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Rizatriptan

Clinical data
Trade names	Maxalt, Maxalt-MLT, Rizafilm, others
AHFS/Drugs.com	Monograph
MedlinePlus	a601109
License data	US DailyMed: Rizatriptan
Pregnancy category	AU: B1
Routes of administration	By mouth
Drug class	Triptan
ATC code	N02CC04 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) / S3 CA: ℞-only US: ℞-only In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability	45%
Protein binding	14%
Metabolism	By monoamine oxidase
Elimination half-life	2–3 hours
Excretion	82% urine; 12% feces
Identifiers
IUPAC name N,N-dimethyl-2-ethanamine
CAS Number	145202-66-0
PubChem CID	5078
IUPHAR/BPS	51
DrugBank	DB00953
ChemSpider	4900
UNII	WR978S7QHH
KEGG	D00675
ChEBI	CHEBI:48273
ChEMBL	ChEMBL905
CompTox Dashboard (EPA)	DTXSID2023565
ECHA InfoCard	100.243.719
Chemical and physical data
Formula	C15H19N5
Molar mass	269.352 g·mol
3D model (JSmol)	Interactive image
SMILES n1cncn1Cc2cc3c(cc2)cc3CCN(C)C
InChI InChI=1S/C15H19N5/c1-19(2)6-5-13-8-17-15-4-3-12(7-14(13)15)9-20-11-16-10-18-20/h3-4,7-8,10-11,17H,5-6,9H2,1-2H3 Key:ULFRLSNUDGIQQP-UHFFFAOYSA-N
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Rizatriptan, sold under the brand name Maxalt among others, is a medication used for the treatment of migraine headaches. It is taken by mouth. It can also be applied on the tongue. It is a serotonin (5-HT) 1B/1D receptor agonist (triptan).

Common side effects include chest pain, dizziness, dry mouth, and tingling. Other side effects may include myocardial infarction, stroke, high blood pressure, serotonin syndrome, and anaphylaxis. Excessive use may result in medication overuse headaches. Use is not recommended during pregnancy and breastfeeding is not recommended within 24 hours after taking a dose. Rizatriptan is in the triptan class and is believed to work by activating the 5-HT₁ receptor.

Rizatriptan was patented in 1991 and came into medical use in 1998. It is available as a generic medication. In 2022, it was the 190th most commonly prescribed medication in the United States, with more than 2 million prescriptions.

Medical uses

Rizatriptan is indicated to treat acute migraine attacks with or without aura. It does not prevent future migraine attacks. A 2010 review found rizatriptan to be more efficacious and tolerable than sumatriptan.

Contraindications

Rizatriptan and other triptans can cause vasoconstriction, they are contraindicated in people with cardiovascular conditions.

Adverse effects

Frequent adverse effects (incidence less than 10%) are dizziness, drowsiness, asthenia/fatigue, and nausea. Clinical adverse experiences were typically mild and short-lasting (2–3 hours).

Interactions

• Propranolol

Mechanism of action

Rizatriptan acts as an agonist at serotonin 5-HT_1B and 5-HT_1D receptors. Like the other triptans sumatriptan and zolmitriptan, rizatriptan induces vasoconstriction—possibly by inhibiting the release of calcitonin gene-related peptide from sensory neurons in the trigeminal nerve.

Society and culture

Brand names

Brand names include Rizalt, Rizalt RPD, Rizact (India), Rizafilm, Maxalt, and Maxalt-MLT.

References

1. ^ "Maxalt- rizatriptan benzoate tablet; Maxalt-MLT- rizatriptan benzoate tablet, orally disintegrating". DailyMed. 1 June 2022. Archived from the original on 23 March 2023. Retrieved 25 December 2023.
2. ^ "Archived copy" (PDF). Archived (PDF) from the original on 2 August 2023. Retrieved 25 December 2023.{{cite web}}: CS1 maint: archived copy as title (link)
3. ^ "Rizatriptan Benzoate Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 23 October 2020. Retrieved 18 March 2019.
4. ^ British National Formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 473. ISBN 9780857113382.
5. "Drug Approval Package: Maxalt/Rizatritan Benzoate NDA# 20864 & 20865". U.S. Food and Drug Administration (FDA). 30 March 2001. Archived from the original on 6 December 2022. Retrieved 25 December 2023.
6. Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 531. ISBN 9783527607495.
7. "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
8. "Rizatriptan Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
9. "Rizatriptan". MedlinePlus. U.S. National Library of Medicine. Archived from the original on 5 July 2016. Retrieved 21 March 2018.
10. Göbel H (2010). "Efficacy and tolerability of rizatriptan 10 mg compared with sumatriptan 100 mg: an evidence-based analysis". Expert Rev Neurother. 10 (4): 499–506. doi:10.1586/ern.10.24. PMID 20367203. S2CID 43395810.
11. ^ Hargreaves RJ, Lines CR, Rapoport AM, Ho TW, Sheftell FD (2009). "Ten years of rizatriptan: from development to clinical science and future directions". Headache. 49: S3–S20. doi:10.1111/j.1526-4610.2008.01335.x. PMID 19161563. S2CID 23587019.
12. Millson DS, Tepper SJ, Rapoport AM (March 2000). "Migraine pharmacotherapy with oral triptans: a rational approach to clinical management". Expert Opinion on Pharmacotherapy. 1 (3): 391–404. doi:10.1517/14656566.1.3.391. PMID 11249525. S2CID 36053513.
13. ^ Wellington K, Plosker GL (2002). "Rizatriptan: an update of its use in the management of migraine". Drugs. 62 (10): 1539–74. doi:10.2165/00003495-200262100-00007. PMID 12093318. S2CID 195693597.
14. "Rishum01_5_982075622.pdf" (PDF). Mohpublic.z6.web.core.windows.net. Retrieved 21 December 2023.
15. "Maxalt Oral: Uses, Side Effects, Interactions, Pictures, Warnings & More". WebMD. Archived from the original on 21 December 2023. Retrieved 21 December 2023.
16. "Rizact 10 mg Tablet - Uses, Dosage, Side Effects, Composition". Practo. Archived from the original on 21 December 2023. Retrieved 21 December 2023.

• Medicine

• Drugs developed by Merck & Co.
• Triazoles
• Triptans
• 5-HT1D agonists
• Headaches
• Tryptamines