Maxalt (also referred to the generic Rizatriptan Benzoate) is the firs-line therapy for the acute migraine attacks. Belonging to the serotonergic class of drugs, Maxalt selectively activates 5-НТ1B/1D serotonin receptors. Put it medically, Rizatriptan is a 5-HT1 agonist.
Mechanism of action
Rizatriptan inhibits the release of neuropeptides what results in the narrowing of intracranial blood vessels which got wider during a migraine attack. The antimigraine effect is achieved in 30 minutes after intake.
Maxalt is indicated to relieve the symptoms of a migraine with/without aura.
Maxalt and Rizatriptan are contraindicated for patients suffering from:
- Angina pectoris;
- Arterial hypertension;
- Basilar migraine;
- Cardiac infarction;
- Coronary insufficiency;
- Hemiplegic migraine;
- Hypertension syndrome;
- Individual intolerance to the drug or its components;
- Ischemic bowel disease;
- Peripheral artery disease;
- Prinzmetal angina pectoris;
- Recent history of stroke;
- Recognized asymptomatic ischemic heart disease;
- Suspected coronary artery disease.
Use in pregnancy and breastfeeding
Maxalt is not recommended for pregnant women as there is no clinical evidence of Rizatriptan safety for an unborn child.
Maxalt is not known to excrete in human milk. However, there are many medicines that can excrete in human milk so that nursing women are advised to take Maxalt only under medical supervision.
Dosage and administration
The drug is available in a form of orally dissolving 5 mg tablets. For adults over 17, Maxalt is recommended at the dose not higher than 10 mg a day; the evident therapeutic effect is also achieved at the lower dose of 5 mg.
If an acute migraine does not subside, the second dose of Maxalt or Rizatriptan might only be administered in 2 hours. The maximum daily use of Maxalt or its generics must not exceed 30 mg. Maxalt is not recommended to be used more than 10 days in a row.
The drug is taken with or without water once acute migraine symptoms occur.
High-fat meal delays the Maxalt absorption. The simultaneous use of ethanol is not advised as the medication causes a significant increase in arterial blood pressure while alcohol induces a drop in pressure what may lead to severe adverse events including dead faint.
Nervous system and sense organs
Dizziness, headache, drowsiness or insomnia, weakness, fatigue, mental activity impairment, disorientation, anxiety, paresthesia, hyperesthesia, blurred vision.
Elevation of arterial blood pressure, heart hurry, face reddening, chest tightness.
Dry mouth, vomiting, diarrhea, nausea, indigestion, paraglossa.
Muscle weakness, the rigidity of muscles, tremor, stiffness, ataxia.
Skin itching, hyperemia, scalded skin syndrome.
Thirst, pain in throat, neck, and stomach, excessive sweating, shortness of breath, faintness.
Severe interactions are potent if Maxalt is concomitantly taken with:
- MAO inhibitors (the Maxalt treatment is only possible in 2 weeks after the last dose of any MAO inhibitor);
- Other 5-HT1 agonists;
- Ergotamine-type medications;
- Any antidepressants;