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Maxalt
Maxalt, the brand name for rizatriptan, is a prescription medication used to treat migraine headaches with or without aura in adults and children aged 6 years and older. Maxalt belongs to a class of medications called triptans, which work by narrowing blood vessels around the brain and reducing substances in the body that can trigger migraine symptoms such as headache, nausea, sensitivity to light, and sound. Maxalt is not intended for the prevention of migraines or for other types of headaches.
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Frequently Asked Questions
How quickly does Maxalt work?
Maxalt typically begins working within 30 minutes to 2 hours after taking the dose. Most patients experience relief within this time frame.
Can I take Maxalt to prevent migraines?
No, Maxalt is not used to prevent migraines. It is designed to treat acute migraine attacks once they begin.
Can Maxalt be used for cluster headaches?
Maxalt is not indicated for the treatment of cluster headaches. Other medications, such as sumatriptan injections or oxygen therapy, may be more appropriate for cluster headaches.
What should I do if my migraine returns after taking Maxalt?
If your migraine returns after taking Maxalt, you may take a second dose 2 hours after the first dose. However, do not take more than 30 mg in a 24-hour period.
Is Maxalt safe to use during pregnancy?
Maxalt should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Discuss with your doctor if you are pregnant or planning to become pregnant while taking Maxalt.
Comprehensive Drug Guide
How Does Maxalt Work?
Maxalt works by stimulating serotonin (5-HT1B and 5-HT1D) receptors in the brain, which causes constriction of blood vessels around the brain and blocks the release of inflammatory substances that can cause migraines. This action helps alleviate the headache and other symptoms of a migraine, such as nausea and light sensitivity, by restoring normal blood flow and reducing inflammation in the brain.
Common Dosages
- 5 mg and 10 mg tablets.
- 5 mg and 10 mg orally disintegrating tablets (MLT).
The typical starting dose is 5 mg or 10 mg as soon as migraine symptoms begin, with a repeat dose allowed if the migraine returns within 24 hours.
Typical Dosing
- For adults: The typical dose is 5 mg or 10 mg, taken as soon as migraine symptoms appear. If the migraine returns or symptoms persist, a second dose may be taken 2 hours after the first dose, but the maximum dose should not exceed 30 mg in a 24-hour period.
- For pediatric patients (6 to 17 years old): The recommended dose is 5 mg for patients weighing less than 40 kg (88 lbs) and 10 mg for patients weighing 40 kg or more.
Typical Dosing
FDA Approved Indications
- Acute treatment of migraine with or without aura in adults.
- Acute treatment of migraine in pediatric patients 6 to 17 years old.
Who Shouldn't Take Maxalt?
- History of ischemic heart disease (heart attack, angina, or coronary artery disease).
- Peripheral vascular disease.
- Uncontrolled hypertension.
- Hemiplegic or basilar migraine.
- History of stroke or transient ischemic attack (TIA).
- Severe liver or kidney disease.
- Known hypersensitivity or allergy to rizatriptan.
Advice From The Pharmacist
- Maxalt should be taken at the first sign of a migraine for the best results. It will not prevent migraines or reduce the frequency of attacks.
- The orally disintegrating tablets (Maxalt-MLT) can be taken without water, as they dissolve on the tongue. This can be convenient for people who experience nausea during migraines.
- If you take Maxalt and your migraine symptoms do not improve, do not take another dose without consulting your doctor.
- Do not exceed the maximum dose of 30 mg in 24 hours to avoid the risk of serious side effects.
- Maxalt may cause drowsiness or dizziness. Avoid driving or operating heavy machinery until you know how it affects you.
- If you experience chest pain, shortness of breath, or signs of an allergic reaction (such as rash, swelling, or difficulty breathing), seek medical attention immediately.
Side Effects of Maxalt
Common Side Effects
- Dizziness
- Drowsiness
- Tiredness or fatigue
- Dry mouth
- Nausea
- Flushing or warmth in the face, neck, or chest
Uncommon/Severe Side Effects
- Chest pain or tightness
- Shortness of breath
- Irregular or fast heart rate
- Severe abdominal pain
- Severe allergic reactions (rash, itching, swelling of the face, lips, or throat, difficulty breathing)
Risks and Warnings of Maxalt
- Cardiovascular Risks: Maxalt can cause serious heart problems, including heart attack, stroke, and other cardiovascular events. This risk is higher in people with underlying heart disease, high blood pressure, or other cardiovascular risk factors. It should not be used in patients with a history of heart disease.
- Serotonin Syndrome: Maxalt may increase the risk of serotonin syndrome, especially when taken with other medications that affect serotonin levels, such as SSRIs or SNRIs. Symptoms of serotonin syndrome include confusion, rapid heart rate, high blood pressure, and agitation.
- Medication Overuse Headache: Overuse of Maxalt (or other migraine medications) can lead to a medication overuse headache. Limit use to fewer than 10 days per month to avoid this.
Interactions with Maxalt
Common Drug Interactions
- Ergotamine-containing drugs: These should not be taken within 24 hours of using Maxalt, as they can increase the risk of cardiovascular side effects.
- Other triptans: Avoid using Maxalt with other triptan medications to prevent excessive narrowing of blood vessels.
- SSRIs and SNRIs: These medications, commonly used to treat depression and anxiety, can increase the risk of serotonin syndrome when taken with Maxalt.
- MAO inhibitors (e.g., phenelzine): Maxalt should not be taken within 2 weeks of stopping an MAO inhibitor, as this may increase the levels of rizatriptan in the body and cause serious side effects.
Alternatives to Maxalt
- Sumatriptan (Imitrex): Another triptan used for acute migraine treatment, available in tablet, nasal spray, and injection forms.
- Zolmitriptan (Zomig): A triptan that can be taken as a tablet or nasal spray for treating migraines.
- Ergotamine (Cafergot): A migraine treatment used when triptans are not effective or tolerated.
- NSAIDs (e.g., ibuprofen, naproxen): Over-the-counter medications that can be effective in relieving migraine symptoms for some patients.
