Rizatriptan (Rizatriptan benzoate)
Also sold as: Rizact, Rizatrip, Maxalt, Rizatab
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet (5mg, 10mg) +1
Indications
- Acute migraine with or without aura in adults
Adult Dosing
Acute migraine (standard tablet)
5–10 mg at onset of headache
May repeat after 2 hours if partial response; maximum 30 mg/day
Onset 30–60 minutes (faster than oral sumatriptan). 10 mg preferred unless on propranolol.
Acute migraine — patients on propranolol
5 mg only
May repeat after 2 hours; maximum 15 mg/day
Propranolol increases rizatriptan levels by approximately 70%. Use 5 mg dose only.
Acute migraine with nausea/vomiting (orally disintegrating wafer)
5–10 mg wafer placed on tongue
Dissolves in saliva without water; repeat after 2 hours if needed
Ideal when patient cannot swallow tablets due to nausea or vomiting.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Mild-moderate impairment | No dose adjustment required |
| Severe impairment | Use with caution |
Hepatic Adjustment
Avoid in severe hepatic impairment. Mild-to-moderate: use with caution.
Pregnancy & Lactation
Pregnancy: Category C
Insufficient human data. Use only if clearly necessary. Avoid in first trimester if possible.
Lactation: Caution
Excreted in animal milk; human data limited. Pump and discard for at least 24 hours after dose as a precaution.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Propranolol | Increases rizatriptan AUC by approximately 70% via MAO-A inhibition — use 5 mg dose only | Major |
| MAOIs (phenelzine, tranylcypromine, moclobemide) | Severe serotonin syndrome and hypertensive crisis — contraindicated within 14 days | Major |
| Ergotamine / dihydroergotamine | Additive vasospasm — do not use within 24 hours | Major |
| SSRIs / SNRIs | Increased serotonin syndrome risk — monitor for symptoms | Moderate |
| Other triptans | Additive vasoconstrictive and serotonergic effects — avoid within 24 hours | Moderate |
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Side Effects
Common
- Dizziness, somnolence
- Chest pressure or tightness (triptan sensation)
- Nausea, dry mouth
- Fatigue, weakness
- Flushing, tingling
Serious / Discontinue If
- Coronary vasospasm (rare)
- Serotonin syndrome (with interacting serotonergic drugs)
- Cerebrovascular events (rare)
- Medication overuse headache with frequent use
Contraindications
- Ischaemic heart disease, angina, history of MI
- Uncontrolled hypertension
- History of stroke or TIA
- Hemiplegic or basilar migraine
- Peripheral vascular disease
- MAOIs within 14 days
- Ergotamine or another triptan within 24 hours
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Rizact 10mg | Cipla | ₹145/2 tab |
| Rizatrip 10mg | Sun Pharma | ₹128/2 tab |
| Maxalt 10mg | MSD | ₹245/2 tab |
Monitoring Required
- Blood pressure prior to initiation
- Frequency of use — limit to ≤10 days/month to prevent medication overuse headache
- Cardiovascular symptoms if used in patients with risk factors
Patient Counseling Points
- Take at the start of the headache — not during aura
- The dissolving wafer is useful if you feel too nauseous to swallow tablets
- If you are taking propranolol for any reason, always use the 5 mg dose — do not take 10 mg
- Do not take more than 3 doses in 24 hours
- Using migraine tablets more than 10 days per month causes rebound (medication overuse) headache
- Inform your doctor if you experience chest tightness, jaw pain, or arm pain after a dose
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EasyClinic auto-flags Rizatriptan interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Priya Nair, DM Neurology, DM Neurology, Senior Consultant Neurologist
Last reviewed: 2026-04-01
References
- Goadsby PJ, et al. Acute treatment of migraine. N Engl J Med. 2002;346:257-270.
- Rizatriptan prescribing information — MSD India.
- Indian Headache Society Guidelines 2021.