Meloxicam and rizatriptan

Pronunciation: mel-OX-ikam and RYE-za-TRIP-tan
Generic name: meloxicam/rizatriptan
Brand name: Symbravo
Dosage form: oral tablet (20 mg/10 mg)
Drug class: Antimigraine agents

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 4, 2025.

What is Meloxicam/Rizatriptan? Acute Migraine Treatment

Meloxicam/rizatriptan is used to treat acute migraines with or without aura in adults. This combination oral migraine medication contains both meloxicam (an NSAID) and rizatriptan (a triptan), providing dual-action migraine relief through different mechanisms of action. Meloxicam/rizatriptan is marketed under the brand name Symbravo.

This prescription migraine medicine is taken when you have a migraine attack. It will only treat a migraine that has already begun and will not prevent headaches or reduce the number of attacks. The maximum dose is 1 tablet every 24 hours. 

Key Facts About Meloxicam/Rizatriptan

• Brand Name: Symbravo (no generic available)
• Drug Type: Combination NSAID/Triptan migraine medication
• Active Ingredients: 20 mg meloxicam + 10 mg rizatriptan per tablet
• FDA Approval: January 30, 2025
• Manufacturer: Axsome Therapeutics, Inc.
• Indication: Acute treatment of migraines with or without aura in adults
• Dosage: Maximum 1 tablet every 24 hours
• Mechanism: Dual-action - NSAID reduces inflammation, triptan targets vascular changes
• Administration: Swallow whole, with or without food, at the first symptoms of a migraine
• Not for: Prevention, children, hemiplegic/basilar migraines, or cluster headaches
• Key Warning: Contains an NSAID (increased risk of heart attack, stroke, and GI bleeding)

How Meloxicam/Rizatriptan Work for Migraine Relief

Dual-Mechanism Migraine Treatment

The two active ingredients in meloxicam/rizatriptan work through different pathways to provide comprehensive migraine relief.

• Meloxicam NSAID Component for Inflammation: Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that relieves pain, reduces fever, and has anti-inflammatory effects. The way it works is not completely understood but is thought to involve inhibition of cyclooxygenase (COX-1 and COX-2) and prostaglandin synthesis, addressing the inflammatory component of migraine pain.
• Rizatriptan Triptan Component for Vascular Relief: Rizatriptan is a triptan medication that works by binding to 5-HT 1B/1D receptors located on blood vessels inside the brain and sensory nerves of the trigeminal system. This mechanism helps address the vascular changes associated with migraine attacks, although the exact way it works is not fully understood.

This combination approach makes meloxicam/rizatriptan (Symbravo) unique among migraine medications by targeting multiple pathways involved in migraine development and pain.

Meloxicam/Rizatriptan Side Effects

Most Common Side Effects

The most frequently reported side effects of meloxicam/rizatriptan include:

• Dizziness
• Feeling tired or fatigued.

These migraine medication side effects are generally mild but may affect your ability to drive or operate machinery.

Managing Side Effects

If you experience dizziness, weakness, or drowsiness while taking meloxicam/rizatriptan:

• Do not drive a car
• Avoid using machinery
• Do not engage in activities that require you to be alert
• Contact your healthcare provider if symptoms persist.

Serious Side Effects and Warnings

Critical Safety Information for NSAID Component

Cardiovascular Risks: Meloxicam/rizatriptan contains meloxicam (an NSAID), which can cause serious side effects, including:

• Increased risk of heart attack or stroke that can lead to death
• Risk may happen early in treatment and may increase with higher doses and longer use
• Avoid taking Symbravo right before or after coronary artery bypass graft (CABG) surgery
• Do not take after a recent heart attack unless directed by your healthcare provider

Emergency Warning Signs. Seek immediate medical help if you experience:

• Chest discomfort lasting more than a few minutes
• Severe tightness, pain, pressure, or heaviness in the chest, throat, neck, or jaw
• Pain in arms, back, neck, jaw, or stomach
• Shortness of breath with or without chest discomfort
• Cold sweat, nausea, vomiting, or lightheadedness
• Weakness on one side of the body or slurred speech.

