Rizatriptan

What is rizatriptan?

Rizatriptan is a type of medicine called a serotonin 5-HT 1B/1D receptor agonist. It's used to treat migraines and ease the headache pain associated with them. 

How does rizatriptan work?

Rizatriptan works by reducing swelling in the blood vessels that surround the brain. This helps ease headache pain. Rizatriptan can treat lots of types of migraine attacks.

Can rizatriptan be used to prevent migraines?

Rizatriptan cannot prevent migraines from occurring. It should only be used to treat a migraine that has already started.

What causes migraines?

It's not known exactly what causes migraines, but it's thought to be caused by abnormal activity in the brain which has an effect on the nerve signals, chemicals and blood vessels. There are several possible factors which can trigger a migraine. These include: 

• Hormonal changes (such as menstruation)
• Stress and anxiety 
• Tension 
• Shock 
• Depression 
• Excitement 
• Tiredness 
• Lack of sleep 
• Disruptive routine 
• Bad posture 
• Tension in the neck and shoulders 
• Jet lag 
• Low blood sugar 
• Dehydration 
• Alcohol 
• Caffeine 
• Irregular meals 
• Chocolate 
• Citrus fruit
• Tyramine (which is found in cured meat, smoked fish, pickled herring and certain cheeses) 
• Bright lights 
• Screens 
• Smoking 
• Climate changes 
• Strong smells or loud noises 
• A stuffy atmosphere 
• The combined contraceptive pill 
• Sleeping tablets 
• Hormone replacement therapy 

These triggers will vary from one individual to the next and can affect people differently. Keeping a diary may be helpful for you to identify your migraine triggers.

How can I prevent migraines?

The best way to prevent migraines is to identify what triggers them so that you can avoid those triggers. This will be different for everyone, so keeping a migraine diary is a useful way to find out what could be triggering your migraines. To do this, record when the migraine attack took place, what your symptoms were, how long they lasted and any environmental factors that were present. For example, what you've had to eat or drink, where you were, how you were feeling that day and any medicines you took. There are also medicines you can take to prevent migraines, but you need to speak to your doctor to find the best solution for you.

What is the difference between a headache and a migraine?

It can be difficult to tell the difference between a headache and a migraine but there are marked differences between the two. The pain of a migraine and a headache can feel similar and can occur either on one side of the head or both. A migraine may cause a throbbing pain and it usually causes additional symptoms such as: 

• Nausea 
• Vomiting 
• Sensitivity to light, sound or smells 
• Worsening of headache with physical exertion 

 A normal headache does not produce additional symptoms and will normally go away either on its own, after drinking water, or after taking over the counter painkillers like paracetamol.

Can I use rizatriptan for tension headaches?

Rizatriptan should not be used for any other type of headache, including tension headaches. You should only use rizatriptan to treat a migraine.

How to take rizatriptan?

Rizatriptan should be taken as soon as possible after a migraine attack starts. Rizatriptan tablets should be taken with water and swallowed whole. Rizatriptan oro-dispersible melts will dissolve on your tongue and do not require water. If your migraine is still there after 2 hours of taking rizatriptan, then you can take another tablet or melt. Wait at least 2 hours between doses and do not take more than 2 doses within 24 hours. Rizatriptan tablets work best when they are taken on an empty stomach, as it takes longer to work after eating.

What should I do if I forget to take rizatriptan?

If you forget to take rizatriptan, you can take it at any time during a migraine attack. Do not take rizatriptan to prevent a migraine or if you have no symptoms.

What should I do if I take too much rizatriptan?

If you take too much rizatriptan, then talk to a doctor or pharmacist right away and take the tablets with you. You may experience the following symptoms in the event of an overdose: 

• Drowsiness 
• Dizziness 
• Vomiting 
• Fainting 
• Slowed heart rate

Common side effects of rizatriptan may include: 

• Dizziness
• Sleepiness 
• Tiredness 
• Headaches 
• Dry mouth 
• Stomach pain
• Chest pain 
• Throat discomfort 
• Heaviness or pressure in the throat, limbs, chest or neck 
• Heart palpitations 
• Decreased skin sensitivity 

Uncommon side effects of rizatriptan may include: 

• Neck pain 
• Increased thirst 
• Difficulty sleeping 
• Heightened blood pressure 
• Indigestion 
• Blurred vision 
• Unsteadiness when walking 
• Altered taste 
• Dizziness 

 Rare side effects of rizatriptan can include: 

