Tab%2520rizatriptan

# Tab Rizatriptan ## Overview Rizatriptan is a selective 5-HT1B/1D receptor agonist (triptan) used for acute treatment of migraine with or without aura. Available as oral tablets and orally disintegrating tablets (ODT). Not for prophylaxis. ## Primary Indications - Acute treatment of migraine headache in adults and pediatric patients ≥6 years. ## Adult Dosing - **Initial**: 5 mg or 10 mg orally at onset of migraine. - **Maximum single dose**: 10 mg. - **Maximum daily dose**: 30 mg (within 24 hours). Do not exceed 3 doses in 24 hours. - **Repeat dosing**: If headache returns after initial relief, may repeat after ≥2 hours. ## Pediatric Dosing (≥6 years, weight ≥20 kg) - **Weight 20–39 kg**: 5 mg orally once. May repeat after ≥2 hours. Maximum daily: 10 mg. - **Weight ≥40 kg**: 10 mg orally once. May repeat after ≥2 hours. Maximum daily: 20 mg. - Safety and efficacy for patients <6 years not established. ## Dose Adjustments - **Hepatic impairment (severe)**: Not recommended. - **Renal impairment**: No adjustment needed for mild-moderate; avoid in severe (CrCl <30 mL/min) as safety not established. - **Concomitant propranolol**: Reduce initial dose to 5 mg. Maximum single dose 5 mg, maximum daily 15 mg (adults). Pediatric: avoid or use 5 mg if weight ≥40 kg, not recommended <40 kg. ## Contraindications - History of ischemic heart disease, coronary artery spasm, cerebrovascular disease, peripheral vascular disease. - Uncontrolled hypertension. - Hemiplegic or basilar migraine. - Concurrent use of ergot derivatives, other triptans, or MAO inhibitors (within 2 weeks). - Severe hepatic impairment or severe renal impairment. ## Adverse Effects - **Common**: Dizziness, somnolence, fatigue, nausea, paresthesia, dry mouth. - **Serious**: Serotonin syndrome (especially with SSRIs/SNRIs), cardiac ischemia, arrhythmia, stroke, hypertensive crisis. - **Rare**: Hypersensitivity reactions, seizures. ## Key Drug Interactions - **MAO inhibitors (within 2 weeks)**: Contraindicated. - **Propranolol**: Increases rizatriptan plasma levels (dose adjustment required). - **Ergotamine/other triptans**: Increased risk of vasospasm; do not use within 24 hours. - **SSRIs/SNRIs**: Increased risk of serotonin syndrome; monitor. ## Monitoring - Assess cardiovascular risk before first use (especially in patients with multiple risk factors). - Monitor for signs of serotonin syndrome when used with serotonergic drugs. - Periodic reassessment of need for acute migraine therapy (avoid medication-overuse headache). ## Clinical Pearls - ODT can be taken without water; dissolves on tongue. - Onset of action: ~30 minutes; may be more effective if taken early in migraine. - Do not use for migraine prophylaxis. - If no response to first dose, do not repeat for same attack; consider other therapy. - Avoid more than 10 doses per month to prevent medication-overuse headache. - Pediatric dosing based on weight is critical; use oral tablet only (ODT not FDA-approved for children <18 years but may be used off-label per guidelines). **Disclaimer**: This information is for educational purposes only. Always verify current prescribing information from the manufacturer’s label and your local formulary. Dosing may vary based on local protocols and patient-specific factors.