Gastrointestinal Risks

Bleeding and Ulcer Warning:

• Increased risk of bleeding, ulcers, and tears of the esophagus, stomach, and intestines
• Can occur anytime during use without warning symptoms
• May cause death in severe cases.

People at higher risk include those: 

• With a history of stomach ulcers or GI bleeding with NSAID use
• Taking corticosteroids, anticoagulants, SSRIs, SNRIs, or aspirin simultaneously
• Of an older age, with longer NSAID use, or poor health
• Who smoke, drink alcohol, have bleeding problems, or have advanced liver disease.

Serious Allergic Reactions

Meloxicam/rizatriptan may cause allergic reactions in some people. Stop taking Symbravo and get emergency help immediately if you develop:

• Sudden wheezing or problems breathing
• Swelling of lips, tongue, throat, or body
• Skin rash, fainting, or problems swallowing
• Skin reddening with blisters or peeling
• Blisters or bleeding of lips, eyelids, mouth, nose, or genitals.

Peripheral Vascular Ischemia

Meloxicam/rizatriptan may cause problems with blood circulation to your legs and feet. Get emergency help for symptoms including cramping and pain in legs or hips, heaviness in leg muscles, burning pain in feet or toes, numbness or tingling in legs, or cold feeling/color changes in legs or feet.

Serotonin Syndrome

Can occur when meloxicam/rizatriptan is taken with SSRIs or SNRIs. Emergency symptoms include hallucinations, agitation, coma, high body temperature, tight muscles, fast heartbeat, trouble walking, or blood pressure changes.

Medication Overuse Headaches

Overuse of meloxicam/rizatriptan may cause worse headaches. Your healthcare provider may need to stop treatment if headaches worsen.

Meloxicam and rizatriptan should only be taken exactly as prescribed and for the shortest time needed.

These are not all the possible side effects of meloxicam and rizatriptan. Tell your healthcare provider if you have any side effect that bothers you or that do not go away. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Related/similar drugs

Before Taking Meloxicam/Rizatriptan

Absolute Contraindications

Do not take meloxicam and rizatriptan if you have or have had:

• An allergic reaction to meloxicam, rizatriptan, NSAIDs, or any ingredients in the tablets
• Heart problems or heart bypass surgery
• Stroke or transient ischemic attack (TIA)
• Blood vessel problems, including ischemic bowel disease
• Hemiplegic or basilar migraines or cluster headaches
• Peripheral vascular disease
• Uncontrolled high blood pressure
• Moderate to severe kidney problems or dialysis.

Do not use meloxicam and rizatriptan for migraine prevention or in children due to safety concerns or unestablished effectiveness.

Medication Interactions - Do NOT take with:

• Propranolol-containing medicines
• Other triptan medications or ergotamine (within 24 hours)
• MAO inhibitors (within 2 weeks).

Tell Your Healthcare Provider if You Have:

• Heart problems or high blood pressure
• Risk factors for heart problems, such as smoking, diabetes, obesity, or being a male over 40 or a post-menopausal female
• A family history of heart disease
• Kidney or liver disease
• Asthma
• Pregnancy or breastfeeding plans, or having issues with fertility

Meloxicam/rizatriptan is not for people with heart disease risk factors unless a cardiac examination shows no problems. 

Pregnancy and Breastfeeding Considerations

Pregnancy: Taking NSAIDs, including meloxicam and rizatriptan, at about 20 weeks of pregnancy or later may harm your unborn baby. If you need to take NSAIDs for more than 2 days when you are between 20 and 30 weeks of pregnancy, your healthcare provider may need to monitor the amount of fluid in your womb around your baby. You should not take NSAIDs after about 30 weeks of pregnancy.

Breastfeeding: Talk to your healthcare provider about the best way to feed your baby if you take meloxicam and rizatriptan.

How do I Take Meloxicam/Rizatriptan?

Recommended Dosage

Take meloxicam/rizatriptan exactly as your healthcare provider prescribes:

• Standard dose: 1 tablet taken as soon as you start to get a migraine
• Maximum dose: 1 tablet every 24 hours
• Safety note: It is not known if taking more than 1 dose of Symbravo in 24 hours is safe and effective.

