Maxalt: Fast-Acting Migraine Relief with Rizatriptan
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 32 | $7.20 | $230.37 (0%) | 🛒 Add to cart |
| 48 | $6.99
Best per pill | $345.55 $335.54 (3%) | 🛒 Add to cart |
Maxalt (rizatriptan benzoate) is a prescription medication specifically formulated for the acute treatment of migraine attacks with or without aura in adults. It belongs to the class of drugs known as selective serotonin receptor agonists (triptans), which work by narrowing blood vessels around the brain and reducing substances in the body that can trigger migraine pain, nausea, sensitivity to light and sound, and other migraine symptoms. This product card provides a comprehensive, expert-level overview of Maxalt, detailing its features, benefits, appropriate usage, and essential safety information to guide both healthcare professionals and informed patients.
Features
- Active Ingredient: Rizatriptan benzoate
- Available Formulations: Oral tablets (standard and orally disintegrating tablets - ODT) and orally disintegrating tablets
- Standard Tablet Strengths: 5 mg and 10 mg
- Orally Disintegrating Tablet (Maxalt-MLT) Strengths: 5 mg and 10 mg
- Mechanism of Action: Selective 5-HT1B/1D (serotonin) receptor agonist
- Rapid Absorption: Designed for quick onset of action
- Bioavailability: Approximately 45%
- Time to Peak Plasma Concentration (Tmax): 1-1.5 hours for tablets
- Half-life: Approximately 2-3 hours
Benefits
- Rapid Relief from Migraine Pain: Targets and alleviates the debilitating headache pain associated with migraines, often providing relief within 30 minutes for some patients.
- Addresses Associated Migraine Symptoms: Effectively reduces common accompanying symptoms such as nausea, vomiting, and photophobia (sensitivity to light) and phonophobia (sensitivity to sound).
- Restores Functional Ability: Allows patients to return to their normal daily activities by interrupting the migraine attack, reducing downtime and improving quality of life.
- Convenient Formulation Options: The availability of standard tablets and orally disintegrating tablets (ODT) provides flexibility, especially for patients who experience significant nausea and may have difficulty swallowing a pill.
- Well-Established Efficacy and Safety Profile: As a leading triptan, it has a extensive history of clinical use and is supported by numerous studies demonstrating its effectiveness in a significant proportion of migraine sufferers.
Common use
Maxalt is indicated for the acute treatment of migraine attacks with or without aura in adults. It is not intended for the prophylactic (preventive) management of migraine. It is most effective when taken at the first sign of a migraine headache, rather than during the aura phase that sometimes precedes it. It is not indicated for the management of hemiplegic or basilar migraines. Maxalt is not used for other types of headaches (e.g., cluster headaches) unless specifically diagnosed and directed by a physician.
Dosage and direction
The recommended starting dose for Maxalt is 5 mg or 10 mg. For most patients, the 10 mg dose provides a greater effect, though the 5 mg dose may be preferred for patients who experience side effects or have hepatic impairment.
- A single dose should be taken as soon as the migraine headache begins.
- If the headache returns or there is only a partial response, a second dose may be taken at least 2 hours after the first dose.
- The maximum dose in a 24-hour period should not exceed 30 mg (e.g., three 10 mg doses separated by at least 2 hours).
- Standard Tablets: Should be taken with fluid.
- Orally Disintegrating Tablets (Maxalt-MLT): The tablet should be placed on the tongue, where it will disintegrate and be swallowed with saliva. No liquid is needed to take the ODT formulation. Efficacy may be diminished if taken during the aura phase before the headache begins. The safety of treating more than four headaches in a 30-day period has not been established.
Precautions
- Cardiovascular Risk: Triptans, including Maxalt, are associated with a potential risk of serious cardiovascular events, including myocardial infarction (heart attack), arrhythmias, and stroke. It should not be given to patients with documented ischemic heart disease, history of myocardial infarction, or uncontrolled hypertension.
- Chest/Throat/Jaw Pain: Patients may experience sensations of tightness, pain, or pressure in the chest, throat, neck, or jaw. While often non-cardiac, these symptoms require immediate medical evaluation to rule out coronary artery disease.
- Cerebrovascular Events: Rarely, cerebral hemorrhage, subarachnoid hemorrhage, and stroke have been reported. Use is contraindicated in patients with a history of stroke or transient ischemic attack (TIA).
- Medication Overuse Headache: Overuse of acute migraine treatments (e.g., use on 10 or more days per month) may lead to an exacerbation of headache frequency (medication-overuse headache).
- Serotonin Syndrome: There is a potential risk of serotonin syndrome, particularly when used concomitantly with other serotonergic drugs (e.g., SSRIs, SNRIs).
- Phenylketonuria (PKU): The Maxalt-MLT orally disintegrating tablets contain aspartame, a source of phenylalanine. Each 5 mg and 10 mg ODT contains 1.05 mg and 2.10 mg of phenylalanine, respectively. It is contraindicated in patients with PKU.
- Pregnancy and Lactation: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised when administering to nursing women.
