Maxalt (rizatriptan) precautions and warnings

There are several precautions and warnings with rizatriptan to be aware of, including potential drug interactions, the risk of a heart attack in some people taking rizatriptan, and the safety of taking this medicine while pregnant. Some of the conditions to let your healthcare provider know about prior to taking rizatriptan include high blood pressure, heart problems, and certain blood vessel conditions. Among the people who should not take this drug are those with untreated high blood pressure and those with a history of heart disease or angina.

You should talk with your healthcare provider prior to taking rizatriptan (Maxalt) if you have:

• Heart problems of any kind, especially a history of heart disease, angina, an irregular heart rhythm, or a heart attack
• High blood pressure (hypertension)
• High cholesterol
• Certain blood vessel conditions, such as peripheral vascular disease, ischemic bowel disease, or Raynaud's phenomenon
• Diabetes
• Kidney problems, including kidney failure (renal failure)
• Liver problems, including liver failure or cirrhosis
• Phenylketonuria
• Depression
• Any allergies, including allergies to foods, dyes, or preservatives.

Also let your healthcare provider know if you:

• Are pregnant or thinking of becoming pregnant
• Are breastfeeding
• Smoke
• Have a family history of heart disease
• Have gone through menopause.

You should also make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Some rizatriptan warnings and precautions to be aware of include:

Rizatriptan has been reported to increase the risk of a heart attack or a life-threatening change in a person's heart rhythm (arrhythmia). You should not take rizatriptan if you have heart disease or a history of a heart attack or chest pain. If you have risk factors for heart disease, it is also strongly recommended that you take your first dose of rizatriptan in your healthcare provider's office. This is so that your healthcare provider can monitor your heart. You should also have your heart checked periodically while taking rizatriptan.

In some cases, a stroke or transient ischemic attack can be misdiagnosed as a migraine. Your healthcare provider should make sure you are not having a stroke, especially if you have never had migraines in the past.

If you have chest pain or tightness in the jaw or neck after taking rizatriptan, contact your healthcare provider immediately. These side effects are fairly common with rizatriptan and are not usually serious. However, your healthcare provider may need to make sure you are not having heart problems.

Medications like rizatriptan can cause blood vessels in the arms, legs, colon (large intestine), and other locations to spasm. This can cause a decrease in blood flow to these areas. Symptoms will vary based on the location. For example, a spasm in the colon can lead to severe abdominal pain (or stomach pain) or bloody diarrhea.

Taking rizatriptan with certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs), can increase your risk of developing a dangerous group of symptoms called serotonin syndrome. Do not use rizatriptan with depression medications without first discussing it with your healthcare provider. Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including: Confusion, hallucinations, A fast heartbeat (tachycardia), Feeling faint, A fever, Sweating, Muscle spasms, Difficulty walking, Diarrhea.

Rizatriptan can cause an increase in blood pressure. You should not take rizatriptan if you have untreated high blood pressure (hypertension).

Rizatriptan may make some people drowsy or dizzy. You should not drive or operate heavy machinery until you know how rizatriptan affects you.

Rizatriptan may not be safe for use during pregnancy. Talk with your healthcare provider before using rizatriptan if you are pregnant. It is not known if rizatriptan passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about this.

Before taking rizatriptan, tell your healthcare provider if you have liver problems (including liver failure or cirrhosis) or kidney problems (including kidney failure). This is important because rizatriptan is removed from the body through the liver and kidneys.

Rizatriptan can interact with certain other medications.

You should not take rizatriptan if you:

• Are allergic to rizatriptan, or any of the inactive components used to make Maxalt.
• Have a history of angina, including stable angina, unstable angina, or variant angina (Prinzmetal's angina).
• Have a history of heart disease or a heart attack.
• Have untreated high blood pressure (hypertension).
• Have hemiplegic or basilar migraines (rare types of migraines involving loss of feeling on one half of the body or pain at the back of the head).
• Have taken ergot medications (e.g. Bromocriptine, Dihydroergotamine, Ergotamine, Pergolide) within the past 24 hours.
• Have taken another triptan medication similar to rizatriptan (e.g. Almotriptan, Eletriptan, Frovatriptan, Naratriptan, Sumatriptan, Zolmitriptan) within that past 24 hours.
• Have taken a monoamine oxidase inhibitor (MAOI) within the past two weeks. Some examples of MAOIs include: Isocarboxazid, Phenelzine, Rasagiline, Selegiline, Tranylcypromine.

There are several situations in which rizatriptan should not be taken, as well as a number of precautions and warnings people should be aware of with rizatriptan. However, it is possible that not all of the warnings or precautions for rizatriptan were discussed in this article. Therefore, you should talk with your healthcare provider about the rizatriptan precautions and warnings that may apply to you.