Maxalt® (rizatriptan benzoate)

Maxalt® (rizatriptan benzoate) is a selective 5-HT1B/1D receptor agonist (triptan) indicated for the acute treatment of migraine, with or without aura, in adults and in children ages 6 to 17 who have a clear migraine diagnosis. It comes in 2 tablet forms, one that is swallowed and one that dissolves in the mouth. The tablets come in 5 mg and 10 mg dosages.

Maxalt generally works within 2 hours. It is intended to reduce acute migraine symptoms of migraine attackss that have already begun. It should not to be used as a prophylactic therapy to prevent the onset of migraine or to treat cluster headaches.

Overuse of acute migraine drugs can cause medication overuse headaches. Overuse is considered dosing on more than 10 days per month. Symptoms of overuse may need to be treated, and detoxification from migraine medications may be required.

What are the ingredients in Maxalt?

The active ingredient in Maxalt is rizatriptan benzoate.

How does Maxalt work?

Maxalt works by binding with 5-HT1B/1D receptors on blood vessels in the brain. It narrows the blood vessels (constriction) in the brainstem. It also reduces inflammatory substances in the body that can trigger head pain, nausea, sensitivity to light and sound, and other migraine symptoms. Maxalt works best if it is taken as soon as migraine symptoms appear.

What are the possible side effects of Maxalt?
Many clinical trials evaluated the safety and efficacy of Maxalt. The most common side effects experienced by those taking Maxalt include:

  • Pain or tight feeling in the chest, throat, jaw, or neck
  • Feeling weak, drowsy, or tired
  • Pressure or heavy feeling in any part of your body
  • Numbness or tingling in the fingers or toes
  • Feeling hot or cold in the extremities
  • Nausea

This is not an exhaustive list of all potential side effects of Maxalt. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Maxalt, contact your doctor or healthcare provider immediately.

Things to note about Maxalt

Maxalt comes in 2 forms, including a tablet swallowed whole and taken with liquids. The other, Maxalt -MLT Orally Disintegrating Tablets dissolve in the mouth. Before starting Maxalt talk with your doctor if you:

  • Have a history of hypersensitivity to rizatriptan benzoate
  • Have a history of coronary artery disease (CAD), angina or heart attacks
  • Have a history of high blood pressure or high cholesterol
  • Have a history of hemiplegic or basilar migraine
  • Have a history of stroke, transient ischemic attacks (TIAs), or circulatory problems
  • Have a history of peripheral vascular disease (circulation problems)
  • Have a history of ischemic bowel disease
  • Have taken a ergot-containing medication or triptan within the 24 hours prior to migraine
  • Have taken a MAO-A inhibitor within 2 weeks prior to your migraine
  • Take anti-depressant medicines including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs)
  • Have severe hepatic (liver) impairment
  • Have severe renal (kidney) problems
  • Are pregnant or planning to get pregnant, as there is limited information on the use of Maxalt in pregnancy. It should be used only if the potential benefit of Maxalt therapy exceeds risk to the fetus.

Individuals with the above conditions should be monitored closely while taking Maxalt.

If there is no response to the first migraine attack treated with the Maxalt, a physician should reconsider the migraine diagnosis prior to using the medication in any subsequent attacks.

A cardiovascular evaluation should be performed on patients who have never taken a triptan medication but who have multiple cardiovascular risk factors (e.g., increased age, diabetes, hypertension, smoking, obesity, strong family history of CAD) before starting Maxalt. For those with a cardiac history, the first dose of Maxalt should be administered in a medically supervised setting, and an electrocardiogram (ECG) should be performed immediately following the dose.

Dosing Information

Maxalt tablets are taken by mouth with water or other liquids. Adults take a 5 mg or 10 mg single dose; repeated doses can be taken separated by least two hours. The maximum adult dose in a 24-hour period is 30 mg. Children from age 6 to 17 weighing less than 88 pounds take a 5 mg single dose; those 88 pounds or more can take 10 mg. The maximum dose for children is a single dose.

A physician will determine the appropriate dose for each patient. If only partial migraine relief is attained or symptoms return quickly, a second dose may be taken 2 hours after the first (except for children).

Keep track of when you have migraine attacks and when you take Maxalt so you can monitor its effectiveness, and communicate with your doctor about how the medication is working for you.

For additional details, read the full prescribing information of Maxalt.

Written by: Linda Saxl Minton | Last reviewed: June 2018.
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