What is the medication sold under the name Maxalt and when is it used?

Maxalt is a brand of the American pharmaceutical company Merck. It is bases on Rizatriptan. This substance is also available under other names when made by other companies. The drugs based on it are used for migraines. If you wish to save buying this medication, you should order generic Maxalt from our online drugstore.

The formulation has high affinity, i.e. the property of binding to certain human receptors, including dopamine, histamine, muscarinic, benzodiazepine, adrenergic, and other receptors.

It has a strong anti-migraine effect, due to the effect on receptors located inside the cranium, expanding due to expansion during a migraine episode.

It causes activation of the 5-HT 1B and 5-HT 1D receptors, which cause pain, the intracranial vessels narrow, inhibiting the release of neuropeptides, resulting in reduced inflammation in the tissues, and the transmission of pain through the central trigeminal nerve is weakened.

The formulation helps to prevent disability due to migraine, eliminates nausea, light phobia caused by migraine attacks.

Pharmacokinetics

Rizatriptan is quickly and almost entirely absorbed in the digestive tract after the intake. The average time to reach maximum plasma level (Tmax) after a single dose is around 1–1.5 hours, which is less than in the use of other migraine medications.

The formulation is metabolized mainly with the participation of monoamine oxidase A.

Eating before using the formulation in healthy volunteers led to a delay in absorption, but did not have a substantial effect on the maximum concentration and Tmax. The absorption, onset of effect, and elimination of the medication in individuals over 65 years of age are the same.

Efficiency of Maxalt

In clinical trials, the effectiveness of Rizatriptan for migraines was evaluated according to criteria such as:

- The share of individuals who have achieved pain elimination or its relief (drop in severity from initially severe/moderate to mild/absent) within two hours after the dosage intake;

- No migraine relapse within 48 hours;

- Time to achieve pain elimination/relief;

- The need to take medications to relieve symptoms within two hours after treatment.

Studies with a total of 4814 individuals indicate that Rizatriptan 10 mg is substantially more effective than placebo in relieving pain within two hours after the intake (18 and 37 %, respectively), maintaining pain-free status for 24 hours (7 and 25%, respectively), reducing the severity of nausea, photophobia, and functional disability.

Indications for Maxalt use

You can buy Maxalt or a generic version of the medication if you suffer from migraine attacks with or without aura, including menstrual migraine.

Contraindications for Maxalt use

- The medication is contraindicated in cases where the patient has a pronounced hypersensitivity (allergy) to the main or one of the auxiliary components.

- Simultaneous administration of MAO inhibitors;

- Severe hepatic or renal failure;

- Cerebrovascular accident, ischemic attack;

- Arterial hypertension;

- Diseases of the coronary arteries, peripheral vessels, coronary heart disease, and others;

- Basilar or hemiplegic migraine. - Non-migraine headaches of unknown cause.

- Use in children.

Pregnancy and lactation

This drug can be used with caution in pregnant women, if necessary. If it is necessary to take the medication during breastfeeding, lactation is stopped.

Dosage and administration

Before you buy Rizatriptan, make sure to get checked and eliminate all other causes of severe headaches. If migraine is confirmed, you can use the medication as follows:

This drug is administered orally. When an attack occurs, the tablet should be put in the mouth, where it will dissolve with saliva. Drinking water with the drug is desirable, but not necessary. It can be used without washing out, if at the time of the attack you don’t have access to drinking water.

The medication is not intended for prevention of migraines.

Eating postpones the effect for about 60 minutes, therefore, to accelerate the action, you should not take it with food.

The recommended dosage is 10 mg. The next dose is possible not earlier than 2 hours later, but the daily dosage must not exceed 20 mg.

Individuals with renal and hepatic insufficiency need to reduce the dosage to 5 mg in 1 dose.

A patient should consult a doctor if the symptoms of the disease did not disappear during the use of the drug or if adverse reactions not listed in the instructions for medical use of the drug are observed.

