Monograph Details

Pain & Pyrexia > Migraine and headache
MAXALT-MLT
Manufacturer
Merck & Co., Inc.
Legal Classification
Rx
Pharmacological Class
Selective 5-HT1B/1D receptor agonist.
Generic Name
Rizatriptan (as benzoate) 5mg, 10mg; orally-disintegrating tabs; peppermint flavor; contains phenylalanine.
Also
MAXALT
Indications
Acute treatment of migraine.
Children
<18yrs: not recommended.
Adults
≥18yrs: Initially 5 or 10mg; may repeat after 2 hrs; max 30mg/day. Concomitant propranolol: use 5mg dose; max 3 doses/day. The safety of treating, on average, more than 4 headaches in a 30-day period has not been established.
Contraindications
Ischemic heart disease (eg, angina pectoris, history of MI, documented silent ischemia). Coronary artery vasospasm (eg, Prinzmetal's angina). Uncontrolled hypertension. Other significant cardiovascular disease. Basilar or hemiplegic migraine. Within 24 hours of other 5-HT1 agonists or ergot-type drugs. During or within 2 weeks after discontinuing MAOIs.
Precautions
Confirm diagnosis. Reevaluate if angina or ischemia symptoms (eg, ischemic bowel syndrome) occur, or if no response after 1st dose. Exclude underlying cardiovascular disease, supervise 1st dose, and consider monitoring ECG in patients with likelihood of unrecognized coronary disease (eg, post-menopausal women, men over age 40, hypertension, hypercholesterolemia, obesity, diabetes, smokers, strong family history). Monitor cardiovascular function in long-term intermittent use. Peripheral vascular or colonic ischemia following other 5-HT1 agonists. Hepatic dysfunction. Dialysis. Pregnancy (Cat.C). Nursing mothers.
Interactions
MAOIs, methysergide, other ergotamines, or other 5-HT1 agonists: see Contraindications. Caution with SSRIs. Exposure increased by propranolol.
Adverse Reactions
Asthenia, somnolence, dizziness, paresthesia, chest/jaw/throat pressure or other pain, dry mouth, nausea, headache; serious cardiac events (rare).
How Supplied
Both—6
Additional Resources
Related Prescribing Note