Maxalt Tablets

What are Maxalt Tablets?

Maxalt is a prescription-only tablet used to treat migraine attacks in adults. Its active ingredient is rizatriptan, one of a group of migraine medicines called triptans.

It is licensed to treat the headache phase of a migraine attack, with or without aura. In other words, it is taken once an attack has already begun, and it will not prevent attacks. Maxalt is not a general painkiller and will not help with other kinds of pain.

Maxalt is also available as an orodispersible wafer called Maxalt Melts. 

How Does Maxalt Work for Migraines?

During a migraine attack, blood vessels surrounding the brain are thought to widen, which contributes to headache pain.

Rizatriptan attaches to two types of serotonin receptors, 5-HT1B and 5-HT1D. These sit on blood vessels inside the skull but outside the brain itself, and on the nerves that supply them. Acting on these receptors is thought to narrow those vessels, reduce the release of substances that cause inflammation in sensitive tissue, and reduce the pain signals passing along the nerve.

How Fast Does Maxalt Work?

Maxalt is absorbed quickly. Headache relief can begin as early as 30 minutes after a dose, with rizatriptan levels in the blood reaching their peak in about 1 to 1.5 hours. Taking Maxalt after eating delays absorption by roughly an hour, so it may take longer to take effect if you have recently eaten.

How Effective is Maxalt for Migraines?

Maxalt tablets were assessed in four multicentre, placebo-controlled trials involving more than 2,000 adults. These trials found that two hours after taking a 10mg tablet, between 67% and 77% of people had gone from moderate or severe headache pain to mild pain or none at all. The equivalent figures were 23% to 40% for placebo. Maxalt also reduced how much attacks interfered with normal activities, and eased nausea, light sensitivity and sound sensitivity. It remained effective for menstrual migraine, meaning attacks that begin within three days either side of a period.

A 2024 systematic review and network meta-analysis published in the BMJ compared 17 licensed migraine treatments across 137 trials and 89,445 adults. Rizatriptan was one of four triptans with the best overall profile for pain freedom at two hours, alongside eletriptan, sumatriptan and zolmitriptan. The authors noted that confidence in the individual comparisons ranged from high to very low.

How to Take Maxalt Tablets

Take Maxalt orally and swallow it whole with a liquid. Do not chew or break the tablet. It can be taken after eating, but this may make it take longer to work. As such, it is usually better to take Maxalt on an empty stomach.

Maxalt is to be taken in response to migraine attacks, and should be administered as soon as possible after a migraine has started. Do not take it as a preventative or cautionary measure.

Maxalt is also available as an oral lyophilisate, designed to dissolve in the mouth. It is useful when liquids are not available, or to avoid nausea that may accompany swallowing tablets.

Only take the medication as it is instructed by your clinician. Check with them if you are unsure how to use the treatment safely.

Maxalt Dosage Information

The standard Maxalt dosage is 10mg, but some people may need less. Those with kidney or liver problems, or who are currently taking propranolol, should take the 5mg dosage. If you are taking propranolol, leave at least two hours between taking it and Maxalt.

If your migraine returns within 24-hours, you may take a second dose of Maxalt. Again, leave at least two hours between doses.

You should not take a second dose of Maxalt if the first did not provide relief. Do not take more than two doses of Maxalt in one 24-hour period. If your condition worsens, seek medical attention.

If You Take Too Many Maxalt Tablets

If you accidentally take more Maxalt tablets than advised, contact a doctor or go to A&E straight away. If in person, take your medication with you so they know what you have taken and how much.

Signs of overdosage include dizziness, drowsiness, vomiting, fainting and slow heart rate.

Maxalt Side Effects and Cautions

Like any medication, Maxalt may cause unwanted side effects. You should know what to expect before starting treatment and consider it when deciding what is right for you. You should also know when seeking medical assistance is advisable.

Potential Side Effects of Maxalt Tablets

Here are the common, uncommon and rare side effects of Maxalt:

The table above compiles the recorded and identifiable side effects of Maxalt. Additional side effects for which the frequency cannot be estimated from the available data are listed in the Patient Information Leaflet. You can also report adverse reactions to your clinician or to MHRA via the Yellow Card Scheme.

When to Seek Medical Attention

Symptoms of allergic reactions, serotonin syndrome, heart attack or stroke are all signs that you should seek immediate medical assistance. These include:

• Allergic reactions: Swelling in and around the face and mouth, difficulty breathing, rash
• Serotonin syndrome: Sweating and high temperature, confusion, agitation or anxiety, fast or irregular heartbeat, muscle irregularities
• Heart attack: Chest pain or tightness, shortness of breath, pain spreading to arms, neck or jaw, sweating, nausea, feeling faint
• Stroke: Weakness or numbness in the arms and face, loss of vision, slurred words

Additionally, inform your clinician if you experience symptoms that suggest an allergic reaction after taking Maxalt, such as rashes or swelling.

Maxalt Tablets Warnings and Interactions

Maxalt will not be suitable for everyone. To ensure it is the right medication for you, it is essential to know who can and cannot use it, and how it may be impacted by other medications.

Do not take Maxalt tablets if you:

• Are allergic to rizatriptan benzoate or any of the other ingredients of Maxalt
• Have moderately severe or severe high blood pressure, or mild high blood pressure that is not controlled by medication
• Have or have had heart problems including heart attack or pain of the chest
• Have severe liver or severe kidney problems
• Have had a stroke or a mini-stroke
• Have blockage problems with your arteries

Precautions Before Taking Maxalt

You must inform your clinician before starting Maxalt if:

• You have kidney or liver problems
• You have a particular heartbeat problem (bundle branch block)
• You have or have had allergies
• Your headaches are associated with dizziness, difficulty in walking, lack of coordination or weakness in the leg and arm
• You have experienced allergic reactions such as swelling of face, lips, tongue and/or throat which may cause difficulty breathing and/or swallowing
• You have had short-lived symptoms including chest pain and tightness
• You are taking a herbal preparation containing St John's wort

Additionally, those at risk of heart disease through factors like high blood pressure, diabetes, family history of heart disease, smoking or using nicotine substitution, being a man over 40 or a postmenopausal woman, should speak with your clinician first.

Maxalt Tablets and Other Medicines 

There are a number of other medications that Maxalt can interact with in negative ways. Do not take Maxalt if you are already taking:

• Triptans, or 5-HT1B/1Ds, such as sumatriptan, naratriptan or zolmitriptan
• A Monoamine Oxidase (MAO) inhibitor such as moclobemide, phenelzine, tranylcypromine, linezolid, or pargyline or if it has been less than two weeks since you stopped taking an MAO inhibitor
• Ergotamine-type medications such as ergotamine or dihydroergotamine for migraines
• Methysergide for migraines

For Ergotamine-type medications and Methysergide, you should wait at least 6 hours after taking Maxalt to take them. You should also wait at least 24 hours before taking Maxalt.

Speak to your clinician regarding administration if you are taking propranolol or SSRIs such as sertraline, escitalopram oxalate, and fluoxetine or SNRIs such as venlafaxine and duloxetine for depression.

Tell your clinician about any recently taken medications, including those that do not require prescriptions.

Pregnancy and Breastfeeding

Maxalt has not been shown to increase the risk of birth defects in the first three months of pregnancy, but its effects after this point are not known. Speak to your prescriber before taking it if you are pregnant, think you may be pregnant, or are planning to conceive.

If you are breastfeeding, you may want to wait 12 hours after taking Maxalt before feeding to avoid exposure in the baby.

Frequently Asked Questions About Maxalt 10mg Tablets