Maxalt (rizatriptan) is an abortive treatment for migraine headaches with or without aura. It is also used off-label to alleviate cluster headaches. In both cases the medication is only effective at stopping headaches that have already begun; it will not prevent future headaches from developing.

The active ingredient in Maxalt, rizatriptan, is in the triptan family of drugs. Like other triptans, Maxalt is highly effective at alleviating migraine pain and symptoms but does carry risk of potentially serious side effects. It is important to discuss use of this product with a doctor and to disclose any other medical conditions or medications being taken before starting treatment.

Maxalt for Maximum Migraine Relief

Like most headache treatments, Maxalt works best if taken at the earliest symptoms that a migraine is starting. For many individuals these early symptoms include aura, nausea or sensitivity to light or noise; for others it is the onset of pain.

Treatment can vary between individuals and guidelines may vary between countries. In most cases, the standard dose for otherwise healthy adults is 5 to 10 mg, which can be followed up with an additional 5 to 10 mg at 2-hour intervals if the symptoms persist or return. Regulatory agencies typically advise taking no more than 20 to 30 mg in a 24 hour period.

Maxalt's effects are dose-dependent; a higher dose provides greater relief. Unfortunately, higher doses also increase risk of potentially severe side effects. In most cases patients new to Maxalt start with 5 mg doses, increasing to 10 mg only if 5 mg proves insufficient. Starting with lower doses also gives an idea of how well a patient tolerates the medication at relatively safe levels.

Effects are noticeable within 15 to 30 minutes of taking a tablet and peak within 1 or 2 hours. Taking with food is optional; food may resolve stomach-related side effects, but the medication works faster if taken on an empty stomach. If vomiting occurs within 15 minutes of taking a dose, a replacement dose should be taken.

Additional methods that tend to alleviate migraine symptoms, such as laying down, dimming lights, taking a hot shower or whatever other techniques work for an individual, will further enhance the effects of Maxalt.

Using Maxalt for Cluster Headaches

As anyone with cluster headaches knows, treating this type of headache can be tricky. Generally more time-sensitive than migraines, the speed with which a cluster headache is treated is often the difference between success and failure. For this reason regular tablets are generally not the first choice for treatment; triptan rapidly-dissolving tablets, nasal sprays and injections are usually preferred.

That said, some patients do find Maxalt tablets successfully abort cluster headaches, particularly if taken at early stages. Dosage and administration is typically the same as for migraines; 5 to 10 mg per dose, repeated after 2 hours if needed.

Warnings & Side Effects

The majority of Maxalt users experience no side effects or only very mild, transient side effects, including:

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

Rarely more serious adverse effects occur, which warrant emergency medical attention:

• Pain or pressure in chest
• Difficulty breathing, speaking or swallowing
• Severe dizziness, disorientation or confusion
• Rapid, pounding or irregular heartbeat
• Persistent cold sweats
• Severe stomach pain
• Blood in stools or vomit
• Pain, weakness or numbness in arms or legs

Individuals who are under 18 and those who have medical conditions or are taking other medications will likely need adjusted doses to prevent potentially dangerous side effects. Speak with a doctor about potential risks before taking Maxalt if:

• Severely overweight or underweight
• There is a history of heart or blood vessel problems
• There is a high risk of heart disease or stroke
• There is a history of high blood pressure
• Other medications are being used

In most cases use should be avoided completely if:

• Pregnant or breastfeeding
• Other triptan medications have been taken in the last 24 hours
• Medications containing ergot have been taken in the last 24 hours
• A monoamine oxidase inhibitor (MAOI) has been taken in the last 2 weeks, or will be taken in the following 2 weeks

If too much Maxalt is taken, or if children or pets consume an unknown amount, emergency medical attention is warranted even if no symptoms are apparent.

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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.