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Drug Interactions between rizatriptan and Treximet

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

SUMAtriptan rizatriptan

Applies to: Treximet (naproxen / sumatriptan) and rizatriptan

CONTRAINDICATED: Coadministration of two or more 5-HT1 receptor agonists and/or ergotamine-containing or ergot-type medications may potentiate the risk of vasospastic reactions, including coronary artery vasospasm, peripheral vascular ischemia and colonic ischemia, due to additive pharmacologic effects. Acute myocardial infarction due to sustained vasospasm occurred in a premenopausal woman with controlled hypertension and no known history of coronary artery disease following two 2 mg doses of methysergide maleate 12 hours apart and a subcutaneous injection of sumatriptan 6 mg.

MANAGEMENT: The concomitant use of two or more 5-HT1 receptor agonists and/or ergotamine-containing or ergot-type medications, or use within 24 hours of each other, is considered contraindicated.

References (9)
  1. (2001) "Product Information. Imitrex (sumatriptan)." Glaxo Wellcome
  2. (2001) "Product Information. Parlodel (bromocriptine)." Sandoz Pharmaceuticals Corporation
  3. (2001) "Product Information. Zomig (zolmitriptan)." Astra-Zeneca Pharmaceuticals
  4. (2001) "Product Information. Migranal (dihydroergotamine nasal)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Amerge (naratriptan)." Glaxo Wellcome
  6. (2001) "Product Information. Maxalt (rizatriptan)." Merck & Co., Inc
  7. (2001) "Product Information. Axert (almotriptan)." Pharmacia and Upjohn
  8. Liston H, Bennett L, Usher B, Nappi J (1999) "The association of the combination of sumatriptan and methysergide in myocardial infarction in a premenopausal woman." Arch Intern Med, 159, p. 511-3
  9. (2003) "Product Information. Relpax (eletriptan)." Pfizer U.S. Pharmaceuticals

Drug and food interactions

Moderate

naproxen food

Applies to: Treximet (naproxen / sumatriptan)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References (1)
  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
Moderate

naproxen food

Applies to: Treximet (naproxen / sumatriptan)

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

References (4)
  1. (2024) "Product Information. Cytisine (cytisinicline)." Consilient Health Ltd
  2. jeong sh, Newcombe D, sheridan j, Tingle M (2015) "Pharmacokinetics of cytisine, an a4 b2 nicotinic receptor partial agonist, in healthy smokers following a single dose." Drug Test Anal, 7, p. 475-82
  3. Vaughan DP, Beckett AH, Robbie DS (1976) "The influence of smoking on the intersubject variation in pentazocine elimination." Br J Clin Pharmacol, 3, p. 279-83
  4. Zevin S, Benowitz NL (1999) "Drug interactions with tobacco smoking: an update" Clin Pharmacokinet, 36, p. 425-38

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Sympatholytics

Therapeutic duplication

The recommended maximum number of medicines in the 'sympatholytics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'sympatholytics' category:

  • rizatriptan
  • Treximet (naproxen/sumatriptan)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Ergot-like drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'ergot-like drugs' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'ergot-like drugs' category:

  • rizatriptan
  • Treximet (naproxen/sumatriptan)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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