How to Use Rizatriptan
Rizatriptan should be taken at the first sign of a migraine headache — but not during the aura phase (the early warning symptoms such as visual disturbances). Taking it as soon as the headache starts gives the best chance of fully aborting the attack.

Standard tablet dosing:

• Take one 10mg tablet at the first sign of migraine pain
• Swallow whole with a glass of water
• If your migraine returns after initial improvement, you can take a second tablet at least 2 hours later
• The maximum dose in 24 hours is 20mg (e.g. two 10mg tablets, or four 5mg tablets)
• Do not take a second dose if the first dose did not work — if there is no response, rizatriptan is unlikely to work for that particular attack

Important usage tips:

• Take at the first sign of pain — rizatriptan is most effective when taken early, before the migraine becomes fully established
• Do not take during aura — wait until the headache itself begins
• Rest in a quiet, dark room after taking rizatriptan to support recovery
• Stay hydrated and avoid food and drinks that may worsen the migraine
• Track your migraines in a headache diary to help identify triggers and treatment response
• Allow at least 2 hours between doses if a second dose is needed

Important Precautions
Cardiovascular safety: Like all triptans, rizatriptan causes mild vasoconstriction, which is the basis of its action against migraine but also the reason it is contraindicated in people with cardiovascular disease. Before prescribing rizatriptan to anyone over 40 or with cardiovascular risk factors, clinicians will typically assess:

• Blood pressure
• Personal and family cardiovascular history
• Cholesterol and diabetes status
• Smoking history
• If you experience chest pain, tightness, or breathlessness after taking rizatriptan — particularly if it is severe or persistent — seek urgent medical attention.

Drug interactions: Important interactions include:

• Propranolol — significantly increases rizatriptan blood levels; use the 5mg dose only with at least 2 hours between doses
• Monoamine oxidase inhibitors (MAOIs) — contraindicated; do not use within 2 weeks of stopping an MAOI (rizatriptan is metabolised by MAO-A)
• Other triptans or ergotamine — do not combine within 24 hours
  Selective serotonin reuptake inhibitors (SSRIs) and SNRIs — risk of serotonin syndrome; use with caution
• Lithium — risk of serotonin syndrome
• St John's Wort — increases serotonin syndrome risk; avoid concurrent use
• Linezolid (an antibiotic with MAOI activity) — avoid concurrent use
  Always inform your clinician about all medications and supplements you take.

Phenylketonuria (PKU): The orodispersible wafer contains aspartame, which is a source of phenylalanine. Patients with phenylketonuria should avoid the wafer formulation and use standard tablets instead.

Pregnancy and breastfeeding: Rizatriptan is not generally recommended in pregnancy or breastfeeding unless the potential benefit outweighs the risk. Although limited human data have not shown clear evidence of harm, decisions should be made in discussion with a clinician. If used while breastfeeding, manufacturers advise discarding breast milk for 24 hours after a dose.

Driving and machinery: Rizatriptan can cause drowsiness or dizziness. Do not drive or operate machinery until you know how it affects you.

Alcohol: Alcohol can worsen migraines and may increase the risk of side effects. It is best avoided during a migraine attack, regardless of whether you have taken rizatriptan.

Medication overuse headache (MOH): Frequent use of any acute migraine treatment — including triptans — can paradoxically lead to more headaches. Limit rizatriptan use to fewer than 10 days per month, and discuss preventive treatment options if your attacks are frequent.