Pronunciation: sim-BRAH-voh
Generic name: meloxicam/rizatriptan
Dosage form: oral tablet
Drug class: Antimigraine agents

Medically reviewed by Carmen Pope, BPharm. Last updated on Apr 3, 2025.

What is Symbravo?

Symbravo is used to treat acute migraine headaches with or without aura in adults. It is a combination tablet that is taken once a day.

Symbravo contains meloxicam and rizatriptan.

• Meloxicam is an NSAID (nonsteroidal anti-inflammatory drug) that relieves pain, reduces fever, and has anti-inflammatory effects. Its mechanism of action is not completely understood but is thought to involve inhibition of cyclooxygenase (COX-1 and COX-2) and prostaglandin synthesis.
• Rizatriptan is a triptan medication that is thought to work by binding to 5-HT 1B/1D receptors located on blood vessels inside the brain and sensory nerves of the trigeminal system, although its exact mechanism is unclear.

Important: Symbravo is NOT for:

• Treating hemiplegic migraines (that make you unable to move on one side of your body)
• Treating basilar migraines (a rare form of migraine with aura)
• Preventing migraines or reducing their frequency
• Treating cluster headaches (safety and effectiveness not established)
• Use in children (safety and effectiveness not established).

Symbravo gained FDA approval on January 30, 2025. There is no generic.

Side effects

The most common side effects of Symbravo are:

• dizziness
• feeling tired.

Serious side effects and warnings

Symbravo contains 2 medicines: meloxicam (an NSAID) and rizatriptan (a triptan). NSAIDs, including Symbravo, can cause serious side effects, including:

• Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:
  • with increasing doses of NSAIDs
  • with longer use of NSAIDs.

Do not take Symbravo right before or after a heart surgery called a coronary artery bypass graft (CABG).

Avoid taking Symbravo after a recent heart attack unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.

Stop taking Symbravo and get emergency help right away if you have any of the following symptoms of a heart attack or stroke:

• • discomfort in the center of your chest that lasts for more than a few minutes, or that goes away and comes back
  • severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
  • pain or discomfort in your arms, back, neck, jaw, or stomach
  • shortness of breath with or without chest discomfort
  • breaking out in a cold sweat
  • nausea or vomiting
  • feeling lightheaded
  • weakness in one part or on one side of your body
  • slurred speech

Symbravo is not for people with risk factors for heart disease unless a heart exam is done and shows no problem. You have a higher risk for heart disease if you:

• • have high blood pressure
  • have high cholesterol levels
  • smoke
  • are overweight
  • have diabetes
  • have a family history of diabetes
• Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach, and intestines:
  • anytime during use
  • without warning symptoms
  • that may cause death

The risk of getting an ulcer or bleeding increases with:

• • history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs
  • taking medicines called “corticosteroids”, “anticoagulants”, “SSRIs” or “SNRIs” (antidepressants), or aspirin (an antiplatelet)
  • increasing doses of NSAIDs
  • older age
  • longer use of NSAIDs
  • poor health
  • smoking
  • advanced liver disease
  • drinking alcohol
  • bleeding problems.
• Serious allergic reactions or serious skin reactions that can be life-threatening. Stop taking Symbravo and get emergency help right away if you develop:
  • sudden wheezing
  • swelling of your lips, tongue, throat, or body
  • rash
  • fainting
  • problems breathing or swallowing
  • reddening of your skin with blisters or peeling
  • blisters or bleeding of your lips, eyelids, mouth, nose, or genitals.

Symbravo should only be used:

• exactly as prescribed
• for the shortest time needed

Symbravo already contains an NSAID (meloxicam). Do not use Symbravo with other medicines to lessen pain or fever or with other medicines for colds or sleeping problems without talking to your healthcare provider first, because they may also contain an NSAID.

