Maxalt-Mlt

• Rizatriptan is used to treat migraines. It helps to relieve headache, pain and other migraine symptoms (including nausea, vomiting and sensitivity to light/sound). Prompt treatment helps you return to your normal routine and may decrease your need for other pain medications.
• Rizatriptan belongs to a class of drugs known as triptans. It affects a certain natural substance (serotonin) that causes narrowing of blood vessels in the brain. It may also relieve pain by affecting certain nerves in the brain.
• Rizatriptan does not prevent future migraines or lessen how often you get migraine attacks.

• Read the Patient Information Leaflet if available from your pharmacist before you start taking Rizatriptan and each time you get a refill. If you have any questions, request a callback from your medical provider or ask your pharmacist.
• Take this medication as directed by your medical provider at the first sign of a migraine.
• Handle the tablets with dry hands. Place the tablet on your tongue, allow it to dissolve and swallow with your saliva. You do not need to take this medication with water or other liquid. It may be taken with or without food, but may work faster when it is taken on an empty stomach.
• Do not break or crush the tablets. If you are using the individually wrapped tablets, do not open the outer pouch until the dose is needed. Peel the foil back and carefully remove the tablet from the blister pack immediately before taking your dose.
• If you are using the tablets from a bottle, leave the tablets in the bottle they came in until you are ready to take a dose. Keep the bottle tightly closed between uses.
• The dosage is based on your medical condition, response to treatment, age and other medications you may be taking. For children, the dosage is also based on weight. Be sure to tell your medical provider and pharmacist about all the products you use (including prescription drugs, nonprescription drugs and herbal products).
• If there is no improvement in your symptoms, do not take more doses of this medication before talking to your medical provider. If your symptoms are only partly relieved, or if your headache comes back, adults may take another dose at least 2 hours after the first dose. Children should not take more than one dose, or 5 milligrams in a 24-hour period. For adults, the US manufacturer recommends a maximum dose of 30 milligrams in a 24-hour period, however, some experts advise not to exceed 20 mg in a 24 hour period as there isn't any efficacy data available above 20 mg.
• If you have a higher risk for heart problems (see “Precautions to be aware of”), your medical provider may perform a heart exam before you start taking Rizatriptan. They may also direct you to take your first dose of this medication at an in-person clinic or medical provider's office to monitor for serious side effects (such as chest pain). Talk to your medical provider for details.
• If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Tell your medical provider if you need to use this medication more often, or if the medication is not working as well, or if your headaches get worse.

• Flushing, feelings of tingling/numbness/prickling/heat, tiredness, weakness, drowsiness or dizziness may occur. If any of these effects last or get worse, tell your medical provider or pharmacist promptly.
• Remember that this medication has been prescribed because your medical provider has judged the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
• This medication may raise your blood pressure. Check your blood pressure regularly and tell your medical provider if the results are high.

• Request a callback from your medical provider right away or seek emergency medical attention if you have any serious side effects, including:

  • Blue fingers, toes or nails
  • Cold hands or feet
  • Hearing changes
  • Mental or mood changes

• Rizatriptan can cause chest pain, which should be evaluated right away by a medical provider. Heart attacks, heart disease and cardiac arrest have been reported as a result of taking this medication. Get medical help right away if the following side effects occur:

  • Chest/jaw/neck tightness
  • Shortness of breath
  • Unusual sweating
  • Fast or irregular heartbeat
  • Fainting
  • Severe stomach or abdominal pain
  • Bloody diarrhea
  • Signs of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes or confusion)  

• There have been reports linking this medication to brain hemorrhage (bleeding in the brain). Get medical help if you experience the following side effects:

  • Sudden tingling, weakness, numbness or paralysis of the face, arm or leg, particularly on one side of the body
  • Headache
  • Nausea and vomiting
  • Confusion
  • Dizziness
  • Seizures
  • Difficulty swallowing
  • Loss of vision or difficulty seeing
  • Loss of balance or coordination
  • Stiff neck and sensitivity to light
  • Abnormal or slurred speech
  • Difficulty reading, writing or understanding speech
  • Change in level of consciousness or alertness, lack of energy, sleepiness or coma
  • Trouble breathing and abnormal heart rate

• This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your medical provider or pharmacist of all the drugs you take (see “Drug Interactions” section). Get medical help right away if you develop some of the following symptoms:

  • Fast heartbeat
  • Hallucinations
  • Loss of coordination
  • Rigidity
  • Severe dizziness
  • Severe nausea/vomiting/diarrhea
  • Twitching muscles
  • Unexplained fever
  • Unusual agitation or restlessness

• A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • Rash
  • Itching or swelling (especially of the face, tongue or throat)
  • Severe dizziness
  • Trouble breathing

• This is not a complete list of possible side effects. If you notice other effects not listed above, request a callback for medical advice. You may also report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

• Before using Rizatriptan, tell your medical provider or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

• Before using this medication, tell your medical provider or pharmacist your medical history, especially of:

  • Blood circulation problems (for example, in your legs, arms/hands or stomach)
  • Certain types of headaches (hemiplegic or basilar migraine)
  • Heart problems (such as chest pain, irregular heartbeat or previous heart attack)
  • Kidney disease
  • Liver disease
  • Seizure
  • Stroke or "mini-stroke" (transient ischemic attack)

• Certain conditions can increase your risk for heart problems. Tell your medical provider if you have any of these conditions, including:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Family history of heart disease
  • Overweight
  • Smoker
  • Postmenopausal (women)
  • Age more than 40 years (men)
• This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your medical provider if you are using marijuana (cannabis).
• This medication may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your medical provider or pharmacist about using this medication safely.
• Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs and herbal products).
• The risk of heart disease, liver disease and high blood pressure increases with age. Older adults may be more sensitive to the side effects of this drug, especially increased blood pressure and heart problems.
• During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your OB/GYN.
• It is unknown if this drug passes into breast milk. Consult your child’s pediatrician or OB/GYN before breastfeeding.

• Drug interactions may change how your medications work or increase your risk for serious side effects.
• This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription and nonprescription drugs and herbal products) and share it with your medical provider and pharmacist.
• Do not start, stop or change the dosage of any medicines without your medical provider's approval.
• This medication can interact with the drugs Propranolol and Bromocriptine.
• Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any MAO inhibitors (Isocarboxazid, Linezolid, Metaxalone, Methylene blue, Moclobemide, Phenelzine, Procarbazine, Rasagiline, Safinamide, Selegiline or Tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your medical provider when to start or stop taking this medication.
• The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as Fluoxetine or Paroxetine, SNRIs such as Duloxetine or Venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
• If you also take any ergotamine medication (such as Dihydroergotamine) or other "triptan" drugs (such as Sumatriptan or Zolmitriptan), you will need to separate your Rizatriptan dose at least 24 hours apart from your dose of these other medications to lessen the chance of serious side effects.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. If symptoms from taking this medication are less severe, call your local poison control center at 1-800-222-1222 right away.

• Do not share this medication with others.
• Certain foods, beverages or food additives (such as red wine, cheese, chocolate and monosodium glutamate) as well as lifestyle patterns such as irregular eating/sleeping habits or stress may bring on a migraine headache. Avoiding these "triggers" may help lessen migraine attacks. Consult your medical provider for more details.
• Lab and/or medical tests (such as blood pressure) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your medical provider for more details.

Not applicable. (See “How to take Rizatriptan” section.)

• Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from 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. Consult your pharmacist or local waste disposal company.