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The following information outlines crucial safety considerations regarding the use of rizatriptan (Maxalt). Please ensure you review these details thoroughly and discuss any concerns with your healthcare provider.

• Cardiovascular Concerns: There is a rare risk of severe heart issues, including heart attack and irregular heart rhythms, occurring shortly after taking rizatriptan (Maxalt). This medication can also elevate blood pressure, sometimes to dangerous levels. Individuals with a history of heart or blood vessel problems should consult their healthcare provider before use. Regular monitoring of blood pressure is advised, and any significant increase should be reported to your provider. Seek emergency medical attention if you experience symptoms such as a heart attack, severe headache, chest pain, or irregular heartbeat. Those at higher risk include individuals over 65, those with diabetes, obesity, high blood pressure, or who smoke.

• Neurological Risks: There have been instances of strokes or brain bleeding associated with triptans like rizatriptan (Maxalt). Symptoms can include sudden weakness on one side of the body, severe headaches, facial drooping, breathing difficulties, or speech and vision changes. These symptoms may mimic those of a migraine. If you've had a previous stroke, rizatriptan (Maxalt) is not suitable for you. Discontinue use and seek immediate medical help if you experience symptoms indicative of a stroke.

• Vascular Effects: Rizatriptan (Maxalt) may cause severe narrowing of blood vessels, potentially resulting in stomach pain, bloody diarrhea, vision problems, or changes in sensation and color of the hands and feet. If such symptoms occur, stop the medication and consult your healthcare provider.

• Overuse Precaution: Exceeding the recommended dosage can diminish the efficacy of rizatriptan (Maxalt) and may increase the frequency of migraine attacks. Inform your provider if you use multiple migraine medications for more than 9 days per month or experience more than four migraine episodes monthly to explore alternative treatments.

• Serotonin Syndrome Risk: There is a risk of developing serotonin syndrome, a serious condition caused by excess serotonin in the brain, when rizatriptan (Maxalt) is used with other medications that increase serotonin levels. These include certain antidepressants and pain medications. If you are taking other drugs that affect serotonin levels, consult your healthcare provider.

• Phenylketonuria Consideration: For those with phenylketonuria (PKU), the orally disintegrating tablets of rizatriptan (Maxalt) contain phenylalanine. It's important to inform your provider if you have PKU so they can prescribe a safer formulation.

Contraindications: Avoid using rizatriptan (Maxalt) if you have the following conditions, as they may pose significant health risks:

• Coronary artery disease.
• Coronary artery vasospasm (e.g., Prinzmetal's angina).
• History of stroke or transient ischemic attack.
• History of hemiplegic or basilar migraines.
• Peripheral vascular disease.
• Ischemic bowel disease.
• Uncontrolled high blood pressure.
• Recent use of ergot-containing or similar medications within the last 24 hours.
• Current or recent use (within the last 14 days) of monoamine oxidase inhibitors (MAOIs) like selegiline (Zelapar).

It is crucial to consult with your healthcare provider before taking rizatriptan (Maxalt) if any of the above conditions apply to you.

When taking this medication, you might experience some common side effects such as dizziness, drowsiness, tiredness, or nausea, which are generally mild. Additionally, you may notice feelings of tingling, dry mouth, or headaches. If these effects persist or worsen, it's advisable to consult with your healthcare provider.

In some cases, the medication can cause more significant symptoms like chest, jaw, or throat pain or pressure, which, while not usually serious, can resemble heart-related conditions. If you experience any severe symptoms like chest pain, shortness of breath, or unusual sweating, seek immediate medical assistance. The medication may also affect blood pressure, so regular monitoring is recommended.

Rare but serious side effects include symptoms indicative of heart problems, such as fast or irregular heartbeat, chest pain, or signs of a stroke like sudden weakness, speech issues, or vision changes. Seek urgent care if these occur. There's also a risk of serotonin syndrome, especially when combined with other serotonin-enhancing drugs, which may present as a fast heartbeat, hallucinations, or severe dizziness.

Furthermore, although rare, some individuals may experience a serious allergic reaction. Symptoms like rash, itching, swelling, or trouble breathing require prompt medical attention. If you encounter any side effects not listed here, it's important to contact your healthcare provider for guidance.

When using Rizatriptan (Maxalt), it is crucial to be aware of potential drug interactions. Avoid using this medication with MAO inhibitors, such as isocarboxazid, linezolid, methylene blue, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine, and others, because it can lead to a severe and possibly life-threatening reaction. MAO inhibitors should not be taken during treatment with Rizatriptan and generally should be avoided for two weeks prior to starting Rizatriptan. Consult your doctor for guidance on when to begin or discontinue use.

Additionally, combining Rizatriptan with drugs that increase serotonin levels, such as certain antidepressants (SSRIs like fluoxetine or paroxetine, and SNRIs like duloxetine or venlafaxine), St. John's wort, or recreational drugs like MDMA/ecstasy, can heighten the risk of serotonin syndrome, a potentially dangerous condition. This risk is more pronounced when starting or increasing doses of these medications.

If you are using ergotamine-based medications (like dihydroergotamine) or other "triptan" drugs (such as sumatriptan or zolmitriptan), ensure that there is at least a 24-hour gap between using these and Rizatriptan to minimize serious side effects. Furthermore, use caution if you are taking medications such as propranolol, as they may increase side effects, necessitating adjustments in dosage or frequency by your doctor. Always inform your healthcare provider and pharmacist about any medications or supplements you are taking to avoid potential interactions.