How to Take Meloxicam/Rizatriptan

• Swallow Symbravo tablets whole - do not crush, divide, or chew
• Can be taken with or without food
• Take at the first sign of migraine symptoms for best results
• Talk to your healthcare provider about what to do if your headache does not go away or comes back.

When NOT to Use Meloxicam/Rizatriptan

Do not use Symbravo for:

• Hemiplegic or basilar migraines
• Migraine prevention
• Cluster headaches
• Children (due to safety concerns or unestablished effectiveness).

What happens if I overdose?

If you take too much meloxicam and rizatriptan, call your healthcare provider or go to the nearest hospital emergency room right away.

What should I avoid while taking meloxicam and rizatriptan?

Meloxicam and rizatriptan may cause dizziness, weakness, or drowsiness. If you have these symptoms, do not drive a car, use machinery, or do anything that requires you to be alert.

Meloxicam/rizatriptan already contains meloxicam (an NSAID). Avoid taking with:

• Over-the-counter pain medications (ibuprofen, naproxen)
• Cold and flu medicines (may contain NSAIDs)
• Fever reducers without provider approval
• Aspirin (can increase bleeding risk).

Always consult your healthcare provider before combining Symbravo with any other pain medications or supplements.

What other medicines will affect meloxicam and rizatriptan?

Tell your healthcare provider about all of the medicines you take, including prescription or over-the-counter medicines, vitamins, or herbal supplements. Meloxicam and rizatriptan, and other medicines may affect each other, causing side effects or changing the way the medicine works. Do not start taking any new medicine without talking to your healthcare provider first. Especially tell your healthcare provider if you take:

• Propranolol containing medicines such as Inderal, Inderal LA, or InnoPran XL
• Medicines used to help your mood, including SSRIs or SNRIs.
• Aspirin or NSAIDs, such as ibuprofen, diclofenac, or celecoxib
• Any anticoagulant medicines

Ask your healthcare provider or pharmacist for a list of these medicines if you are not sure. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Meloxicam and rizatriptan ingredients

Only available as Symbravo.

Active ingredients: meloxicam and rizatriptan.

Inactive ingredients (Symbravo): colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose, partially hydrolyzed polyvinyl alcohol, polyethylene glycol, povidone, pregelatinized starch, sodium bicarbonate, sulfobutyl-ether-ß-cyclodextrin sodium, talc, and titanium dioxide.

Each tablet contains 20 mg of meloxicam and 10 mg of rizatriptan.

Storage

Store at room temperature between 68°F to 77°F (20°C to 25°C)

Safely discard outdated or unused medicine

Keep out of reach of children

Who makes meloxicam and rizatriptan?

Meloxicam and rizatriptan is made under the brand name Symbravo by Axsome Therapeutics, Inc., New York, NY 10007.

Frequently Asked Questions About Meloxicam/Rizatriptan

What makes meloxicam/rizatriptan (Symbravo) different from other migraine medications?

Symbravo is the first FDA-approved combination of an NSAID (meloxicam) and a triptan (rizatriptan) in a single tablet, providing dual-mechanism migraine relief that targets both inflammatory and vascular components of migraine.

How quickly does meloxicam/rizatriptan work for migraines?

Take Symbravo at the first sign of migraine symptoms for best results. The onset time may vary between individuals. Consult your healthcare provider about what to expect and when to seek additional treatment if symptoms persist.

Can I take meloxicam/rizatriptan with other migraine medications?

Do not take meloxicam/rizatriptan with other triptan medications, ergotamine-containing medicines, or within 24 hours of these medications. Always consult your healthcare provider before combining any migraine treatments.

Is meloxicam/rizatriptan suitable for migraine prevention?

No, Symbravo is designed for acute migraine treatment only. It will not prevent headaches or reduce the number of migraine attacks. Discuss migraine prevention options with your healthcare provider if needed.

What should I do if meloxicam/rizatriptan doesn't work for my migraine?

Contact your healthcare provider to discuss alternative treatment options. Do not take more than one Symbravo tablet in 24 hours, as the safety of higher doses has not been established.

Can I cut or crush meloxicam/rizatriptan tablets?

No, Symbravo tablets must be swallowed whole. Do not crush, divide, or chew the tablets, as this may affect the medication's effectiveness and safety.

Further information

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

Medical Disclaimer