What it is and what it is used for

for Rizatriptan belongs to a class of medicines called selective serotonin 5-HT1B/1D receptor agonists. Rizatriptan is used to treat the headache phase of the migraine attack in adults. Treatment with Rizatriptan reduces swelling of blood vessels surrounding the brain. This swelling results in the headache pain of a migraine attack.

What you need to know before you take it

e Rizatriptan

Do not take Rizatriptan if:

• you are allergic to rizatriptan benzoate or any of the other ingredients of this medicine (listed in section 6)
• you have moderately severe or severe high blood pressure or mild high blood pressure that is not controlled by medicines
• you have or have ever had heart problems including heart attack or pain on the chest (angina) or you have experienced heart disease-related signs
• you have severe liver or severe kidney problems
• you have had a stroke (cerebrovascular accident-CVA) or mini stroke (transient ischaemic attack-TIA)
• you have blockage problems with your arteries (peripheral vascular disease)
• you are taking monoamine oxidase (MAO) inhibitors such as moclobemide, phenelzine, tranylcypromine or pargyline (medicines against depression) or linezolid (an antibiotic) or if it has been less than two weeks since you stopped taking MAO inhibitors
• you are now taking ergotamine-type medicines, such as ergotamine or dihydro-ergotamine to treat your migraine or methysergide to prevent a migraine attack
• you are taking any other medicine in the same class, such as sumatriptan, naratriptan or zolmitriptan to treat your migraine (see Other medicines and Rizatriptan below). If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking Rizatriptan.

Warnings and precautions Talk to your doctor or pharmacist before taking Rizatriptan, if:

• you have any of the following risk factors for heart disease: high blood pressure, diabetes, you smoke or you are using nicotine substitution, your family has a history of heart disease, you are a man over 40 years of age, or you are a post-menopausal woman
• you have kidney or liver problems
• you have a particular problem with the way your heart beats (bundle branch block)
• you have or have had any allergies
• your headache is associated with dizziness, difficulty in walking, lack of coordination or weakness in the leg and arm
• you use any herbal preparation containing St. John's wort
• you have had an allergic reaction like swelling of the face, lips, tongue and/or throat which may cause difficulty breathing and/ or swallowing (angioedema)
• you are taking selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram oxalate, and fluoxetine or serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine and duloxetine for depression
• you have had short lived symptoms including chest pain and tightness. If you take Rizatriptan too often, this may result in you getting a chronic headache. In such cases you should contact your doctor as you may have to stop taking Rizatriptan. Tell your doctor or pharmacist about your symptoms. Your doctor will decide if you have a migraine. You should take Rizatriptan only for a migraine attack. Rizatriptan should not be used to treat headaches that might be caused by other, more serious conditions.

Other medicines and Rizatriptan Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. This includes herbal medicines and those you normally take for a migraine. This is because Rizatriptan can affect the way some medicines work. Also, other medicines can affect Rizatriptan. Do not take Rizatriptan if you are taking:

• a 5-HT1B/1D agonist (sometimes referred to as 'triptans'), such as sumatriptan, naratriptan or zolmitriptan
• a monoamine oxidase (MAO) inhibitor such as moclobemide, phenelzine, tranylcypromine, linezolid or pargyline or if it has been less than two weeks since you stopped taking an MAO inhibitor

• ergotamine-type medicines such as ergotamine or dihydro-ergotamine to treat your migraine
• methysergide to prevent a migraine attack. The above listed medicines when taken with Rizatriptan may increase the risk of side effects. You should wait at least 6 hours after taking Rizatriptan before you take ergotamine- type medicines such as ergotamine or dihydro-ergotamine or methysergide. You should wait at least 24 hours after taking ergotamine-type medicines before taking Rizatriptan. Ask your doctor for instructions and the risks about taking Rizatriptan if you are taking:
• propranolol (see section 3)
• SSRIs such as sertraline, escitalopram oxalate and fluoxetine or
• SNRIs such as venlafaxine and duloxetine for depression. Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription.

Rizatriptan with food and drink Rizatriptan can take longer to work if it is taken after food. Although it is better to take it on an empty stomach, you can still take it if you have eaten.

Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby ask your doctor or pharmacist for advice before taking this medicine. Available data on the safety of rizatriptan when used during the first 3 months of pregnancy do not suggest an increased risk of birth defects. It is not known whether Rizatriptan is harmful to an unborn baby when taken by a pregnant woman after the first 3 months of pregnancy. If you are breastfeeding, you may postpone breastfeeding for 12 hours after treatment to avoid exposure in your baby.

Driving and using machines You may feel sleepy or dizzy while taking Rizatriptan. If this happens, do not drive or use any tools or machines.

Rizatriptan contains aspartame This medicine contains 1.45mg aspartame in each orodispersible tablet. This medicine contains 2.90mg aspartame in each orodispersible tablet. Aspartame is a source of phenylalanine. It may be harmful if you have phenylketonuria (PKU), a rare genetic disorder in which phenylalanine builds up because the body cannot remove it properly.

How to take it

Rizatriptan Rizatriptan is used to treat migraine attacks. Take this medicine as soon as possible after your migraine headache has started. Do not use it to prevent attack. Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. The recommended dose is 10mg. If you are currently taking propranolol or have kidney or liver problems you should use the 5mg dose of Rizatriptan. You should leave at least 2 hours between taking propranolol and Rizatriptan up to a maximum of 2 doses in a 24-hour period.

Method of administration

• Open the blister with dry hands.
• The score line is not intended for breaking the tablet.
• The orodispersible tablet should be placed on your tongue, where it dissolves and can be swallowed with the saliva.
• The Rizatriptan orodispersible tablet can be used in situations in which liquids are not available or to avoid the nausea and vomiting that may accompany the ingestion of tablets with liquids.