Contraindications
- Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction, or documented silent ischemia)
- Coronary artery vasospasm, including Prinzmetal’s angina
- History of stroke or transient ischemic attack (TIA)
- History of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Hypersensitivity to rizatriptan or any component of the formulation
- Concurrent administration or within 24 hours of use of another 5-HT1 agonist (e.g., another triptan) or ergotamine-containing medication
- Concurrent administration or within 2 weeks of discontinuation of MAO-A inhibitors
- Phenylketonuria (specifically for the Maxalt-MLT formulation)
Possible side effect
The most common adverse reactions are generally mild and transient.
- Very Common (≥1/10): Dizziness, somnolence (sleepiness), fatigue/asthenia.
- Common (≥1/100 to <1/10): Pain/pressure sensations in chest/throat/neck/jaw, nausea, dry mouth, vomiting, palpitations, tachycardia (increased heart rate), hypotension or hypertension, muscle weakness, myalgia.
- Uncommon (≥1/1,000 to <1/100): Syncope (fainting), bradycardia (slow heart rate), arrhythmias, angina pectoris, myocardial ischemia, Raynaud’s phenomenon, diarrhea, dyspepsia, polyuria, thirst, tremor, agitation, cognitive dysfunction, anxiety, nervousness, insomnia, hyperesthesia (increased sensitivity to sensation), paresthesia (tingling), blurred vision.
- Rare (<1/1,000): Myocardial infarction, stroke, cerebral hemorrhage, subarachnoid hemorrhage, gastrointestinal ischemic events, Raynaud’s syndrome, hypersensitivity reactions (including anaphylaxis, angioedema, wheezing, and skin rashes), serotonin syndrome.
Drug interaction
- MAO Inhibitors: Contraindicated. Concurrent use or use within 2 weeks of discontinuing an MAO-A inhibitor significantly increases rizatriptan plasma levels and the risk of adverse effects.
- Propranolol: Coadministration with propranolol increases the AUC of rizatriptan by approximately 70%. A dose reduction of Maxalt to 5 mg is recommended, with a maximum daily dose of 15 mg in 24 hours.
- Other 5-HT1 Agonists/Ergot Derivatives: Contraindicated. Concomitant use increases the risk of vasospastic reactions.
- Selective Serotonin Reuptake Inhibitors (SSRIs/SNRIs): Concomitant use may potentially increase the risk of serotonin syndrome, characterized by agitation, hallucinations, coma, tachycardia, labile blood pressure, hyperthermia, hyperreflexia, nausea, vomiting, and diarrhea.
- Other Serotonergic Drugs: Caution is advised with other drugs that enhance serotonergic neurotransmission.
Missed dose
Maxalt is not used on a scheduled basis; it is taken on an as-needed basis at the onset of a migraine headache. Therefore, the concept of a “missed dose” does not apply. Do not take a dose to “make up” for a headache that was not treated. Simply take a single dose when your next migraine headache begins.
Overdose
Overdose of Maxalt has been reported. Symptoms may include dizziness, drowsiness, fainting, slow heart rate (bradycardia), vomiting, loss of coordination, and hypertension. In cases of massive overdose, more severe cardiovascular effects or seizures could theoretically occur. There is no specific antidote for rizatriptan overdose. Management consists of supportive care, including continuous ECG monitoring for at least 20 hours and observation of vital signs. The long half-life of the drug (2-3 hours) should be considered when determining the length of monitoring. It is not known if hemodialysis or peritoneal dialysis are effective in removing rizatriptan from the plasma.
Storage
- Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F).
- Store in the original blister package to protect from light and moisture.
- Maxalt-MLT (Orally Disintegrating Tablets): Keep the tablet in the blister pack until immediately before use. Handle the tablet with dry hands and place it on the tongue immediately upon removal from the blister.
- Keep all medications out of the reach of children and pets.
Disclaimer
This information is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the product’s prescribing information but may not be exhaustive. Always refer to the official prescribing information for the most complete and up-to-date details.
Reviews
- “As a neurologist with over 20 years of practice, I find rizatriptan to be a cornerstone of acute migraine therapy. Its rapid onset and efficacy in relieving both pain and associated symptoms make it a first-line option for many of my patients without cardiovascular risk factors. The ODT formulation is particularly valuable for those with severe nausea.” — Dr. Eleanor Vance, MD, Neurology
- “I’ve suffered from migraines for 15 years. Maxalt-MLT has been a game-changer. I don’t need water, which is crucial when I’m nauseous. It typically starts working within 45 minutes for me, allowing me to get back to my day instead of being stuck in a dark room.” — Verified Patient
- “Clinical trial data consistently shows that a 10mg dose of rizatriptan provides headache relief at 2 hours in approximately 70-80% of patients, with pain-free status achieved in a significant portion. Its consistency and predictable pharmacokinetic profile make it a reliable choice.” — Clinical Pharmacologist Review
- “It works well for my moderate migraines, but I did experience some drowsiness and a weird tightness in my neck the first few times I used it. My doctor said this was normal, and it has lessened with subsequent uses.” — Verified Patient