Rizatriptan

What is Rizatriptan Used For?

Rizatriptan is a prescription medication used to treat acute migraine attacks, with or without aura. It contains the active ingredient rizatriptan benzoate and belongs to a group of medicines called triptans, which are specifically designed to relieve migraine symptoms once an attack has started. Rizatriptan does not prevent migraines from happening, but it can significantly reduce headache pain and associated symptoms such as nausea, sensitivity to light, and sensitivity to sound when taken early during an attack. 

In the UK, Rizatriptan is commonly prescribed as tablets or orodispersible wafers. It is considered an effective option for people who experience moderate to severe migraines. Triptans are not similar to painkillers such as ibuprofen and paracetamol, since they work to target migraine-specific pathways when an attack occurs, rather than just reducing pain. 

How Does Rizatriptan Work?

Rizatriptan only becomes effective once a migraine attack is in progress. It is not meant as a preventative measure. During a migraine, blood vessels in the brain widen and release chemical signals that cause pain, nausea, and sensitivity to light or sound. Rizatriptan works by attaching to specific receptors (5-HT1B and 5-HT1D) in the brain and mimicking the effects of the neurotransmitter serotonin, helping to narrow widened blood vessels and return them to a more normal size. 

At the same time, the treatment reduces the release of substances that trigger symptoms such as throbbing pain, nausea, and light sensitivity. It also blocks pain signals from reaching the brain. Rizatriptan is most effective when taken as soon as migraine symptoms begin, rather than waiting until the pain becomes severe.

How Effective is Rizatriptan?

Rizatriptan is a widely studied treatment for migraine, with strong evidence supporting its effectiveness. Large clinical trials have shown that rizatriptan provides rapid and meaningful relief for many people experiencing migraine attacks. 

Key findings from major studies include:

• High success rates: Research shows that the 10 mg dose provides significant pain relief for approximately 70% of users within two hours. This is much more effective than a placebo, which typically only helps about 25-30% of the time.
• Patient Preference: In studies where people tried different migraine medications for separate attacks, a significant majority preferred rizatriptan. This preference is usually due to how quickly the medication works and how reliably it relieves migraines every time they start.

These studies show that rizatriptan is a highly effective and reliable option for stopping migraine attacks. When taken as soon as a migraine begins, it offers a predictable and rapid path to feeling better.

How Long Does Rizatriptan Take to Work?

Comparative studies have demonstrated that rizatriptan often begins to work faster than other common treatments, such as sumatriptan. Many people notice their pain starting to fade in as little as 30 to 60 minutes, allowing them to return to their daily activities sooner.

Rizatriptan Prescription Criteria

Rizatriptan is prescribed to adults diagnosed with migraine, with or without aura. It is suitable for people whose migraines do not respond adequately to simple painkillers. It is not recommended for individuals with certain heart or circulation conditions, or for those with uncontrolled high blood pressure. 

It's important to note that Rizatriptan tablets and Rizatriptan orodispersible wafers are prescribed only for migraine headaches and no other variations. The medication is not suitable as a preventative measure and should solely be used after a migraine begins.

Rizatriptan Warnings

While Rizatriptan is an effective treatment for migraines, it may not be suitable for everyone. Understanding the following Rizatriptan warnings can help you determine whether the treatment is appropriate for your circumstances.

The treatment is unsuitable if you:

• Have high blood pressure
• Are allergic to the active ingredient or any other ingredients in the medication
• Have severe liver disease or severe kidney problems
• Have had a stroke or heart attack, or exhibited any signs of heart issues
• Are taking monoamine oxidase inhibitor (MAOI) treatments
• Are taking any other 'triptan' medications or migraine treatments
• Are taking methysergide to prevent a migraine attack
• Have reduced blood flow to your legs and arms due to blocked arteries (peripheral vascular disease)
• Are taking ergotamine-type medicines, such as dihydro-ergotamine
• Are taking any other medications in the same class as Rizatriptan, such as  sumatriptan or zolmitriptan

You should also consult a GP or other healthcare professional before taking Rizatriptan for migraines if you:

• Are at a high risk of developing heart disease or have issues with heart rhythm
• Experience dizziness or poor coordination, as well as your migraine headache
• Take St John's Wort
• Feel a tightening of the chest
• Are using serotonin-norepinephrine reuptake inhibitor (SNRI) or selective serotonin reuptake inhibitor (SSRI) treatments
• Have a history of severe allergic reactions

A full list of Rizatriptan warnings and contraindications is available in the Patient Information Leaflet, which you should read before taking any new medication. 

