Maxalt - Comprehensive Usage Guide: instructions, indications, composition, side effects
Composition
- Active Ingredient: Rizatriptan benzoate
- Excipients: May include microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, hypromellose, triacetin, titanium dioxide (E171), and other inactive ingredients depending on the formulation.
Official Forms
- Maxalt is available in various formulations, including:
- Tablets: Available in strengths such as 5 mg and 10 mg.
Pharmacological Group
- Maxalt belongs to the pharmacological group of selective serotonin 5-HT1 receptor agonists (triptans) (ATC code: N02C C04).
Pharmacological Properties
- Pharmacodynamics: Rizatriptan is a selective agonist for serotonin (5-HT1B and 5-HT1D) receptors. Its primary action is to cause vasoconstriction of cranial arteries and inhibition of neuropeptide release, resulting in the relief of migraine headache.
- Pharmacokinetics: Rizatriptan is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations achieved within 1-1.5 hours after oral administration. It undergoes extensive hepatic metabolism via monoamine oxidase (MAO) and cytochrome P450 enzymes. The elimination half-life is approximately 2-3 hours.
Indications
- Maxalt is indicated for the acute treatment of migraine attacks with or without aura in adults. It is not intended for the prophylactic therapy of migraine or for the treatment of cluster headaches.
Contraindications
- Maxalt is contraindicated in individuals with:
- Hypersensitivity to rizatriptan or any component of the formulation
- Ischemic heart disease (e.g., angina pectoris, history of myocardial infarction)
- Prinzmetal’s angina
- Peripheral vascular disease
- Uncontrolled hypertension
- History of stroke or transient ischemic attack (TIA)
- Severe hepatic impairment
- Concomitant use with ergotamine derivatives or other 5-HT1 receptor agonists
- Concomitant use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOIs
Interactions
- Maxalt may interact with various medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), MAOIs, ergotamine derivatives, and other triptans, potentially increasing the risk of serotonin syndrome or other adverse effects. Caution is advised when co-administering Maxalt with these agents.
Specifics of Use
- Maxalt tablets should be taken orally with a full glass of water, preferably as soon as migraine symptoms appear. The dosage and frequency of administration depend on the severity of the migraine and the patient’s response to therapy.
Pregnancy and Breastfeeding
- Maxalt should be used during pregnancy only if the potential benefits justify the potential risks to the fetus. It is not recommended for use during breastfeeding, as rizatriptan may be excreted in human breast milk.
Impact on Motor Functions
- Maxalt may cause dizziness or drowsiness. Patients should be cautious when driving or operating machinery until they know how Maxalt affects them.
Dosage and Administration
- The recommended starting dose of Maxalt is 5 mg, taken as soon as migraine symptoms appear. If migraine relief is not achieved, a second dose may be taken after at least 2 hours, not exceeding a total daily dose of 30 mg.
- For patients with hepatic impairment or mild to moderate renal impairment, a lower starting dose of 5 mg is recommended.
Overdose
- In case of overdose, supportive measures should be initiated as needed. Symptoms of overdose may include serotonin syndrome, chest pain, bradycardia, hypertension, and central nervous system depression. Patients should seek medical attention if overdose is suspected.
Side Effects
- Common side effects of Maxalt may include:
- Dizziness
- Fatigue
- Somnolence
- Nausea
- Dry mouth
- Chest pain or tightness
- Palpitations
- Serious adverse effects such as myocardial ischemia, myocardial infarction, ventricular tachycardia, and transient ischemic attack (TIA) may occur rarely.
Storage and Shelf Life
- Maxalt should be stored at room temperature (25°C) in a dry place, protected from light and moisture. Check the expiration date on the packaging and discard any expired or unused medication.
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