Maxalt: Fast-Acting Relief from Migraine Pain
| Product dosage: 10mg | |||
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Maxalt (rizatriptan benzoate) is a prescription medication specifically designed for the acute treatment of migraine attacks with or without aura in adults. It belongs to a 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. This product card provides a comprehensive, expert-level overview of Maxalt, detailing its proper use, mechanism, and important safety information to ensure informed and effective treatment.
Features
- Active Ingredient: Rizatriptan benzoate
- Available Formulations: Oral tablets (standard and orally disintegrating tablets - ODT) and orally disintegrating wafers
- Standard Tablet Strengths: 5 mg and 10 mg
- Mechanism of Action: Selective 5-HT1B/1D (serotonin) receptor agonist
- Rapid Dissolution: Orally Disintegrating Tablet (ODT) formulation dissolves on the tongue without the need for water
- Targeted Therapy: Specifically designed to address the complex pathophysiology of a migraine attack
Benefits
- Provides rapid relief from debilitating migraine headache pain, often within 30 minutes for some patients.
- Effectively reduces associated migraine symptoms, including nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia).
- Helps restore normal function, allowing for a quicker return to daily activities and productivity.
- Offers a convenient, portable, and discreet treatment option with the orally disintegrating formulation, ideal for use when water is not available.
- Provides a targeted therapeutic approach that addresses the underlying vascular and neurological components of a migraine, unlike general pain relievers.
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 migraine headache pain, rather than during the aura phase or once the pain is already severe. It is not indicated for the treatment of cluster headaches or other types of headache (e.g., tension-type). Patients should not use more than two doses in a 24-hour period.
Dosage and direction
The recommended dose is either 5 mg or 10 mg. A 10 mg dose generally provides a greater effect, but the 5 mg dose may be preferred for patients who experience significant side effects. The maximum single dose should not exceed 10 mg. The maximum dosage in a 24-hour period is 30 mg. For the standard tablet: Swallow the tablet whole with water. For the Maxalt-MLT orally disintegrating tablet: Remove the blister pack from the foil pouch with dry hands. Place the tablet on the tongue, where it will dissolve rapidly and be swallowed with saliva. No water is needed. Doses should be taken at least 2 hours apart if a second dose is needed and permitted by a physician.
Precautions
- Use only after a clear diagnosis of migraine has been established.
- Not for use in patients with unrecognized coronary artery disease (CAD) or risk factors for CAD without a prior cardiovascular evaluation.
- Use with caution in patients with risk factors for heart disease (e.g., hypertension, high cholesterol, diabetes, smoking, strong family history, postmenopausal women, males over 40).
- May cause dizziness or drowsiness. Patients should not drive or operate machinery until they know how Maxalt affects them.
- May cause a transient increase in blood pressure.
- Use with caution in patients with hepatic impairment; a maximum dose of 5 mg is recommended for patients with moderate to severe liver impairment.
- Phenylketonurics: Maxalt-MLT orally disintegrating tablets contain phenylalanine (a component of aspartame).
Contraindications
- History of coronary artery disease (e.g., angina pectoris, history of myocardial infarction, documented silent ischemia).
- Coronary artery vasospasm, including Prinzmetal’s angina.
- Other significant underlying cardiovascular diseases.
- Uncontrolled hypertension.
- History of stroke or transient ischemic attack (TIA).
- Peripheral vascular disease.
- Ischemic bowel disease.
- Hemiplegic or basilar migraine.
- Concurrent administration or within 24 hours of another 5-HT1 agonist (e.g., another triptan) or an ergotamine-containing or ergot-type medication (e.g., dihydroergotamine, methysergide).
- Concurrent administration or within 2 weeks of discontinuation of a monoamine oxidase (MAO) A inhibitor.
- Hypersensitivity to rizatriptan benzoate or any component of the formulation.
