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Information ⬇

rizatriptan benzoate

Maxalt, Maxalt-MLT, RizaFilm

Drugs

ergot-containing drugs: Prolonged vasospastic reactions

MAO inhibitors, propranolol: Increased blood rizatriptan level

selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, other triptans: Increased risk of serotonin syndrome

serotonin receptor agonists: Additive vasospastic effects

Class and Category ⬆ ⬇

Pharmacologic class: Selective serotonin receptor agonist
Therapeutic class:Antimigraine

Indications and Dosages ⬆ ⬇

* To relieve acute migraine headache

Orally Disintegrating Tablets, Tablets

Adults. 5 or 10 mg when migraine headache starts; repeated 2 hr later, as needed. Additional doses spaced at least 2 hr apart, as needed. Maximum: 30 mg daily; treating more than 4 headaches in a 30-day period.

Children ages 6 to 17 weighing 40 kg (88 lb) or more. 10 mg as a single dose when migraine headache starts.

Children ages 6 to 17 weighing less than 40 kg (88 lb). 5 mg as a single dose when migraine headache starts.

Oral Film

Adults. 10 mg as a single dose when migraine headache starts. Doses repeated, as needed after at least 2 hr has lapsed from previous dose being given. Maximum: 30 mg/24 hr.

Children ages 12 to 17 weighing 40 kg (88 lb) or more. 10 mg as a single dose when migraine headache starts.

Dosage Adjustment

For adult patients taking propranolol, initial dosage should not exceed 5 mg, and maximum dosage limited to three 5-mg doses in any 24-hour period. For pediatric patients weighing 40 kg (88 lb) or more taking propranolol, dosage reduced to 5 mg as a single dose.

Drug Administration ⬆ ⬇

P.o.

RouteOnsetPeakDuration

P.O.

0.5–2 hr

1–1.5 hr

Unknown

P.O./MLT

0.5–2 hr

1.6–2.5 hr

Unknown

Half-life: 2–3 hr

Childbearing Considerations ⬆ ⬇

Pregnancy

Lactation

Mechanism of Action ⬆ ⬇

Binds to selective 5-hydroxytryptamine receptor sites on cerebral blood vessels, causing vessels to constrict, which may decrease the characteristic pulsing sensation and thus relieve the pain of migraine headaches. Relieves pain also by inhibiting the release of proinflammatory neuropeptides and reducing transmission of trigeminal nerve impulses from sensory nerve endings during a migraine attack.

Contraindications ⬆ ⬇

Basilar or hemiplegic migraine, coronary artery vasospasm (including Prinzmetal angina), history of stroke or transient ischemic attack, hypersensitivity to rizatriptan or its components, ischemic bowel disease, ischemic coronary artery disease or other significant underlying cardiovascular disease, uncontrolled hypertension, use within 14 days of MAO inhibitor therapy, use within 24 hr of ergotamine-containing or ergot-type drugs or other serotonin receptor agonists

Adverse Reactions ⬆ ⬇

Nursing Considerations ⬆ ⬇

! WARNING

Assess patient’s cardiovascular status and institute continuous ECG monitoring, as ordered, immediately after giving rizatriptan in patients with cardiovascular risk factors because of possible asymptomatic cardiac ischemia.

! WARNING

Monitor patient for a hypersensivitity reaction, which may become life-threatening, such as angioedema. If present, notify prescriber, expect drug to be discontinued, and provide supportive care, as needed and ordered.

! WARNING

Monitor patients with peripheral vascular disease because drug may cause vasospastic reactions, leading to colonic andvascular ischemia with abdominal pain and bloody diarrhea. Assess bowel sounds and peripheral circulation frequently during therapy.

! WARNING

Monitor patient closely for serotonin syndrome if she is taking rizatriptan along with a selective serotonin reuptake inhibitor or serotonin–norepinephrine reuptake inhibitor. Notify prescriber immediately if the patient exhibits agitation, coma, diarrhea, hallucinations, hyperreflexia, hyperthermia, incoordination, labile blood pressure, nausea, tachycardia, or vomiting, as serotonin syndrome can be life-threatening. Provide supportive care.

Patient Teaching ⬆ ⬇

! WARNING

Advise phenylketonuric patient not to use orally disintegrating tablet form because it contains phenylalanine.

! WARNING

Instruct patient to seek emergency care immediately if cardiac symptoms, such as chest pain, occur after administration.

! WARNING

Alert patient that drug may cause an allergic reaction. If present, tell patient to notify prescriber and, if severe, to seek immediate medical care.

! WARNING

Warn patients with peripheral vascular disease to report immediately abdominal pain or bloody diarrhea.

NDC Code ⬆