Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Selective 5-HT1B/1D agonist (triptan)

Rizatriptan

Brand names: Maxalt, Maxalt Melt

Used in: Headache & Migraine

Rizatriptan is a triptan (5-HT1B/1D receptor agonist) used for the acute treatment of migraine attacks. It is not used for migraine prevention.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Although rizatriptan benzoate 5 mg tablets and orally disintegrating tablets are available in the marketplace, MAXALT Tablets and MAXALT-MLT Orally Disintegrating Tablets are no longer marketed in the 5 mg strength. Adults: 5 or 10 mg single dose; separate repeat doses by at least two hours; maximum dose in a 24-hour period: 30 mg ( 2.1 ) Pediatric patients 6 to 17 years: 5 mg single dose in patients less than 40 kg (88 lb); 10 mg single dose in patients 40 kg (88 lb) or more ( 2.2 ) Adjust dose if co-administered with propranolol ( 2.4 ) 2.1 Dosing Information in Adults The recommended starting dose of rizatriptan benzoate is either 5 mg or 10 mg for the acute treatment of migraines in …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-01-29. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It stimulates 5-HT1B/1D receptors, causing constriction of dilated cranial blood vessels and inhibiting the release of pro-inflammatory neuropeptides involved in migraine.

Prescribing in practice

  • It is contraindicated in ischaemic heart disease, previous myocardial infarction, coronary vasospasm, cerebrovascular disease and uncontrolled hypertension because it causes vasoconstriction.
  • Overuse can cause medication-overuse headache, so limit the frequency of treatment days and review patients who use it often.
  • It interacts with propranolol, which raises rizatriptan levels (a lower triptan dose may be needed), and with other serotonergic drugs, increasing the risk of serotonin toxicity.

Monitoring

Assess cardiovascular risk before first use; review attack frequency and the number of treatment days to detect medication overuse, and check for interacting serotonergic medicines.

Counselling the patient

  • Use it to treat an attack, not to prevent migraines, and avoid using acute treatment on too many days each week to prevent rebound headaches.
  • Report chest tightness, chest pain or throat tightness.
  • Tell your prescriber about all other medicines, especially propranolol and antidepressants.

Evidence & guidelines

Licensed and guideline-recommended for acute migraine (NICE NG217 / CKS Migraine).

Reference: NICE CG150; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways