Rizatriptan Explained

Rizatriptan, sold under the brand name Maxalt among others, is a medication used for the treatment of migraine headaches. It is taken by mouth.[1] It can also be applied on the tongue. It is a serotonin (5-HT) 1B/1D receptor agonist (triptan).

Common side effects include chest pain, dizziness, dry mouth, and tingling.[1] Other side effects may include myocardial infarction, stroke, high blood pressure, serotonin syndrome, and anaphylaxis.[1] Excessive use may result in medication overuse headaches.[1] Use is not recommended during pregnancy and breastfeeding is not recommended within 24 hours after taking a dose. Rizatriptan is in the triptan class and is believed to work by activating the 5-HT1 receptor.[1]

Rizatriptan was patented in 1991 and came into medical use in 1998.[2] [3] It is available as a generic medication.[4] In 2021, it was the 159th most commonly prescribed medication in the United States, with more than 3million prescriptions.[5] [6]

Medical uses

Rizatriptan is indicated to treat acute migraine attacks with or without aura. It does not prevent future migraine attacks.[7] A 2010 review found rizatriptan to be more efficacious and tolerable than sumatriptan.[8]

Contraindications

Rizatriptan and other triptans can cause vasoconstriction, they are contraindicated in people with cardiovascular conditions.

Adverse effects

Frequent adverse effects (incidence less than 10%) are dizziness, drowsiness, asthenia/fatigue, and nausea. Clinical adverse experiences were typically mild and short-lasting (2–3 hours).[9]

Interactions

Mechanism of action

Rizatriptan acts as an agonist at serotonin 5-HT1B and 5-HT1D receptors.[11] Like the other triptans sumatriptan and zolmitriptan, rizatriptan induces vasoconstriction—possibly by inhibiting the release of calcitonin gene-related peptide from sensory neurons in the trigeminal nerve.[11]

Society and culture

Brand names

Brand names include Rizalt, Rizalt RPD, Rizact (India), Rizafilm, Maxalt, and Maxalt-MLT.[12] [13] [14]

Notes and References

  1. Web site: Rizatriptan Benzoate Monograph for Professionals . Drugs.com . American Society of Health-System Pharmacists . 18 March 2019 . 23 October 2020 . https://web.archive.org/web/20201023130856/https://www.drugs.com/monograph/rizatriptan-benzoate.html . live .
  2. Web site: Drug Approval Package: Maxalt/Rizatritan Benzoate NDA# 20864 & 20865 . U.S. Food and Drug Administration (FDA) . 30 March 2001 . 25 December 2023 . 6 December 2022 . https://web.archive.org/web/20221206085052/https://www.accessdata.fda.gov/drugsatfda_docs/nda/98/20864-20865.cfm . live .
  3. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 531 .
  4. Book: British National Formulary : BNF 76. 2018. Pharmaceutical Press. 9780857113382. 473. 76.
  5. Web site: The Top 300 of 2021 . ClinCalc . 14 January 2024 . 15 January 2024 . https://web.archive.org/web/20240115223848/https://clincalc.com/DrugStats/Top300Drugs.aspx . live .
  6. Web site: Rizatriptan - Drug Usage Statistics . ClinCalc . 14 January 2024.
  7. Web site: Rizatriptan. MedlinePlus. U.S. National Library of Medicine. 21 March 2018. 5 July 2016. https://web.archive.org/web/20160705113031/https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601109.html. live.
  8. Göbel H . Efficacy and tolerability of rizatriptan 10 mg compared with sumatriptan 100 mg: an evidence-based analysis.. Expert Rev Neurother . 10 . 4 . 499–506. 2010 . 20367203. 10.1586/ern.10.24. 43395810.
  9. Hargreaves RJ, Lines CR, Rapoport AM, Ho TW, Sheftell FD . Ten years of rizatriptan: from development to clinical science and future directions.. Headache . 2009 . 49. S3–S20. 19161563. 10.1111/j.1526-4610.2008.01335.x. 23587019.
  10. Millson DS, Tepper SJ, Rapoport AM . Migraine pharmacotherapy with oral triptans: a rational approach to clinical management . Expert Opinion on Pharmacotherapy . 1 . 3 . 391–404 . March 2000 . 11249525 . 10.1517/14656566.1.3.391 . 36053513 .
  11. Wellington K, Plosker GL . Rizatriptan: an update of its use in the management of migraine . Drugs . 62 . 10 . 1539–74 . 2002 . 12093318 . 10.2165/00003495-200262100-00007 . 195693597 .
  12. Web site: Rishum01_5_982075622.pdf . December 21, 2023 . Mohpublic.z6.web.core.windows.net.
  13. Web site: Maxalt Oral: Uses, Side Effects, Interactions, Pictures, Warnings & More . December 21, 2023 . WebMD . 21 December 2023 . https://web.archive.org/web/20231221221212/https://www.webmd.com/drugs/2/drug-8440/maxalt-oral/details . live .
  14. Web site: Rizact 10 mg Tablet - Uses, Dosage, Side Effects, Composition . December 21, 2023 . Practo . 21 December 2023 . https://web.archive.org/web/20231221221212/https://www.practo.com/medicine-info/rizact-10-mg-tablet-36132 . live .

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