Drug products: Maxalt, Maxalt Rapitab, Maxalt®, Maxalt® Rapitab®, Rizasmelt, Rizatriptan 2care4, Rizatriptan Actavis, Rizatriptan Aurobindo, Rizatriptan Glenmark, Rizatriptan Mylan, Rizatriptan Orifarm, Rizatriptan Sandoz, Rizatriptan STADA, Rizatriptan Teva
ATC code: N02CC04
Substances: rizatriptan, rizatriptan benzoate
Studies show the effect of rizatriptan in acute migraine to be similar in men and women.
Rizatriptan is used to treat acute migraine attacks .Migraine is almost twice as common in women as in men [2, 3]. In a Swedish population- based study the one-year prevalence was 16.7 % in women and 9.5 % in men  which is slightly lower than three months prevalence reported from the US . Another indication for (parenteral) triptans is cluster headache . This is a trigeminal autonomic cephalgia with very painful, unilateral and short-lasting headache attacks. Cluster headache is rare with an estimated prevalence of 0.1%. In contrast to migraine, cluster headache is more common in men than in women . The men-women ratio has recently been estimated to 2.5, older studies show a more pronounced male risk . Smoking is a risk factor for cluster headache and the increased risk in women has been associated with more smoking in women [5, 6].
The pharmacokinetics of single oral doses of rizatriptan 2.5-15 mg administrated to healthy volunteers was studied in a randomized, crossover study (12 men, 12 women). The mean AUC of oral rizatriptan was 19-35% higher in women than in men. However, the difference is not likely to be of clinical relevance. Plasma clearance of rizatriptan was about 25% higher in men than in women. No difference in the dose-effect relationship between men and women was noted . In another study (6 men, 6 women), where healthy volunteers received a single dose rizatriptan 10 mg, half-life was longer in men. Other pharmacokinetic parameters showed no sex differences [8, 9]. No pharmacokinetic differences between elderly men and women have been found .
The efficacy of rizatriptan 5 mg in adolescents (12-17 years old) was established in two randomized, placebo-controlled trials (212 men, 263 women). Rizatriptan 5 mg was shown to be more effective than standard care (patient’s usual migraine therapy) during long-term use (over 1 year). Treatment effects for pain relief were not dependent on patient’s sex .
Time to pain freedom in acute migraine with rizatriptan 10 mg was compared to standard care in a prospective, open-label study (197 men, 1292 women; mean age 41.7 years). There were no significant differences in time to pain freedom between men and women .
Results from randomized, double-blind studies of migraineurs (66 men, 280 women) show no sex differences in response to frovatriptan 2.5 mg, rizatriptan 10 mg, zolmitriptan 2.5 mg or almotriptan 12.5 mg .
According to trials performed by the pharmaceutical company, incidence of adverse reactions did not differ between men and women .
Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan).
Date of litterature search: 2020-01-17
Reviewed by: Mia von Euler, Diana Rydberg
Approved by: Karin Schenck-Gustafsson