RIZATRIPTAN
Drugs in Pregnancy and Lactation.
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Name: RIZATRIPTAN
Class: Antimigraine
Risk Factor: CM
Fetal Risk Summary
Rizatriptan, an oral, selective 5-hydroxytryptamine1B/1D receptor agonist, is indicated for the treatment of acute migraine attacks with or without aura in adults.
Reproduction studies have been conducted in rats and rabbits (1). Female rats were treated before and during mating, and throughout gestation and lactation with doses that produced maternal plasma exposures 15 and 225 times, respectively, the exposure in humans from the maximum recommended human dose of 30 mg (MRHD). These doses were not maternally toxic, but did reduce birth weights, and pre- and post-weaning weight gain in offspring. The no-effect dose was approximately 1.5 times the MRHD. No teratogenic effects were observed in rats and rabbits given doses 225 and 115 times, respectively, the MRHD during organogenesis. Fetal weights were decreased at these doses, but maternal weight gain was also reduced. The no-effect doses were approximately 15 times the MRHD.
Rizatriptan crosses the placentas of rats and rabbits (1). The relatively low molecular weight of the free base (about 269) suggests that placental transfer of the drug will also occur in humans.
The Merck Pregnancy Registry program has data on 24 pregnancies exposed to rizatriptan (2). The outcome data for 19 of the pregnancies that were in clinical trials included 3 spontaneous abortions (SABs), 5 elective abortions (EAs), 1 patient lost to follow-up, and 11 liveborn infants (1 set of twins). Two liveborns (male twins) were delivered at 34 weeks' gestation. In a comparison group of 11 pregnancies that were exposed to comparator drugs, placebo, or no medications, the outcomes were 2 SABs, 1 EA, 4 lost to follow-up, and 4 liveborn infants. Five pregnancies, four prospective and one retrospective, were enrolled in a postmarketing surveillance program. The outcomes in the prospective cases were one normal term live birth, one fetal death due to cord accident, and two outcomes pending. The retrospective report involved an infant with a de novo (i.e., spontaneous occurrence) duplication of chromosome 2 that was thought to be related to advanced maternal age. Although no adverse outcomes were observed in liveborn offspring, the limited number of exposures studied are not sufficient to detect a risk of rare disorders such as birth defects (2). Health care providers are encouraged to report prenatal exposures to rizatriptan by calling (800) 986–8999.
Breast Feeding Summary
No reports describing the use of rizatriptan in human lactation have been located. The relatively low molecular weight of the free base (about 269) suggests that the drug will be excreted into breast milk. The effects of this exposure on a nursing infant are unknown.
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References
- Product information. Maxalt. Merck, 2001.
- Second Annual Report from the Merck Pregnancy Registry for Maxalt (rizatriptan benzoate). October, 2000.
Q&A about Rizatriptan
I take this medication for my migraine attacks. I'd like to know whether this medication merely numbs the head like a painkiller or does this medication try to get da enlargened blood vessels to get back to normal size?
I suffer from migraine headaches and there is a perscription called Maxalt - MLT (rizatriptan benzoate). I was wondering if it made you gain weight, or lose weight, or maybe it doesn't effect weight at all, i just was wondering cause i wasnt sure.
I suffer from migraine headaches, and there is a prescription called Maxalt - MLT (rizatriptan benzoate) and i was wondering if it makes you gain weight, or lose weight, or maybe it doesnt effect your weight...just wasnt sure.
i am on a repeat prescription for 10mg maxalt for migraines,on my last prescription it said i had to see my gp before being given another prescription,i am only on 2 a month why does he want to see me????any ideas
Weekly migraines are taking over my days,i have 2/3 a week,i am not stressed,i have checked my diet,.i just cannot find the trigger! i have suffered since i was 17,33 now,and they are becoming more painfull and more frequent.My GP has prescribed migralieve,then sanomigran,then rizatriptan,propranalol and now almotriptan,none of which work.I would prefer to use herbal remedies because i am on other medication for osteoarthritis,mainly tramadol and gabapentin.BUT I WOULD TRY ANYTHING!! Oh and i have had my eyes checked for strain,they were fine, and i do not take a contraceptive pill.Any advice would be really welcomed,Thankyou to anyone who takes the time to answer,i do appreciate it X X X
Numerous clinical studies suggest that taking 5-HTP (Hydroxy Tryptophan) supplements increase Serotonin which has been found to have important antidepressant benefits. Higher levels of Serotonin are associated with decreased depression, improved sleep, alleviation of anxiety, relief from and prevention of migraine headaches and weight loss resulting from reduced carbohydrate cravings. Reduced levels of Serotonin are associated with feelings of stress, anxiety and helplessness. 5-HTP assists in increasing your brain's Serotonin level gently and naturally by providing the precursor material for the syntheses of Serotonin. Other symptoms of Serotonin deficiency can include: carbohydrate cravings, migraines, obsessive compulsive behaviors, and other behavioral disorders. Restoring Serotonin is the basis for one of the most popular classes of drugs prescribed today. These drugs, including Prozac, Zoloft, Paxil and others are widely used to treat depression, anxiety, and insomnia. They are effective because they increase the availability of Serotonin. Increasing the availability of the Serotonin also helps the Amino Acid 5-Hydroxy Tryptophan work. This means that the body uses some of the 5-HTP in your diet to make Serotonin. Increase 5-HTP and you may increase Serotonin. Is 5-HTP the same as Tryptophan? No. The body takes Tryptophan and converts it to 5-HTP, which it then converts to Serotonin. Hydroxy Tryptophan may cause drowsiness and should not be taken while driving or operating machinery.
