Maxalt (rizatriptan benzoate) is a prescription medication specifically formulated for the acute treatment of migraine headaches with or without aura in adults. It belongs to a class of drugs known as selective serotonin receptor agonists (triptans), which work by narrowing blood vessels around the brain and blocking the release of substances that trigger migraine pain, nausea, sensitivity to light and sound, and other migraine symptoms. This targeted action helps to halt a migraine attack after it has begun, restoring patients to normal function. It is not intended for the prophylactic treatment of migraine or for the management of hemiplegic or basilar migraine. Maxalt represents a significant therapeutic option for those seeking to regain control over their lives from the debilitating effects of migraine.

Features

• Active Ingredient: Rizatriptan benzoate
• Available Formulations: Oral tablets (standard and orally disintegrating - Maxalt-MLT)
• Standard Tablet Strengths: 5 mg and 10 mg
• Orally Disintegrating Tablet (ODT) Strengths: 5 mg and 10 mg
• Rapid Absorption: Designed for quick onset of action
• Selective Mechanism: Binds selectively to serotonin (5-HT1B/1D) receptors

Benefits

• Provides rapid relief from the intense pain of a migraine headache, often within 2 hours for a significant number of patients.
• Effectively reduces or eliminates associated migraine symptoms, including nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia).
• The orally disintegrating tablet (MLT) formulation offers a convenient, water-free option for administration, which is particularly beneficial when nausea is present or access to water is limited.
• Helps patients resume normal daily activities and productivity more quickly by aborting the migraine attack.
• Offers a proven, targeted therapeutic approach for a common neurological condition.

Common use

Maxalt is commonly used at the first sign of a migraine headache. It is most effective when taken early in the course of an attack, during the mild pain phase, though it can be taken at any time. It is not used to prevent migraines from occurring. Patients use Maxalt to treat the discrete episode of a migraine, seeking to reverse the cranial vasodilation and neurogenic inflammation that characterize an attack. It is intended for use only when a clear diagnosis of migraine has been established.

Dosage and direction

The recommended dose is either 5 mg or 10 mg. For most patients, the 10 mg dose is the preferred starting dose. If the headache returns, a second dose may be taken after at least 2 hours have passed since the first dose. The maximum dose in a 24-hour period should not exceed 30 mg. The tablets should be taken whole with water. The orally disintegrating tablets (Maxalt-MLT) are placed on the tongue, where they disintegrate rapidly and are swallowed with saliva; no liquid is needed. Do not break the orally disintegrating tablet blister pack until ready to use.

Precautions

Prior to using Maxalt, patients must discuss their full medical history with their healthcare provider, especially pertaining to heart, liver, or kidney disease, blood circulation problems, strokes or TIAs, uncontrolled hypertension, or phenylketonuria (for the MLT formulation, which contains phenylalanine). This medication may cause dizziness or drowsiness; patients should not drive or operate machinery until they know how Maxalt affects them. It should not be used in patients with risk factors for heart disease unless a cardiovascular evaluation provides satisfactory results. Use is generally not recommended in patients aged over 65, as this population may have a higher risk of adverse cardiovascular events.

Contraindications

Maxalt is contraindicated in patients with:

• Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction, or documented silent ischemia)
• Coronary artery vasospasm, including Prinzmetal’s angina
• History of stroke or transient ischemic attack (TIA)
• Peripheral vascular disease
• Ischemic bowel disease
• Uncontrolled hypertension
• Hemiplegic or basilar migraine
• Severe hepatic impairment
• Hypersensitivity to rizatriptan or any component of the formulation
• Concurrent administration or within 24 hours of use of another 5-HT1 agonist (e.g., another triptan) or ergotamine-containing medication
• Concurrent administration or within 2 weeks of discontinuation of MAO-A inhibitors

Possible side effect

Like all medications, Maxalt can cause side effects, although not everybody gets them. Common side effects may include:

• Dizziness
• Drowsiness/sedation
• Fatigue/tiredness
• Pain or pressure sensation in the chest, neck, throat, or jaw (non-cardiac)
• Nausea
• Dry mouth Less common but serious side effects require immediate medical attention. These include:
• Symptoms of a heart attack (e.g., chest/jaw/left arm pain, shortness of breath)
• Symptoms of a stroke (e.g., sudden numbness/weakness, confusion, trouble speaking, vision problems)
• Severe stomach pain or bloody diarrhea
• Significant rise in blood pressure
• Serotonin syndrome (agitation, hallucinations, fever, fast heart rate, muscle stiffness, nausea)

Drug interaction

Maxalt has the potential for significant drug interactions. It is crucial to inform your doctor of all medications you are taking, including prescription, over-the-counter, and herbal products.

• MAO Inhibitors: Contraindicated. Do not use Maxalt within 2 weeks of taking an MAO-A inhibitor (e.g., phenelzine, tranylcypromine).
• Other Triptans and Ergotamines: Contraindicated. Do not use within 24 hours of another triptan (e.g., sumatriptan, zolmitriptan) or ergot-type medication (e.g., dihydroergotamine, ergotamine).
• Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Concomitant use may increase the risk of serotonin syndrome. This includes medications like fluoxetine, paroxetine, sertraline, citalopram, venlafaxine, and duloxetine.
• Propranolol: Concurrent use increases the plasma concentration of Maxalt. A 5 mg dose of Maxalt is recommended for patients taking propranolol, with a maximum of 3 doses in 24 hours (15 mg total).

Missed dose

Maxalt is not taken on a scheduled basis; it is used only to treat an acute migraine attack as needed. Therefore, the concept of a “missed dose” does not apply. Simply take one tablet at the onset of your next migraine headache, following the dosage instructions.

Overdose

In cases of overdose, symptoms could include severe dizziness, drowsiness, fainting, slow heart rate, vomiting, and loss of coordination. There is also a theoretical increased risk of more serious cardiovascular events or serotonin syndrome. If an overdose is suspected, contact a poison control center or emergency room immediately. Treatment of overdose should consist of supportive care, including continuous ECG monitoring for at least 24 hours and general symptomatic treatment.

Storage

Store Maxalt tablets at room temperature between 20°C to 25°C (68°F to 77°F), in a dry place, protected from light and moisture. Keep the orally disintegrating tablets in their original blister package until immediately before use. Keep all medications out of the reach of children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided may not cover all possible uses, directions, precautions, drug interactions, or adverse effects.

Reviews

• “As a long-time migraine sufferer, Maxalt has been a game-changer. The ODT version is a lifesaver when I’m too nauseous to swallow a pill with water. It typically starts working within 45 minutes for me, allowing me to get back to my workday.” – Sarah K., 42
• “I was skeptical after other medications failed, but my neurologist recommended Maxalt. The 10mg dose effectively relieves my pain about 80% of the time. I do experience some drowsiness afterward, so I plan to rest for an hour after taking it.” – Michael T., 35
• “It works quickly, but the chest tightness I sometimes feel is unsettling. I’ve discussed this with my doctor, and he assured me it’s a known, typically benign side effect. The trade-off for pain relief is worth it for me, but it’s something to be aware of.” – Jennifer L., 50
• “The efficacy is reliable. I keep a dose in my purse and my desk at all times. For me, the key is taking it at the very first hint of a headache. If I wait too long, it’s less effective.” – David R., 29