• Fainting 
• Wheezing 
• Difficulty breathing 
• Nausea 
• Diarrhoea 
• Sweating 
• Flushing 
• Shaking 
• Tingling in the fingers and toes 
• Difficulty thinking 
• Muscle weakness 
• Rash 
• Confusion 
• Nervousness 
• Muscle pain 
• Arrhythmia 
• Swelling around the face 
• Seizure 
• Serotonin syndrome 
• Heart attack 
• Ischemic colitis
• Blood vessel spasms
• Stroke 

Signs of an allergic reaction to rizatriptan include: 

• Rash 
• Itching 
• Wheezing and difficulty breathing 
• Swelling 
• Peeling and blistering of the skin 
• Toxic epidermal necrolysis 

 If you experience any of these serious side effects after taking rizatriptan, seek emergency medical attention immediately. 

If you experience a chronic headache as a result of taking rizatriptan, tell your doctor and stop taking the medicine.

Contraindications

Do not take rizatriptan if: 

• You are allergic to rizatriptan or any of the other ingredients in the medicine 
• You have uncontrolled high blood pressure 
• You have ever had a heart attack, angina or other heart problems 
• You have ever had a stroke or a mini stroke 
• You have peripheral vascular disease 
• You have liver or kidney problems 
• You are taking monoamine oxidase (MAO) inhibitors or if it has been less than 2 weeks since you stopped taking them 
• You are taking other migraine treatments 
• You are under 18 years old

 Tell your doctor if: 

• You have high blood pressure 
• You have diabetes 
• You smoke 
• You have a family history of heart disease 
• You have kidney or liver problems 
• You have problems with your heartbeat 
• You have any allergies 
• You are experiencing dizziness, difficulty walking, lack of coordination or weakness in your arms and legs 
• You are using St. John's wort 
• You are taking selective serotonin reuptake inhibitors (SSRIs)
• You have experienced chest pain or tightness

Drug interactions

Do not take rizatriptan if you are taking: 

• Any other type of triptans, including sumatriptan, naratriptan or zolmitriptan 
• Monoamine oxidase inhibitors (MAOs) 
• Ergotamine 
• Dihydroergotamine 
• Methysergide

Can Rizatriptan be taken with Ibuprofen?

You should check with your doctor or pharmacist before taking rizatriptan with ibuprofen. If you need to take them both, take rizatriptan first on an empty stomach. After 1 or 2 hours, see how your migraine feels. If you still have pain, then you can take ibuprofen (if it is suitable for you) with some food.

Rizatriptan and alcohol

Drinking alcohol while you are taking rizatriptan can increase the risk of side effects. Alcohol is also likely to make your migraine worse because it can cause dehydration, so it is not recommended to drink alcohol while using rizatriptan. 

Rizatriptan and pregnancy

Speak to your doctor if you are pregnant or planning a baby to check if rizatriptan is right for you.

Is rizatriptan addictive?

Taking rizatriptan too often can result in dependency and may give you headaches. But overall, rizatriptan is not addictive. Always take rizatriptan as your doctor has prescribed; only use it when you feel a migraine coming on.

Can I drive while taking rizatriptan?

If you experience dizziness or tiredness after taking rizatriptan, you should not drive or operate machinery.

Rizatriptan vs sumatriptan

Rizatriptan and sumatriptan work in similar ways to treat migraines, but rizatriptan usually relieves migraine symptoms faster. Both are available from Dr Felix.

Alternatives to rizatriptan

Over the counter painkillers, such as paracetamol and ibuprofen, are the first type of treatment recommended to treat a migraine attack. If this doesn't provide relief, then your doctor may prescribe triptans such as rizatriptan or sumatriptan. Antiemetics, such as Buccastem, can be given if you experience nausea or vomiting. These are all available online from Dr Felix.

Active ingredients

The active ingredient in rizatriptan tablets is rizatriptan.

Inactive ingredients

The other ingredients in rizatriptan are lactose monohydrate, microcrystalline cellulose, pregelatinised maize starch, iron oxide red (E172) and magnesium stearate.

Please note: generic rizatriptan tablets may contain different ingredients. Check the patient information leaflet for full details.

Which ingredients can cause an allergic reaction?

None of the active or inactive ingredients in Buccastem have been associated with cases of severe allergic reactions. Severe allergic reactions present as severe dizziness, hives, swelling of the face/lips or trouble breathing. You should get emergency medical attention right away if you experience any of these symptoms.