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Rizatriptan oral

Updated 2 Feb 2023 | Acute migraine treatment


Oral formulations containing rizatriptan.

Drugs List

  • MAXALT 10mg tablets
  • MAXALT 5mg tablets
  • MAXALT MELT 10mg oral lyophilisate tablet
  • rizatriptan 10mg oral lyophilisates sugar-free
  • rizatriptan 10mg orodispersible tablets sugar-free
  • rizatriptan 10mg tablets
  • rizatriptan 5mg orodispersible tablets sugar-free
  • rizatriptan 5mg tablets
  • Therapeutic Indications


    Acute treatment of migraine attacks with or without aura



    The recommended dose is 10mg. If headache returns after relief of initial attack, one further dose only may be taken. The second dose should be separated by at least two hours. Maximum two doses in any 24 hour period.

    If there is no response to the first dose, a second dose should not be taken for the same attack.

    Patients who do not respond to treatment of an attack may respond to treatment for subsequent attacks.

    A lower dose of 5mg should be used by patients on propranolol. Separate dose of rizatriptan from propranolol by 2 hours.

    Patients with Renal Impairment

    The recommended dose is 5mg. If headache returns after relief of initial attack, one further dose only may be taken. The second dose should be separated by at least two hours. Maximum two doses in any 24 hour period.

    Patients with Hepatic Impairment

    The recommended dose is 5mg. If headache returns after relief of initial attack, one further dose only may be taken. The second dose should be separated by at least two hours. Maximum two doses in any 24 hour period.


    For oral administration

    The absorption of rizatriptan tablets is delayed for approximately one hour when administered together with food.


    Children under 18 years
    Suspected ischaemic heart disease
    Within 2 weeks of discontinuing MAOIs
    History of cerebrovascular accident
    History of transient ischaemic attack
    Ischaemic heart disease
    Moderate hypertension
    Peripheral vascular disease
    Severe hepatic impairment
    Severe renal impairment
    Uncontrolled hypertension

    Precautions and Warnings

    Predisposition to ischaemic heart disease
    Glucose-galactose malabsorption syndrome
    Lactose intolerance
    Mild hepatic impairment
    Mild renal impairment

    Not for use in atypical headache
    Not indicated in hemiplegic, ophthalmoplegic or basilar migraine
    Reduce dose in patients with hepatic impairment
    Reduce dose in patients with renal impairment
    Some formulations contain aspartame - caution in phenylketonuria
    Advise ability to drive/operate machinery may be affected by side effects
    Some formulations contain lactose
    Advise patient to avoid using rizatriptan within 2 hours of propranolol
    Avoid ergotamine-type medication for 6 hrs after rizatriptan administration
    Avoid rizatriptan for 24hrs after ergotamine-type medication administration
    Only for use where a clear diagnosis of migraine has been established
    Excessive use may increase frequency of headache, may require withdrawal
    Discontinue if angioedema occurs
    If angina-like symptoms occur, discontinue treatment and investigate.
    Advise patient not to take St John's wort concurrently
    Breastfeeding: Do not breastfeed & discard milk for 24 hours after therapy

    Discontinue permanently if angioedema occurs. Do not rechallenge with another 5HT 1B/1D agonist.

    Evaluate cardiac risk in patients with risk factors for coronary artery disease including hypertension, diabetes, smokers, users of nicotine replacement therapy, men aged over 40 years, postmenopausal women, patients with bundle branch block and patients with a strong family history for coronary artery disease.

    Pregnancy and Lactation


    Use rizatriptan with caution during pregnancy.

    At the time of writing, there are insufficient data to establish the safety of rizatriptan in pregnancy.

    Animal studies do not indicate harmful effects at dose levels that exceed therapeutic dose levels with respect to the development of the embryo or foetus, or the course of gestation, parturition and post-natal development.

    The manufacturer recommends only using rizatriptan if clearly necessary.


    Use rizatriptan with caution during breastfeeding.

    There is currently no published experience on the use of rizatriptan with breastfeeding. It is excreted in high levels into the milk of lactating rats, and its molecular weight suggests human excretion is likely. The effect of this exposure on the nursing infant is unknown. LactMed suggests that while use of rizatriptan is not a reason to discontinue breastfeeding, alternative drugs may be preferred, particularly for newborn or premature infants.

    If rizatriptan is used during breastfeeding, the manufacturer suggests that milk should be discarded during and for 24 hours after treatment to minimise infant exposure.


    Rizatriptan oral lyophilisates or orodispersible tablets should be placed on the tongue and allowed to dissolve.

    Patients should be instructed not to remove the blister from the outer sachet until just prior to dosing. The blister pack should then be peeled open with dry hands and the oral lyophilisate or orodispersible tablets placed on the tongue.

    Migraine or treatment with rizatriptan may cause somnolence in some patients. Dizziness has also been reported in some patients receiving rizatriptan. Patients should, therefore, be advised to evaluate their ability to perform complex tasks during migraine attacks and after administration of rizatriptan.

    Patients should be advised not to take concurrent St. John's Wort.

    Patient should be advised that rizatriptan should not be taken within two hours of propranolol administration.

    Side Effects

    Abdominal pain
    Anaphylactoid reaction
    Blurred vision
    Cerebrovascular accident
    Chest pain
    Dry mouth
    ECG changes
    Facial oedema
    Facial pain
    Hot flushes
    Hypersensitivity reactions
    Impairment of mental skills
    Ischaemic colitis
    Muscle weakness
    Myocardial infarction
    Myocardial ischaemia
    Neck pain
    Peripheral vascular disorders
    Pharyngeal discomfort
    Pharyngeal oedema
    Sensation of heaviness
    Sensation of tightness
    Serotonin syndrome
    Tongue swelling
    Toxic epidermal necrolysis
    Unpleasant taste


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: January 2019

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Maxalt 5mg and 10mg tablets. Merck Sharp and Dohme Ltd. Revised July 2018.

    Summary of Product Characteristics: Maxalt Melt 10mg Oral Lyophilisates. Merck Sharp and Dohme Ltd. Revised July 2018.

    Summary of Product Characteristics: Rizatriptan 5mg Orodispersible tablets. Merck Sharp and Dohme Ltd. Revised October 2017.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Rizatriptan Last revised: 03 December 2018
    Last accessed: 15 January 2019

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.