Uses of Rizagrin: - Acute migraine headache Acute migraine attacks History of MI, peripheral vascular disease, transient ishaemic attack, ischaemic heart disease or Prinzmetal's angina; uncontrolled hypertension; basilar or hemiplegic migraine; severe hepatic or renal impairment. Adolescent <18 yr.

How to use Rizatriptan: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Rizatriptan may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Acute migraine attacks Adult: Initially, 10 mg. If ineffective, 2nd dose should not be taken for the same attack. If symptoms recur after initial response, a further dose of 10 mg may be given. Doses should be separated by at least 2 hr. Max: 20 mg/24 hr. If patient is also taking propanolol, initiate with 5 mg. Max: 10 mg/24 hr. Ensure that the 2 drugs are separated by at least 2 hr. Hepatic Impairment For mild-moderate impairment, initate with 5 mg. Further dose of 5 mg may be taken after an interval of at least 2 hr. Max: 10 mg/24 hr. Avoid in severe impairment. Child Dose: Migraine Headache Acute treatment of migraine with or without aura <6 years: Safety and efficacy not established 6-17 years (<40 kg): 5 mg PO once q24hr 6-17 years: (40 kg or greater): 10 mg PO once q24hr Dosing considerations Efficacy and safety of treatment with more than 1 dose within 24 hours in pediatric patients has not been established 6-17 years (<40 kg) taking propranolol: Do not administer rizatriptan 6-17 years (>40 kg) taking propranolol: Limit dose to 5 mg PO once q24hr as necessary; not to exceed 5 mg/24hr Renal Dose: Renal Impairment For mild-moderate impairment, initate with 5 mg. Further dose of 5 mg may be taken after an interval of at least 2 hr. Max: 10 mg/24 hr. Avoid in severe impairment.

Increased serum concentrations with propranolol. Increased risk of vasospastic reactions when used with ergotamine and methysergide. Concurrent use with SSRIs may increase risk of serotonin syndrome. Potentially Fatal: Concurrent use with or within 2 wk of stopping MAOI treatment.

History of MI, peripheral vascular disease, transient ishaemic attack, ischaemic heart disease or Prinzmetal's angina; uncontrolled hypertension; basilar or hemiplegic migraine; severe hepatic or renal impairment. Adolescent <18 yr.

Common - Dizziness - Dryness in mouth - Heaviness - Jaw pain - Nausea - Neck pain - Sleepiness - Throat pain - Weakness >10% Drowsiness (13-30%, dose related),Fatigue (13-30%, dose related),Dizziness (11-15%) 1-10% Dizziness (4-9%),Somnolence (4-8%),Fatigue (4-7%; dose related),Nausea (4-6%),Asthenia (1-5%),Hot flashes (1-5%),Paresthesia (3-4%),Dry mouth (3%),Chest pain (2-3%),Pain/pressure in chest, neck, throat, jaw (<2%),Headache (<2%),Dyspnea (>1%),Hypoesthesia (>1%),Palpations (>1%),Skin flushing (>1%) <1% Tachycardia,Angioedema,Wheezing,Hypertensive crisis,Bradycardia,Hallucination,Epidermal necrolysis,Hearing impairment,Arrhythmias,Myocardial infarction and coronary artery vasospasm in patients with CAD risk factors Potentially Fatal: Toxic epidermal necrolysis.

Precaution: Elderly; mild to moderate hepatic or renal impairment; coronary artery disease; pregnancy, lactation. May cause drowsiness. History of seizures. Ensure an interval of at least 24 hr after stopping an ergotamine compound and starting a serotonin (5-HT1) agonist. Lactation: Unknown; use with caution in breastfeeding

Rizatriptan is a selective serotonin (5-HT1) agonist in cranial arteries responsible for vasoconstriction and reduction of inflammation associated with antidromic neuronal transmission.