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This document outlines crucial safety information and warnings regarding the use of rizatriptan (Maxalt). It is essential to carefully consider these points and discuss any concerns with your healthcare provider.

• Cardiovascular Concerns: Although uncommon, serious heart issues, including heart attacks and irregular heart rhythms, have been reported shortly after taking rizatriptan. Additionally, this medication may elevate blood pressure, sometimes to hazardous levels. Individuals with a history of cardiovascular or vascular problems should consult their healthcare provider before use. Regular monitoring of blood pressure is advised, and any significant increase should be reported. Seek immediate medical attention if you experience symptoms like heart attack, severe headache, chest pain, or irregular heartbeat. Elevated risk is noted in those with heart conditions, individuals over 65, diabetic patients, obese individuals, those with high blood pressure, and tobacco users.

• Stroke and Brain Injury: There is a risk of life-threatening strokes or cerebral bleeding associated with triptans like rizatriptan. Symptoms can mimic migraines, such as sudden weakness, severe headaches, facial drooping, breathing difficulties, or speech and vision changes. Rizatriptan should not be used by individuals with a history of strokes. If you experience stroke symptoms, discontinue use and seek emergency medical care, particularly if migraine symptoms are new.

• Blood Vessel Constriction: Rizatriptan can cause severe narrowing of blood vessels, potentially leading to severe gastrointestinal issues, visual disturbances, and sensory changes in extremities. If such symptoms occur, cease medication use and consult a healthcare provider for further evaluation.

• Overuse and Dosage: Exceeding the recommended dosage of rizatriptan can reduce its effectiveness and may result in more frequent or severe migraine episodes. Notify your healthcare provider if you use migraine medications on more than nine days a month or experience more than four migraines monthly while on rizatriptan. They may suggest alternative treatments.

• Serotonin Syndrome: A rare but serious condition, serotonin syndrome, may develop when rizatriptan is combined with other medications that increase serotonin levels, such as certain antidepressants and pain medications. Be aware of this risk if you are taking such medications.

• Phenylketonuria (PKU) Caution: The orally disintegrating tablets of rizatriptan contain phenylalanine, a risk for individuals with PKU. Inform your healthcare provider if you have PKU to ensure a suitable formulation is prescribed.

Contraindications:

• Do not use rizatriptan if you have coronary artery disease, coronary artery vasospasm, a history of stroke or transient ischemic attack, history of hemiplegic or basilar migraines, peripheral vascular disease, ischemic bowel disease, or uncontrolled high blood pressure.
• Avoid if you have used ergot-type medications or other triptans within the last 24 hours.
• Do not take rizatriptan if you are currently using or have used a monoamine oxidase inhibitor (MAOI) in the past 14 days.

Please consult your healthcare provider for any questions or if any of the conditions apply to you.

Common side effects:

• dizziness
• sleepiness
• tiredness
• nausea
• tingling or prickling sensation
• dry mouth
• headache
• feelings of pressure in the chest or throat

Serious side effects:

• chest pain
• irregular heartbeat
• symptoms resembling a heart attack
• signs of a stroke
• serotonin syndrome
• severe allergic reactions

Interactions with high risk of serious adverse effects and should be avoided:

• Isocarboxazid
• Linezolid
• Methylene Blue
• Phenelzine
• Tranylcypromine
• Other MAO inhibitors (e.g., moclobemide, procarbazine, Rasagiline, safinamide, Selegiline)
• MDMA
• St. John's wort
• Fluoxetine
• Paroxetine
• Duloxetine
• Venlafaxine
• Sumatriptan
• Zolmitriptan
• Ergotamine
• Dihydroergotamine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Almotriptan
• Bromocriptine
• Eletriptan
• Ergoloid Mesylates
• Ergonovine
• Frovatriptan
• Naratriptan
• Methylergonovine
• Methysergide
• Propranolol
• Amitriptyline
• Amphetamine
• Benzhydrocodone
• Benzphetamine
• Buprenorphine
• Butorphanol
• Citalopram
• Codeine
• Desvenlafaxine
• Dextroamphetamine
• Dihydrocodeine
• Dolasetron
• Escitalopram
• Fenfluramine
• Fentanyl
• Fluvoxamine
• Granisetron
• Hydrocodone
• Hydromorphone
• Lasmiditan
• Levomilnacipran
• Levorphanol
• Lisdexamfetamine
• Lithium
• Lorcaserin
• Meperidine
• Metaxalone
• Methadone
• Methamphetamine
• Milnacipran
• Mirtazapine
• Morphine
• MorphineSulfate Liposome
• Nalbuphine
• Nefazodone
• Ondansetron
• Oxycodone
• Oxymorphone
• Palonosetron
• Pentazocine
• Reboxetine
• Remifentanil
• Sertraline
• Sibutramine
• Sufentanil
• Tapentadol
• Tramadol
• Trazodone
• Vilazodone
• Vortioxetine
• Ziprasidone