How Do You Take Rizatriptan?

Rizatriptan should be taken as soon as you notice your migraine headache has started. It’s designed to stop a migraine once it has begun, rather than being taken daily to prevent attacks. If your migraine improves but later returns, you may take a second dose after a suitable interval.

To take Rizatriptan orodispersible melts, first peel back the foil to access it; don't try to push it through the packaging. Ensure your hands are clean and dry before handling. Do not split or crush the wafer, and place it directly on your tongue. Let it dissolve naturally on your tongue; there's no need to take it with water. It may be preferable to take it on an empty stomach to help with absorption.

Conventional Rizatriptan tablets should be swallowed whole with water. The pills can be taken with or without food; however, absorption may be slower if taken after a meal.

It's important to note that Rizatriptan is intended to treat one migraine episode at a time. You should not take Rizatriptan to treat a second, separate migraine attack before the first one has clearly ended, and it should not be taken on days when you do not have migraine symptoms.

Rizatriptan Dosage for Migraines

The usual Rizatriptan dosage for migraines is 10 mg, taken at the start of a migraine attack. If the first dose provides some relief, a second dose may be taken after at least 2 hours, only if symptoms return. The maximum recommended dose is 20 mg in 24 hours.

Rizatriptan works best if taken at the onset of a migraine headache, but it can also be effective if used later on. If you do not respond positively to the initial dose, do not take a second one. Instead, it’s recommended that you speak to a healthcare professional for further advice.

If you are currently taking propranolol or have kidney or liver problems, a 5 mg dose of Rizatriptan should be used. Leave at least 2 hours between taking propranolol and  Rizatriptan, up to a maximum of 2 doses within a 24-hour period.

Do not take more than 2 doses of Rizatriptan in a 24-hour period (no more than 2 doses of 10 mg OR 5 mg in this timeframe). If you think you have taken too much of the treatment, consult a healthcare professional immediately. 

Rizatriptan Side Effects

Like all medications, Rizatriptan orodispersible wafers and conventional tablets can cause side effects, though some people may not experience anything. Here are some potential Rizatriptan side effects to be aware of:

The above table is not an exhaustive list of potential Rizatriptan side effects. More information is available in the Patient Information Leaflet. If you are concerned about any of the symptoms listed here, consult a medical professional before taking the treatment.

How to Buy Rizatriptan in the UK

You can buy Rizatriptan tablets and orodispersible wafers in the UK from a physical or online pharmacy, such as Prescription Doctor, after a consultation with a GP or clinician to determine whether the treatment is suitable for your circumstances and medical history.

Can You Buy Rizatriptan Online?

Yes, you can buy Rizatriptan online from reputable pharmacies like Prescription Doctor. You will first need to complete a questionnaire covering your medical history and any other treatments you may be taking. These details are then reviewed by a clinician to determine if the medication is suitable for you. 

If your order is approved by our experienced clinicians, the medication is dispatched from our General Pharmaceutical Council-registered pharmacy in discreet packaging. Orders approved before 3pm on a weekday are also eligible for next-day delivery. An alternative treatment may be recommended if Rizatriptan is not right for your circumstances.

Can You Buy Rizatriptan Over the Counter in the UK?

No, you cannot buy Rizatriptan over the counter in the UK. This is because the treatment is classified as a prescription-only medicine (POM). You can obtain a prescription for Rizatriptan from a GP or an online pharmacy after completing a consultation.

Is Rizatriptan on the NHS?

Yes, Rizatriptan is available on the NHS. Sumatriptan 50mg/100mg tablets are usually the first-line choice for acute migraine attacks, but other medications, such as Rizatriptan, Naratriptan, and Almotriptan, may be offered if Sumatriptan is unsuitable or has not been effective in treating your migraines.