Rizatriptan Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Migraine

For the acute treatment of a migraine attack: (Note: rizatriptan should not be used in patients with basilar or hemiplegic migraine.)
5-10 mg orally once. Tablets are available either as orally disintegrating tablets or as tablets designed to be swallowed.

The 10 mg dose may provide a greater effect than the 5 mg dose.

Doses should be separated by at least 2 hours.

Renal Dose Adjustments

In patients with renal impairment (CrCl 10-60 mL/min), the AUC of rizatriptan was not significantly different from that in healthy subjects.

Liver Dose Adjustments

Hepatic impairment from mild to moderate alcoholic cirrhosis of the liver produced plasma concentrations similar in patients with mild hepatic insufficiency compared to a control group of healthy subjects. Plasma concentrations were approximately 30% greater in patients with moderate hepatic insufficiency. Reduction of dosing to 5 mg with no more than 10 mg in a 24-hour period is advisable in patients with moderate hepatic impairment. Usage in severe hepatic impairment is not recommended.

Precautions

Rizatriptan should not be administered to patients with a history, signs, or symptoms of ischemic cardiac, cerebrovascular, or peripheral vascular syndromes. Because rizatriptan may increase blood pressure, this drug should not be administered to patients with uncontrolled hypertension.

Rizatriptan should be used with caution in patients with moderate hepatic insufficiency due to an increase in plasma concentrations of approximately 30%. The drug should be administered with extreme caution if it to be used at all to patients with severe hepatic dysfunction.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Rizatriptan should be used with caution in dialysis patients due to a decrease in the clearance of rizatriptan, resulting in approximately 44% increase in plasma concentrations. The dose should be reduced to 5 mg with no more than 10 mg in any 24-hour period. Repeated dosing in renally impaired patients has not been evaluated.

Other Comments

Liquid is not necessary for administration of the orally disintegrating tablets. The orally disintegrating tablet is designed to be placed on the tongue, where it will dissolve and be swallowed with saliva.

The maximum recommended dose in any 24 hour period is 30 mg.

Rizatriptan should not be given to patients in whom unrecognized coronary artery disease (CAD) is predicted by the presence of risk factors unless a cardiovascular evaluation provides satisfactory clinical evidence that the patient is reasonably free of coronary artery and ischemic myocardial disease or other significant underlying cardiovascular disease.

For patients who may be at increased risk of unrecognized cardiovascular disease, but who are determined to have a satisfactory cardiovascular evaluation, the first dose of rizatriptan should be given under direct medical supervision. Because cardiac ischemia may occur in the absence of clinical symptoms, use of an electrocardiogram (ECG) during the interval immediately following a dosage of rizatriptan may be appropriate for patients with risk factors.

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