Rizatriptan, sold under the brand name Maxalt among others, is a medication used for the treatment of migraine headaches.[1][3] It is taken by mouth.[1][3] It can also be applied on the tongue.[2] It is a serotonin (5-HT) 1B/1D receptor agonist (triptan).[1][2]
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Trade names | Maxalt, Maxalt-MLT, Rizafilm, others |
AHFS/Drugs.com | Monograph |
MedlinePlus | a601109 |
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Routes of administration | By mouth |
Drug class | Triptan |
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Bioavailability | 45% |
Protein binding | 14% |
Metabolism | By monoamine oxidase |
Elimination half-life | 2–3 hours |
Excretion | 82% urine; 12% feces |
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ECHA InfoCard | 100.243.719 |
Chemical and physical data | |
Formula | C15H19N5 |
Molar mass | 269.352 g·mol−1 |
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Common side effects include chest pain, dizziness, dry mouth, and tingling.[3] Other side effects may include myocardial infarction, stroke, high blood pressure, serotonin syndrome, and anaphylaxis.[3] Excessive use may result in medication overuse headaches.[3] Use is not recommended during pregnancy and breastfeeding is not recommended within 24 hours after taking a dose.[4] Rizatriptan is in the triptan class and is believed to work by activating the 5-HT1 receptor.[3]
Rizatriptan was patented in 1991 and came into medical use in 1998.[5][6] It is available as a generic medication.[4] In 2021, it was the 159th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[7][8]
Rizatriptan is indicated to treat acute migraine attacks with or without aura.[1][2] It does not prevent future migraine attacks.[9] A 2010 review found rizatriptan to be more efficacious and tolerable than sumatriptan.[10]
Rizatriptan and other triptans can cause vasoconstriction, they are contraindicated in people with cardiovascular conditions.[11]
Frequent adverse effects (incidence less than 10%) are dizziness, drowsiness, asthenia/fatigue, and nausea. Clinical adverse experiences were typically mild and short-lasting (2–3 hours).[11]
Rizatriptan acts as an agonist at serotonin 5-HT1B and 5-HT1D receptors.[13] Like the other triptans sumatriptan and zolmitriptan, rizatriptan induces vasoconstriction—possibly by inhibiting the release of calcitonin gene-related peptide from sensory neurons in the trigeminal nerve.[13]
Brand names include Rizalt, Rizalt RPD, Rizact (India), Rizafilm,[2] Maxalt,[1] and Maxalt-MLT.[1][14][15][16]
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