Please speak to the pharmacist to check they are suitable for you.
- Pain relief – Paracetamol 500mg two tablets up to four times daily; Aspirin 300-900mg up to 4 times daily, or Ibuprofen 400mg up to four times daily
- Anti-sickness – Buccastem M 3mg up to two times daily. These tablets are designed to work when placed under your lip. As you don't have to swallow them, they are particularly good if vomiting is one of your migraine symptoms.
Take one tablet with water when your migraine headache begins. Taking this treatment with fizzy water can help it to work faster. If you experience an aura (visual disturbance), wait until this is over before taking Rizatriptan.
Rizatriptan lyophilisate (Maxalt Melt) melts in the mouth so does not need to be taken with water.
If after two hours your migraine is not completely better, or has come back, you can take another tablet. Do not take more than 20mg Rizatriptan in 24 hours.
Strength and dosage
Rizatriptan is available in 5mg and 10mg tablets. It is usually recommended to use the 10mg tablets. It may be advised to reduce the dose to 5mg if you are also taking propranolol. Do not take more than 20mg of Rizatriptan in 24 hours.
Side effects can include, feeling drowsy or dizzy, nausea and vomiting, dry mouth, heart racing, headaches, sleep disturbance and muscle or joint stiffness. Less commonly pain or tightness in the chest. If chest pain is severe and does not pass quickly, seek urgent medical help. Rare but serious side effects can include, irregular heart rhythms, seizures, tremors, visual disturbances and severe allergic reactions.
For full information on side effects and correct use, see the patient information leaflet. If you feel very unwell, or experience significant side effects, go to your local A&E department or call 999.
Important information about Rizatriptan
Do not mix Rizatriptan with another triptan when treating the same migraine attack. Rizatriptan should not be used on a daily basis, as this may lead to a medication overuse headache. If your headache gets significantly worse, or you develop any unusual symptoms, you should see a doctor urgently.
Safety: taking other medicines
As is true of all medication, Rizatriptan can interact with other medicines, which can sometimes be dangerous. This is why it's important that you let us know which prescription, over-the-counter medicines and recreational drugs you are taking so that we can prescribe Rizatriptan safely.
Do not combine Rizatriptan with another prescription medicine before consulting your GP. Alternatively, you can send us a message via your Patient Record.
We can also prescribe Sumatriptan or Vydura to treat migraines, which may be more suitable for you. Vydura can also be prescribed as a preventative measure for people who have lots of migraines.
Other prescription pain relief and anti-sickness medicines will have to be prescribed by your GP. These include Metoclopramide 10mg, Migramax (aspirin 900mg plus metoclopramide 10mg), and Paramax (paracetamol 500mg plus metoclopramide 5mg).