Other serious side effects include:

• Stomach and intestinal problems. Get emergency help right away if you have:
  • sudden or severe stomach pain
  • severe stomach pain after meals
  • sudden unexplained weight loss
  • severe nausea or vomiting
  • severe constipation or diarrhea
  • bloody diarrhea.
• Problems with blood circulation to your legs and feet (peripheral vascular ischemia). Get emergency help right away if you have any of the following symptoms of peripheral vascular ischemia including:
  • cramping and pain in your legs or hips
  • feeling of heaviness or tightness in your leg muscles
  • burning or aching pain in your feet or toes while resting
  • numbness, tingling, or weakness in your legs
  • cold feeling or color changes in 1 or both legs or feet.
• Medication overuse headaches. Some people who use too many Symbravo tablets may have worse headaches (medication overuse headache). If your headaches get worse, your healthcare provider may decide to stop your treatment with Symbravo.
• Serotonin syndrome. A condition called serotonin syndrome can happen when Triptan medicines such as Symbravo are taken with certain other medicines called SSRIs or SNRIs. Stop taking Symbravo and get emergency help right away if you have any of the following symptoms of serotonin syndrome:
  • Mental changes such as seeing things that are not there (hallucinations)
  • agitation or coma
  • high body temperature
  • tight muscles
  • fast heartbeat
  • trouble walking
  • changes in your blood pressure.

Stop taking Symbravo and call your healthcare provider right away if you get any of the following symptoms:

• nausea
• vomit blood
• more tired or weaker than usual
• there is blood in your bowel movement, or it is black and sticky like tar
• diarrhea 
• itching
• unusual weight gain
• your skin or eyes look yellow
• skin rash or blisters with fever
• indigestion or stomach pain
• swelling of the arms, legs, hands, and feet
• flu-like symptoms
• tenderness in your right upper side
• vision problems.

These are not all the possible side effects of Symbravo. 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

Do not take Symbravo if you:

• have or have had heart problems
• right before or after heart bypass surgery
• have or have had a stroke or a transient ischemic attack (TIA)
• have or have had blood vessel problems, including ischemic bowel disease
• have or had hemiplegic migraines or basilar migraines
• narrowing of blood vessels of your legs and arms (peripheral vascular disease), stomach (ischemic bowel disease), or kidneys
• have uncontrolled high blood pressure
• take propranolol-containing medicines
• have taken any medicines in the last 24 hours called 5-HT1 agonists (triptans) or contain ergotamine
• take an antidepressant medicine called a monoamine oxidase (MAO) inhibitor or have taken a MAO inhibitor within the last 2 weeks
• are allergic to meloxicam, rizatriptan, NSAIDs or any of the ingredients in Symbravo
• have had an asthma attack, hives, or other allergic reaction after taking aspirin or any other NSAIDs
• have moderate to severe kidney problems and are at risk of kidney failure, or if you are on dialysis.

Talk to your healthcare provider before taking this medicine if you have any of the conditions listed above or if you are not sure if you take any of these medicines.

Before you take Symbravo, tell your healthcare provider about all of your medical conditions, including if you:

• have or have had heart problems, high blood pressure, chest pain, or shortness of breath.
• have any risk factors for heart problems or blood vessel problems such as:
• have high blood pressure
• have diabetes
• have high cholesterol
• have a family history of heart problems
• smoke
• are post-menopausal
• are obese
• are a male over 40
• have kidney or liver problems.
• have asthma.
• have any other medical condition.
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed.

NSAIDs are associated with reversible infertility. Consider the withdrawal of Symbravo in women who have difficulties conceiving.

Pregnancy

Taking NSAIDs, including Symbravo, 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 Symbravo.

How do I take Symbravo?

Take Symbravo exactly as your healthcare provider tells you to take it.

• Take 1 tablet as soon as you start to get a migraine.
  • It is not known if taking more than 1 dose of Symbravo in 24 hours is safe and effective.
  • Talk to your healthcare provider about what to do if your headache does not go away or comes back.
• Swallow Symbravo tablets whole.
• Do not crush, divide, or chew Symbravo tablets.
• Symbravo can be taken with or without food.

Other information

Do not take aspirin with Symbravo without talking to your healthcare provider first. Aspirin is an NSAID, but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.

Some NSAIDs are sold without a prescription (over the counter). Talk to your healthcare provider before using over-the-counter NSAIDs with Symbravo.

What happens if I overdose?

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

Dosing information

The recommended dose is 1 Symbravo tablet by mouth.

• The maximum dose is 1 tablet (meloxicam 20 mg and rizatriptan 10 mg).

What should I avoid while taking Symbravo?

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

What other medicines will affect Symbravo?

Tell your healthcare provider about all of the medicines you take, including prescription or over the counter medicines, vitamins, or herbal supplements. Symbravo and other medicines may affect each other causing side effects or 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.

Symbravo ingredients

Active ingredients: meloxicam and rizatriptan.

Inactive ingredients: 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 Symbravo?

Symbravo is made by Axsome Therapeutics, Inc., New York, NY 10007.

Further information

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

Medical Disclaimer