Rizatriptan
Mechanism :
Selective agonist for serotonin (5-HT1B and 5-HT1D receptors) in cranial arteries.
Indication :
- Acute treatment of migraine with or without aura
Contraindications :
Hypersensitivity to rizatriptan or any component of the formulation; documented ischemic heart disease or other significant cardiovascular disease, history of stroke or transient ischemic attack; peripheral vascular disease; ischemic bowel disease; uncontrolled hypertension; basilar or hemiplegic migraine; during or within 2 weeks of MAO inhibitors; during or within 24 hours of treatment with another 5-HT1 agonist, or an ergot-containing or ergot-type medication.
Dosing :
Use in children 6 years and above.
<40 kg:
5 mg PO as a single dose.
≥40 kg:
10 mg PO as a single dose.
Adverse Effect :
Dizziness, drowsiness, fatigue, paresthesia, nausea, xerostomia, chest pain, flushing, palpitations, weakness, jaw pain, pharyngeal edema.
Interaction :
Antiemetics (5HT3 Antagonists): May enhance the serotonergic effect of Serotonin Modulators resulting in serotonin syndrome.
Antipsychotic Agents: Serotonin Modulators may enhance the adverse/toxic effect of Antipsychotic Agents.
Ergot Derivatives: May enhance the vasoconstricting effect of Serotonin 5-HT1D Receptor Agonists.
Monoamine Oxidase Inhibitors: May decrease the metabolism of Serotonin 5-HT1D Receptor Agonists.
Opioid Analgesics: May enhance the serotonergic effect of Serotonin Modulators.
Propranolol: May increase the serum concentration of Rizatriptan.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Use with caution 5 mg, repeated after 2 hours; maximum 15 mg daily |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Dose as in GFR<10 mL/min |
| HD | Unknown dialysability. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GR=10–20 mL/min |
Hepatic Dose :
Dose adjustment guidelines are not available, however in moderate to severe hepatic impairment the concentration can go up by 30% therefore use caution when administering, and monitor closely.