In patients receiving propranolol, the 5mg dose of rizact tablets should be used, up to a maximum of three doses in any 24-hour period.

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Rizatriptan should only be used where a clear diagnosis of migraine has been establishedRizatriptan should not be administered to patients with basilar or haemiplegic migraineAs with other 5-HT 1B1D agonistssensations of tightnesspainpressure and heaviness have been reported after treatment with rizatriptan in the precordiumthroatneck and jawThese events have not been associated with arrhythmias or definite ischaemic electrocardiogramECGchanges in clinical trialsone patient experienced chest pain with possible ischaemic ECG changesBecause drugs in this class may cause coronary artery vasospasmpatients who experience signs or symptoms suggestive of angina following dosing should be evaluated for the presence of coronary artery diseaseCADor a predisposition to Prinzmetal’s variant angina before receiving additional doses of medicationand should be monitored by ECG if dosing is resumed and similar symptoms recurSimilarlypatients who experience other symptoms or signs suggestive of decreased arterial flowsuch as ischaemic bowel syndrome or Raynaud’s syndrome following the use of any 5-HT 1 agonist are candidates for further evaluation.

As with other 5-HT1 agonistssensations of tightnesspainpressureand heaviness in the precordiumthroatneck and jaw commonly occur after treatment with rizatriptan and are usually noncardiac in originHoweverif a cardiac origin is suspectedpatients should be evaluatedPatients shown to have CAD and those with Prinzmetal’s variant angina should not receive 5-HT1 agonists.

Rizatriptanshould not be given to patients with ischemic or vasospastic coronary artery diseaseThere have been rare reports of serious cardiac adverse reactionsincluding acute myocardial infarctionoccurring within a few hours following administration of rizatriptanSome of these reactions occurred in patients without known coronary artery diseaseCAD5-HT1 agonistsincluding rizatriptanmay cause coronary artery vasospasmPrinzmetal’s Anginaeven in patients without a history of CAD.

The administration of rizatriptan with other 5-HT 1 agonistse.gsumatriptanzolmitriptannaratriptanhas not been evaluated in migraine patientsBecause their vasospastic effects may be additiveco-administration of rizatriptanand other 5-HT 1 agonists within 24 hours of each other is not recommended.

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