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Rizatriptan

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Rizatriptan
Clinical data
Trade namesMaxalt, Maxalt-MLT, Rizafilm, others
AHFS/Drugs.comMonograph
MedlinePlusa601109
License data
Pregnancy
category
  • AU: B1
Routes of
administration		By mouth
Drug classTriptan
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability45%
Protein binding14%
MetabolismBy monoamine oxidase
Elimination half-life2–3 hours
Excretion82% urine; 12% feces
Identifiers
  • N,N-dimethyl-2-[5-(1H-1,2,4-triazol-1-ylmethyl)-1H-indol-3-yl]ethanamine
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.243.719 Edit this at Wikidata
Chemical and physical data
FormulaC15H19N5
Molar mass269.352 g·mol−1
3D model (JSmol)
  • n1cncn1Cc2cc3c(cc2)[nH]cc3CCN(C)C
  • InChI=1S/C15H19N5/c1-19(2)6-5-13-8-17-15-4-3-12(7-14(13)15)9-20-11-16-10-18-20/h3-4,7-8,10-11,17H,5-6,9H2,1-2H3 checkY
  • Key:ULFRLSNUDGIQQP-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

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]

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 2022, it was the 190th most commonly prescribed medication in the United States, with more than 2 million prescriptions.[7][8]

Medical uses

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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]

Contraindications

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Rizatriptan and other triptans can cause vasoconstriction, they are contraindicated in people with cardiovascular conditions.[11]

Adverse effects

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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]

Interactions

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Mechanism of action

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Further information: Serotonin receptor agonist and Triptan § Mechanism_of_action

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]

Society and culture

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Brand names

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Brand names include Rizalt, Rizalt RPD, Rizact (India), Rizafilm,[2] Maxalt,[1] and Maxalt-MLT.[1][14][15][16]

References

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  1. ^ a b c d e f g "Maxalt- rizatriptan benzoate tablet; Maxalt-MLT- rizatriptan benzoate tablet, orally disintegrating". DailyMed. 1 June 2022. Archived from the original on 23 March 2023. Retrieved 25 December 2023.
  2. ^ a b c d e "Archived copy" (PDF). Archived (PDF) from the original on 2 August 2023. Retrieved 25 December 2023.{{cite web}}: CS1 maint: archived copy as title (link)
  3. ^ a b c d e f "Rizatriptan Benzoate Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 23 October 2020. Retrieved 18 March 2019.
  4. ^ a b British National Formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 473. ISBN 9780857113382.
  5. ^ "Drug Approval Package: Maxalt/Rizatritan Benzoate NDA# 20864 & 20865". U.S. Food and Drug Administration (FDA). 30 March 2001. Archived from the original on 6 December 2022. Retrieved 25 December 2023.
  6. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 531. ISBN 9783527607495.
  7. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  8. ^ "Rizatriptan Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
  9. ^ "Rizatriptan". MedlinePlus. U.S. National Library of Medicine. Archived from the original on 5 July 2016. Retrieved 21 March 2018.
  10. ^ Göbel H (2010). "Efficacy and tolerability of rizatriptan 10 mg compared with sumatriptan 100 mg: an evidence-based analysis". Expert Rev Neurother. 10 (4): 499–506. doi:10.1586/ern.10.24. PMID 20367203. S2CID 43395810.
  11. ^ a b Hargreaves RJ, Lines CR, Rapoport AM, Ho TW, Sheftell FD (2009). "Ten years of rizatriptan: from development to clinical science and future directions". Headache. 49: S3 – S20. doi:10.1111/j.1526-4610.2008.01335.x. PMID 19161563. S2CID 23587019.
  12. ^ Millson DS, Tepper SJ, Rapoport AM (March 2000). "Migraine pharmacotherapy with oral triptans: a rational approach to clinical management". Expert Opinion on Pharmacotherapy. 1 (3): 391–404. doi:10.1517/14656566.1.3.391. PMID 11249525. S2CID 36053513.
  13. ^ a b Wellington K, Plosker GL (2002). "Rizatriptan: an update of its use in the management of migraine". Drugs. 62 (10): 1539–74. doi:10.2165/00003495-200262100-00007. PMID 12093318. S2CID 195693597.
  14. ^ "Rishum01_5_982075622.pdf" (PDF). Mohpublic.z6.web.core.windows.net. Retrieved 21 December 2023.
  15. ^ "Maxalt Oral: Uses, Side Effects, Interactions, Pictures, Warnings & More". WebMD. Archived from the original on 21 December 2023. Retrieved 21 December 2023.
  16. ^ "Rizact 10 mg Tablet - Uses, Dosage, Side Effects, Composition". Practo. Archived from the original on 21 December 2023. Retrieved 21 December 2023.
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