If migraine returns within 24 hours In some patients, migraine symptoms can return within a 24-hour period. If your migraine does return, you can take an additional dose of Rizatriptan. You should always wait at least 2 hours between doses.

If after 2 hours you still have migraine If you do not respond to the first dose of Rizatriptan during an attack, you should not take a second dose of Rizatriptan for treatment of the same attack. It is still likely, however, that you will respond to Rizatriptan during the next attack. Do not take more than 2 doses of Rizatriptan in a 24-hour period. You should always wait at least 2 hours between doses. If your condition worsens, seek medical attention.

Use in children and adolescents The use of Rizatriptan in children under 18 years of age is not recommended.

Use in patients older than 65 years There have been no full studies to look at how safe and effective Rizatriptan is amongst patients older than 65 years.

Pharmacodes

rizatriptan

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme (website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store). By reporting side effects you can help provide more information on the safety of this medicine.

How to store it

Rizatriptan

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may happen with this medicine. In studies, the most common side effects reported were dizziness, sleepiness and tiredness. Tell your doctor right away if you have symptoms of allergic reactions, serotonin syndrome, heart attack or stroke (see the list below). In addition, tell your doctor if you experience any symptoms that suggest an allergic reaction (such as a rash or itching) after taking Rizatriptan.

Common: may affect up to 1 in 10 people

• tingling (paraesthesia), headache, decreased sensitivity of skin (hypoesthesia), decreased mental sharpness, insomnia
• fast or irregular heartbeat (palpitation)
• flushing (redness of the face lasting a short time)
• throat discomfort
• feeling sick (nausea), dry mouth, vomiting, diarrhoea, indigestion (dyspepsia)
• feeling of heaviness in parts of the body, neck pain, stiffness
• pain in abdomen or chest.

Uncommon: may affect up to 1 in 100 people

• bad taste in your mouth
• unsteadiness when walking (ataxia), dizziness (vertigo), blurred vision, tremor, fainting (syncope)
• confusion, nervousness
• high blood pressure (hypertension); thirst, hot flushes, sweating
• rash, itching and lumpy rash (hives), swelling of face, lips, tongue and/or throat which may cause difficulty breathing and/or swallowing (angioedema), difficulty breathing (dyspnoea)
• feeling of tightness in parts of the body, muscle weakness
• changes in rhythm or rate of the heartbeat (arrhythmia); abnormalities of the electrocardiogram (a test that records the electrical activity of your heart), very fast heartbeat (tachycardia)
• facial pain; muscle pain.

Rare: may affect up to 1 in 1000 people

• wheezing
• allergic reaction (hypersensitivity); sudden life-threatening allergic reaction (anaphylaxis)
• stroke (this generally occurs in patients with risk factors for heart and blood vessel disease (high blood pressure, diabetes, smoking, use of nicotine substitution, family history of heart disease or stroke, man over 40 years of age, postmenopausal women, particular problem with the way your heart beats [bundle branch block]))
• slow heartbeat (bradycardia).

Not known: frequency cannot be estimated from the available data

• heart attack, spasm of blood vessels of the heart. These generally occur in patients with risk factors for heart and blood vessel disease (high blood pressure, diabetes, smoking, use of nicotine substitution, family history of heart disease or stroke, man over 40 years of age, post-menopausal women, particular problem with the way your heart beats [bundle branch block])
• a syndrome called "serotonin syndrome" that may cause side effects like coma, unstable blood pressure, extremely high body temperature, lack of muscle co-ordination, agitation, and hallucinations
• severe shedding of the skin with or without fever (toxic epidermal necrolysis)
• seizure (convulsions/fits)
• spasm of blood vessels of the extremities including coldness and numbness of the hands or feet
• spasm of the blood vessels of the colon (large bowel), which can cause abdominal pain.

Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and blister after "EXP". The expiry date refers to the last day of the month. Do not store above 30oC. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

Contents of the pack and other information

What Rizatriptan contains The active substance is rizatriptan. Each Rizatriptan 5mg orodispersible tablet contains 7.265mg of rizatriptan benzoate equivalent to 5mg of rizatriptan. Each Rizatriptan 10mg orodispersible tablet contains 14.53mg of rizatriptan benzoate equivalent to 10mg of rizatriptan. The other ingredients are: microcrystalline cellulose, maize starch, silica colloidal anhydrous, aspartame (E951), mint powder (consisting of mint oil, terpeneless mint oil, eucalyptol, menthone, isomenthone, menthyl acetate, menthol) and magnesium stearate.

What Rizatriptan looks like and contents of the pack 5mg orodispersible tablets are white, round, biconvex tablets with dimensions 7.1±0.1mm and 2.4±0.2mm in thickness. 10mg orodispersible tablets are white, round, biconvex tablets with a score line in one side and dimensions 10.0±0.1mm and 2.9±0.2mm in thickness. Pack sizes: Packs with 2, 3, 6, 12 or 18 orodispersible tablets. Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder: Aspire Pharma Ltd Unit 4, Rotherbrook Court Bedford Road Petersfield Hampshire GU32 3QG United Kingdom

Manufacturer: Pharmathen S.A. 6 Dervenakion str. 15351 Pallini Attiki Greece Or Pharmathen International S.A. Industrial Park Sapes Rodopi Prefecture Block No 5 Rodopi 69300 Greece This leaflet was last revised in 01/2025 1010074-P7.2

Pharmacodes

Reporting of side effects

If you take more Rizatriptan than you should, talk to your doctor or pharmacist straight away. Take the medicine pack with you. Signs of overdose can include dizziness, drowsiness, vomiting, fainting and slow heart rate. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Pharmacodes

If you take more Rizatriptan than you should