Rizact tablets should not be used within 24 hours of treatment with another 5-ht 1 agonist, or an ergotamine-containing or ergot-type medication like dihydroergotamine or methysergide.
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Doses of RIZACT Tablets should be separated by at least 2 hoursno more than 30 mg should be taken in any 24-hour periodThe safety of treatingon averagemore than four headaches in a 30-day period has not been established.
Rizatriptan should be used with caution in patients with moderate hepatic impairment due to an increase in plasma concentrations of approximately 30For a given attackif a patient has no response to the first dose of rizatriptanthe diagnosis of migraine should be reconsidered before administration of a second dose.
Cytochrome P450 isoformsRizatriptan is not an inhibitor of the activities of human liver cytochrome P450CYP450isoforms3A4/51A22C92C19 or 2E1rizatriptan is a competitive inhibitorKi=1,400 nMof CYP450 2D6but only at highclinically irrelevant concentrations.
As with other 5-HT1 agonistssensations of tightnesspainpressureand heaviness in the precordiumthroatneck and jaw commonly occur after treatment with rizatriptan and are usually noncardiac in originHoweverif a cardiac origin is suspectedpatients should be evaluatedPatients shown to have CAD and those with Prinzmetal’s variant angina should not receive 5-HT1 agonists.
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