rizatriptan

CLINICAL USE

Acute treatment of migraine

DOSE IN NORMAL RENAL FUNCTION

10 mg, repeated after 2 hours if required; maximum of 2 doses in 24 hours

PHARMACOKINETICS

Molecular weight :391.5 (as benzoate)

%Protein binding :14

%Excreted unchanged in urine : 14

Volume of distribution (L/kg) :110 litres (females), 140 litres (males)

half-life – normal/ESRD (hrs) :2–3/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Use with caution 5 mg, repeated after 2 hours; maximum 15 mg daily

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GR=

10 to 20

mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antidepressants: risk of CNS toxicity with MAOIs and linezolid – avoid for 2 weeks after discontinuation of MAOI; possibly increased serotonergic effects with duloxetine; increased serotonergic effects with St John’s wort – avoid concomitant use

Ergot alkaloids: increased risk of vasospasm – avoid concomitant use
Propranolol: rizatriptan levels increased, reduce dose of rizatriptan to 5 mg (max 10 mg in 24 hours)

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

Administration with food delays absorption by approximately 1 hour
Metabolised to mainly inactive metabolites <1% excreted in the urine as active N-monodesmethyl metaboliteAUC increases by 44% in haemodialysis patients

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