Overdose

An overdose of Maxalt can cause:

- Dizziness;

- Drowsiness;

- Arterial hypertension, other heart or vessels disorders;

- Potentiating of other side effects.

In this case, symptomatic treatment should be performed. The effectiveness of hemodialysis is not confirmed.

Adverse effects of Rizatriptan

The drug is usually well tolerated if used in recommended doses. But when you buy generic Rizatriptan for the first time some side effects may occur:

- Allergic reactions - anaphylactic shock, dermatosis;

- Insomnia, nervousness;

- Dizziness, drowsiness, reduced sense of touch or sensation, tremor;

- Ataxia, dysgeusia, fainting;

- Cramps, blurred vision;

- Tachycardia, bradycardia, arrhythmia, ECG abnormalities;

- Ischemia, myocardial infarction, flushing;

- Arterial hypertension, wheezing, shortness of breath;

- Ischemic colitis, fatigue, asthenia;

- Nausea, vomiting, dyspepsia;

- Hyperemia, sweating, myalgia.

Frequency of Maxalt adverse effects compared to Placebo

Interactions of Maxalt

- Through a synergistic effect, the simultaneous use of Rizatriptan with ergotamine, ergot alkaloids derivatives, other 5HT1B / 1D receptor agonists increases the risk of coronary spasm and blood tension raising effects. Therefore, their combination is prohibited.

- Rizatriptan is metabolized with the participation MAO-A. It’s level in the blood and the severity of negative effect on the heart can substantially increase when the drug is combined with MAO inhibitors so their simultaneous use is prohibited.

- Plasma Rizatriptan level may increase while it is used with Propranolol. Thus, the dosage of Rizatriptan should be lowered to 5 mg.

- There are reports of serotonin syndrome (changed mental state, autonomic nervous system disorders, and neuromuscular disorders) that have appeared after the use of SSRI antidepressants with the anti-migraine drug.

- It is recommended that you wait at least six hours after taking the medication before using ergotamine-type drugs (e.g. ergotamine, dihydroergotamine). Before taking Rizatriptan, you should wait at least 24 hours after using drugs containing ergotamine. Although these medicines were used in clinical pharmacology studies involving 16 healthy male volunteers, no additional vasospastic effect was observed, such an additional effect is theoretically possible.

- In the simultaneous use of the medications from the class and herbal formulations containing St. John's wort, adverse reactions can be observed more often.

- The potential for drug interactions with CYP 2D6 isoenzyme substrates should be considered.

Special recommendations

- You should order Maxalt only if you are diagnosed with migraine of non-basilar or hemiplegic type.

- The formulation must not be used to treat atypical headaches, that is, headaches that may be caused by potentially serious health conditions (e.g., acute cerebrovascular disorders, rupture of aneurysms), in which narrowing of the vessels can be dangerous.

- Rizatriptan can cause transient symptoms, such as pain and a feeling of tightness in the chest, which can become intense and spread to the larynx. If such symptoms suggest the presence of coronary heart disease, the drug cannot be used in the future, and an appropriate examination should be carried out.

- The formulation should not be prescribed without prior examination to individuals with suspected undiagnosed heart disease or to individuals at risk of developing coronary atherosclerosis (for example, patients with arterial hypertension, diabetes, smokers, men over 40 years old, women after menopause, cases of serious diseases of the coronary arteries in the family, and others).

- In patients using the medications from the class, angioedema may develop (e.g., swelling of the face, tongue, and larynx). In case of swelling occurrence, the patient should be monitored until the symptoms disappear. If they don’t, the treatment should be stopped immediately and the medication should be replaced with another one belonging to a different class of active substances.

- Long-term use of any pain medication to treat a headache can provoke an exacerbation of it. If there is a suspicion or occurrence of a headache provoked by excessive use of medications, you should stop treatment and consult a doctor.

- Migraines or Rizatriptan use may cause drowsiness in some patients so it’s advised to refrain from driving when taking the pills.

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