Possible side effect
Common side effects (may affect up to 1 in 10 people):
- Dizziness, drowsiness, fatigue
- Nausea, dry mouth
- Chest pain or tightness (non-cardiac), pressure sensations
- Pain or pressure in the neck, throat, or jaw
Less common side effects:
- Palpitations, tachycardia (increased heart rate)
- Flushing, feeling of warmth
- Paresthesia (tingling sensation)
- Diaphoresis (sweating)
Serious side effects (seek immediate medical attention if experienced):
- Symptoms of a heart attack (e.g., chest, jaw, or left arm pain; shortness of breath)
- Symptoms of a stroke (e.g., sudden numbness or weakness, confusion, trouble speaking)
- Severe stomach pain or bloody diarrhea (signs of gastrointestinal ischemia)
- Significant rise in blood pressure
- Serotonin syndrome (agitation, hallucinations, fast heart rate, dizziness, tremors, nausea)
Drug interaction
- MAO Inhibitors: Contraindicated. Concomitant use can drastically increase rizatriptan plasma levels. Do not use within 2 weeks of discontinuing an MAO-A inhibitor.
- Other Triptans and Ergot Derivatives: Contraindicated. Concomitant use increases the risk of prolonged vasospastic reactions.
- Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Concomitant use may potentially increase the risk of serotonin syndrome, a rare but serious condition.
- Propranolol: Concomitant use increases the plasma concentration of rizatriptan. A maximum single dose of 5 mg of Maxalt is recommended, with a maximum daily dose of 15 mg in 24 hours.
- Other adrenergic neuron blocking drugs may also interact.
Missed dose
Maxalt is not used on a scheduled basis; it is taken only during an acute migraine attack. Therefore, the concept of a “missed dose” does not apply. Do not take a dose to make up for a missed scheduled dose, as this medication is not for prevention.
Overdose
In cases of overdose, symptoms may include severe dizziness, drowsiness, fainting, slow heart rate (bradycardia), vomiting, and loss of coordination. There is no specific antidote for rizatriptan overdose. Treatment should consist of supportive measures, including continuous ECG monitoring for at least 20 hours, and monitoring of vital signs. The patient’s airway should be maintained. It is critical to seek immediate emergency medical attention or contact a Poison Control center in the event of a known or suspected overdose.
Storage
- Store at room temperature between 20°C to 25°C (68°F to 77°F). Excursions permitted between 15°C and 30°C (59°F and 86°F).
- Keep the medication in its original blister pack or bottle to protect from light and moisture.
- For Maxalt-MLT ODT: Keep the tablet in the blister pack inside the foil pouch until immediately before use.
- Keep all medications out of the reach of children and pets.
- Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.
Disclaimer
This product information is for educational purposes only and does not constitute medical advice. It is not exhaustive. A healthcare professional must diagnose migraines and determine if Maxalt is an appropriate treatment based on an individual’s complete medical history, current health status, and risk profile. The patient must read the official Medication Guide provided by the pharmacist with the prescription. Never initiate or alter a treatment regimen without the direct supervision and advice of a qualified physician.
Reviews
“After years of suffering with migraines that left me bedridden, Maxalt has been a game-changer. The ODT version is a lifesaver at work when I feel an attack coming on. I have significant relief within 45 minutes, allowing me to continue my day.” – Sarah K., verified patient.
“As a neurologist, I find rizatriptan to be a highly effective and generally well-tolerated abortive therapy for many of my migraine patients. Its rapid onset of action is a key benefit for restoring function. It is crucial, however, that patients are properly screened for cardiovascular contraindications prior to use.” – Dr. Evan R., MD, Neurologist.
“The efficacy is undeniable, but I did experience noticeable chest tightness and fatigue after taking the 10mg dose. My doctor switched me to the 5mg dose, which provides adequate relief with far fewer side effects for me.” – Mark T., verified patient.
“From a pharmacist’s perspective, patient education is paramount with triptans. Ensuring patients understand the dosing limits, the warning signs of serious adverse events, and the important drug interactions makes therapy with Maxalt both safe and effective.” – Jennifer L., PharmD.