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Maxalt MLT (rizatriptan) is a powerful triptan medication effective at alleviating the pain, auras, light and sound sensitivity, nausea, and other symptoms associated with migraine headaches. It also sees off-label use in mitigating cluster headache pain.

This product is distinct from Maxalt RPD in that this product, Maxalt MLT, is orally-dissolving tablets (ODT). Maxalt MLT is ideal for patients who have difficulty swallowing whole tablets; simply place an orally-dissolving tablet on the tongue and let it dissolve.

Managing Migraines with Maxalt MLT

Maxalt MLT is available in two strengths; 5 mg or 10 mg orally-dissolving tablets. In most cases patients are started on 5 mg doses. If 5 mg does not provide substantial relief dosage may be increased to 10 mg. If 5 mg produces no noticeable effects, alternative treatments should be considered; it's likely the headache is not actually a migraine, or is a hemiplegic or basilar migraine, neither of which respond well to triptan medications.

Once it is established that Maxalt MLT does work, treatment is straightforward:

• Take one dose at the first signs a migraine is developing.
• If symptoms are not sufficiently alleviated, or the headache returns, an additional dose may be taken after 2 hours.
• Always wait at least 2 hours between doses.
• Do not exceed 30 mg of Maxalt MLT in a 24-hour period.
• Do not take other triptan medications within a day of taking Maxalt MLT.

Another advantage of Maxalt MLT over Maxalt RPD is the speed at which effects are felt; Maxalt MLT orally-dissolving tablets start working in about 15 minutes, while it takes Maxalt RPD tablets about 30 to 60 minutes to produce significant effects. Faster-acting medications are obviously desirable in any pain relief, but are particularly beneficial in severe migraines and cluster headaches where the speed at which the medication is absorbed is often the difference between the medication working well or not. Of course, for every advantage there is a drawback; the effects of Maxalt MLT do not last as long as Maxalt RPD tablets.

Precautions & Adverse Effects

Like any medication, Maxalt MLT can produce undesirable side effects. Individuals with certain preexisting conditions are at increased risk of experiencing adverse effects from this product, or any other triptan medication:

• Any heart or blood vessel problems
• Severe or untreated hypertension
• Inadequate blood supply to the intestine (ischemic bowel disease)
• Any high risk factors for heart disease or stroke

The above conditions are a concern because triptan drugs are vasoconstrictors; they narrow blood vessels. Any condition in which blood flow is impaired for any reason to any part of the body is worrisome with triptans; likewise narrower blood vessels means higher blood pressure.

Patients who do not have blood pressure or circulation issues typically only experience mild side effects, including:

• Drowsiness
• Dizziness
• Diarrhea
• Dry mouth
• Flushing
• Muscle pain or cramps
• Nausea
• Stomach cramps
• Tremors
• Vomiting

Some medications can also cause complications with Maxalt MLT; as with preexisting conditions, any medication which influences circulation or increases blood pressure---this includes recreational drugs like alcohol and cocaine---can cause potentially dangerous side effects. Of particular concern are:

• SSRIs, SNRIs, MAOIs and some other antidepressants
• Medications containing ergotamine, another vasoconstrictor migraine treatment
• Other medications containing triptans
• St John’s Wort

It is wise to check with a doctor or pharmacist before mixing any medications and patients are strongly advised to do so before taking Maxalt MLT.