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 the swelling in the blood vessels which surround the brain, causing the pain to ease off. The medicine works to treat all types of migraine attacks. 

Can Rizatriptan be used to prevent migraines?

Rizatriptan cannot prevent migraines from occurring. It should only be used to treat an active migraine attack. 

What causes migraines?

It's not know what exactly 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. 

How can I prevent migraines?

The best way to prevent migraines is to identify what triggers them so that you can avoid it. 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'd eaten and drank, where you were, how you were feeling that day and any medications you had taken. There are also medications you can take to prevent migraines. These are available on prescription and include Topiramate, Propranolol, Amitriptyline and Botulinum toxin type A. 

What is the difference between a headache and a migraine?

It can be difficult to determine 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.

Can I use Rizatriptan for tension headaches?

Rizatriptan should not be used for any other type of headache. It should only be used to treat a migraine. 

Active ingredients

The active ingredient is Rizatriptan.

Inactive ingredients

The other ingredients contained in Rizatriptan are lactose monohydrate, microcrystalline cellulose, pregelatinised maize starch, iron oxide red (E 172) and magnesium stearate.

How to take Rizatriptan

Rizatriptan should be taken as soon as possible after a migraine attack starts. The tablets should be taken with water and swallowed whole. If your migraine still persists after 2 hours of taking Rizatriptan then you can take another tablet. Wait at least 2 hours between doses and do not exceed 2 doses within a period of 24 hours. Rizatriptan works best when it is taken on an empty stomach as it takes longer to work after eating.                                                                                                

The usual dose of Rizatriptan is 10mg to treat a migraine. If you have any liver or kidney problems or if you are taking Propranolol, then you should take a 5mg dose.

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 it as a preventative measure 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 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 may include: 

• Neck pain 

• Increased thirst 

• Difficulty sleeping 

• Heightened blood pressure 

• Indigestion 

• Blurred vision 

• Unsteadiness when walking 

• Altered taste 

• Dizziness 

Rare side effects 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 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 seek 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 contained 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 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

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 SSRIs (antidepressants)

• You have experienced chest pain or tightness 

Drug interactions

Do not take Rizatriptan if you are taking: 

• Any other type of Triptans (5-HT agonists) which include Sumatriptan, Naratriptan or Zolmitriptan 

• Monoamine oxidase inhibitors (MAOs) 

• Ergotamine 

• Dihydroergotamine 

• Methysergide 

Can Rizatriptan be taken with Ibuprofen?

It's usually fine to take Ibuprofen or another over-the-counter painkiller if your first dose of Rizatriptan does not work. You should check with your doctor or pharmacist before taking any other medicines alongside Rizatriptan. 

Rizatriptan and alcohol

Drinking alcohol while you are taking Rizatriptan can increase the risk of side effects. It is also likely to make your migraine worse so it is not recommended to drink alcohol while using Rizatriptan. 

Rizatriptan and pregnancy

Speak to your doctor if you are pregnant so that they can determine the suitability of this medication. 

Is Rizatriptan addictive?

Taking Rizatriptan too often can result in dependency and may induce headaches. Always take Rizatriptan as your doctor has prescribed, only using it when you feel a migraine coming on. 

Can I drive while taking Rizatriptan?

If you experience dizziness or tiredness after taking Rizatriptan do not drive or operate machinery. 

Rizatriptan vs Sumatriptan

Rizatriptan and Sumatriptan work in similar ways but Rizatriptan usually relieves migraine symptoms faster.

Alternatives to Rizatriptan

Over-the-counter painkillers are the first type of treatment recommended to treat a migraine attack. If this doesn't provide relief then your doctor may prescribe you with Triptans such as Rizatriptan or Sumatriptan. Anti-emetics can be given if you experience nausea or vomiting which also come as a suppository if you are unable to swallow tablets. 

Sources

NHS> Migraines https://www.nhs.uk/conditions/migraine/treatment/

Patient Information Leaflet https://www.medicines.org.uk/emc/product/7184/pil

Medicine Net> Migraine vs Headache: How to Tell the Difference https://www.medicinenet.com/migraine_vs_headache_whats_the_difference/article.htm