Link below for more infomation...good luck
I suffer from acute Migraines and my insurance does not cover it. It comes to over $600 for a month supply. I simply cannot afford that but my migraines are so bad that i can't even get up sometimes. Does anyone know of a over-the-counter equivalent?
I just don't want to keep taking Tylenol.
-Please help-
The prescription given to me by my doctor is: Rizatriptan Benzoate
I suffer from migraine headaches. The insurance through my work does not cover migraine medication at all (and there is no way to upgrade the insurance to a plan that pays for it). Does anyone know of any cheap prescription medication for migraines? I know that rizatriptan (Maxalt) works really well for me, but it costs $117 for 6 pills.
This questiuon is about my husband and his awful headaches.
Brief history- 5 yrs ago he started to get headaches and migranes, went to docs had MRI scan all clear told 1 in 5 people have migrane so just get on with it, things got worse head aches lasted for 2 weeks at a time, back to docs husband demanded to see specilist, had more scans which where all clear told he had tension headaches given low dose of Amitrityline which has increased to a high dose ( he takes this everyday and when he has a migrane he has to take 10mg of Maxalt (Rizatriptan).
My husband still gets headaches everyday he takes normal painkillers as well ( we have checked and this is ok along side his normal medication).
I know the specilist is doing his job and I have looked at many websites but do you suffer something similar and how have you learned to deal with it? have you had or heard of surgery for this ? Any serious ideas/help/advice this is affecting my husbands quality of life.
Thanks in advace.
Eventually, I was taking, pain medications, and it was determined that my headaches were probably due to multiple head injuries in the past, which had also resulted in a seizure disorder.
I have now stopped all medications except some medications which help prevent seizures and headaches. Follow a headache prevention diet, and control my headaches with biofeedback. Though it has taken time to get the proper combination.
Get your husband with a specialist, have him continue to work until a treatment is reached, do not believe anyone who says they can cure the headaches with any miracle 100% cure rate treatment like dbgyong, it does not exist. But there is a treatment for everyone.
A good source of information is the National Headache Foundation. Look at the information under Educational Resources. There is a lot and much of it won't apply, but there is valuable information which you can use, like headache diaries, diets, etc...
www.headaches.org
I have noted that one person recommended chiropractic manipulation, another mentioned that they had hemiplegic migraines. My migraines it turns out were of the basilar artery form. As a caution, basilar artery and hemiplegic migraines not only should not take the triptan type migraine meds, they should never have chiropractic. Never try chiropractic until cleared by your specialist. Chiropractic may help, but if the chiropractic physician is not trained in headaches he can cause a stroke in certain types of migraines.
Dont give up, there is a treatment for everyone, it just takes time!
EDIT: FOR Joan F: years of research on paracetamol (one of the most researched medications in history) has never shown any suggestion of the medication leading to gastric ulcers. I have some problems with the widespread use of paracetamol in combination medications as it is overused and thought to be overly benign by the public, but ulcers it is not suspected of.
I suffer from migraines very often.At least 3-4 times a wk.Maximum is bout 5 days a week.My doc tried many medicines on me but2no avail.Im curently takin rizatriptan maxalt wafers for an attack.It helps but wat can i do2lessen da frequency of these headaches? I knw migraines are chronic but i require help 4 makin them come less often. Im only 23 & hav taken too much medication in my life already.
so keep a journal of your activities and diet and it might be a huge help
good luck and hope you feel better soon
I am writing a term paper on 'Triptans' (the seratonin agonists: 5-HT agonists). However, I am having a hard time finding the lethal dose of a given triptan (sumatriptan, rizatriptan etc.). I have looked in the merck index, and in the FDS annual reports.
Can anyone find one for me please?
You've chosen a difficult topic. There is not much known about Triptan overdose because the 5HTP subsites it binds to are not very well studied. However there is evidence that an overdose can lead to severe, prolonged vasospasm. Also, when combined with SSRI or SNRI antidepressants, there is an increased likelihood of Serotonin Syndrome. It is possible that overdose with Triptans could result in Serotonin Syndrome too and/or in elevated blood pressure, seizures etc. If I find more information on this I will let you know. Hope this helps. Feel free to drop me aline if you wish.
NB: Overdose in animals has been fatal and has been heralded by convulsions, tremor, paralysis, inactivity, ptosis, erythema of the extremities, abnormal respiration, cyanosis, ataxia, mydriasis, salivation, and lacrimation.
