Maxalt and Maxalt XLT are brand names for the generic drug rizatriptan, used to relieve pain caused by migraine attacks.
Maxalt belongs to a group of drugs known as 5-hydroxytryptamine agonists, more commonly known as triptans.
Triptans work by increasing the brain’s sensitivity to serotonin, a neurotransmitter that causes blood vessels to contract. This relieves pressure in the brain that causes migraines.
Manufactured by Merck & Co., Maxalt was approved by the Food and Drug Administration (FDA) in 1998.
Don’t take Maxalt if you:
- Are allergic to rizatriptan or any other ingredients in the drug
- Have migraines caused by a disorder in your brain stem
- Have migraines that cause weakness on one side of your body
- Have high blood pressure that is not under control
- Have ischemic heart disease or other significant cardiovascular disease
- Have coronary artery vasospasm (including Prinzmetal’s angina)
- Have a history of stroke or transient ischemic attack (TIA)
Talk to your doctor before taking Maxalt if you:
- Have peripheral vascular disease (PVD) or poor circulation to the brain
- Have poor circulation in your bowels
- Are on dialysis
- Have liver problems
Pregnancy and Maxalt
The effects of Maxalt on a pregnant woman’s unborn child have not been studied.
If you’re pregnant, you and your doctor should determine whether the possible benefits of taking Maxalt are worth the potential risks to your baby’s health.
Scientists aren’t sure how taking Maxalt might affect a nursing baby, so talk to your doctor before taking the drug if you’re breastfeeding.
It’s always a good idea to talk to your doctor about all of your medications if you’re pregnant, planning a pregnancy, or breastfeeding.
Maxalt Side Effects
Common Side Effects
Tell your doctor if any of the following side effects are severe or don’t go away:
- Increased tiredness
- Dry mouth
- Pain or tightness in your chest, neck, or jaw
- Sensations of tingling, stabbing, or burning in your toes or fingertips
- Serious Side Effects
The following serious side effects require medical attention or emergency treatment:
- Allergic reaction (anaphylaxis) that may be life-threatening, characterized by hives, trouble breathing, and swelling of the throat and mouth
- Severe skin reactions
- Lack of blood flow to the heart, racing heartbeat, or irregular heartbeat
- Bleeding in the brain or between the brain and skull
- Heart attack or coronary artery spasm
- High blood pressure
- Lack of blood flow to the intestines or spleen
- Raynaud’s disease (coldness and numbness in the fingers and toes)
Taking Maxalt more than 10 days in a month may lead to more severe migraines.
If you’re taking another drug that affects serotonin levels in the body (many drugs for depression do this), taking Maxalt may put you at risk for a dangerous reaction caused by high levels of serotonin, known as serotonin syndrome.
Symptoms of serotonin syndrome include a racing heartbeat, enlarged pupils, extremely stiff muscles, diarrhea, and the inability to control body movements.
Severe cases of serotonin syndrome may cause seizures, an unusually high fever, and loss of consciousness.
If you have any of these symptoms, stop taking Maxalt and contact your doctor immediately.
Tell your doctor(s) and pharmacist about all prescription, over-the-counter, illegal, recreational, herbal, nutritional, or vitamin-containing drugs and supplements you’re taking.
Don’t take Maxalt if you’re taking any of the following drugs:
- Ergotamines like D.H.E. 45 (dihydroergotamine), Ergomar (ergotamine) and Methergine (methylergonovine)
- Matulane (procarbazine)
- Monoamine oxidase inhibitors (MAOIs) like Marplan (isocarboxazid)
- Nardil (phenelzine)
- Other triptans like Amerge (naratriptan), Frova (frovatriptan), Relpax (eletriptan), and Zomig (zolmitriptan)
- Parkinson’s drugs like Eldepryl, Emsam, or Zelapar (selegiline)
Other drugs that may have serious interactions with Maxalt include:
- Azilect (rasagiline)
- Brintelliex (vortioxetine)
- Celexa (citalopram), Cymbalta (duloxetine), Lexapro (citalopram), and Pristiq (desvenlafaxine)
- Parlodel or Cycloset (bromocriptine)
- Savella (milnacipran)
- The herbal supplement St. John’s wort
- Viibrid (vilazodone)
- Zyvox (linezolid)
Maxalt and Alcohol
Alcohol – like Maxalt – can cause nausea, dizziness, dry mouth, and headaches.
Drinking alcohol while taking Maxalt can make these side effects worse.
Try to limit or avoid alcohol while taking Maxalt if possible.
Maxalt and Grapefruit Juice
While it’s known that the liver breaks down Maxalt, scientists aren’t sure whether it handles the drug the same way as certain chemicals found in grapefruit – which could lead to an interaction.
Your best bet is to avoid grapefruit and grapefruit juice while taking Maxalt.
Both original Maxalt and quick-dissolving tablets come in doses of 5 milligrams (mg) and 10 mg.
Generic rizatriptan is available in similar doses.
Never take more than 30 mg of Maxalt in a day, and never take more tablets at a time than what your doctor has prescribed.
If you suspect an overdose of Maxalt, contact an emergency room or poison control center right away.
You can reach a poison control center at 800-222-1222.
Missed Dose of Maxalt
Since you should only take Maxalt when you’re having a migraine, missing a dose shouldn’t be an issue.