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Rizatriptan

Classification: A

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

Summary

The effect of rizatriptan in acute migraine is similar in men and women.
 
The present evidence concerning differences between men and women is limited and do not motivate differentiation in dosing or treatment.

Additional information

Pharmacokinetics and dosing

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 ~25% higher in men than in women. No difference in the dose-effect relationship between men and women was noted [1]. 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 [2, 3]. No pharmacokinetic differences between elderly men and women have been found [4].

Effects

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. Treatment effects for pain relief were not dependent on sex [5].Time to pain freedom with rizatriptan 10 mg compared to usual care was evaluated in a prospective, open-label study (197 men, 1292 women; mean age 41.7 years). There were no differences in time to pain freedom between men and women [6].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 [7].

Adverse effects

According to trials done by the original manufacturer, incidence of adverse reactions did not differ between men and women [8].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Updated: 2019-02-26

Date of litterature search: 2014-06-17

References

  1. Lee Y, Conroy JA, Stepanavage ME, Mendel CM, Somers G, McLoughlin DA et al. Pharmacokinetics and tolerability of oral rizatriptan in healthy male and female volunteers. Br J Clin Pharmacol. 1999;47:373-8. PubMed
  2. Goldberg MR, Lowry RC, Musson DG, Birk KL, Fisher A, De Puy ME et al. Lack of pharmacokinetic and pharmacodynamic interaction between rizatriptan and paroxetine. J Clin Pharmacol. 1999;39:192-9. PubMed
  3. Dooley M, Faulds D. Rizatriptan: a review of its efficacy in the management of migraine. Drugs. 1999;58:699-723. PubMed
  4. Musson DG, Birk KL, Panebianco DL, Gagliano KD, Rogers JD, Goldberg MR. Pharmacokinetics of rizatriptan in healthy elderly subjects. Int J Clin Pharmacol Ther. 2001;39:447-52. PubMed
  5. Visser WH, Winner P, Strohmaier K, Klipfel M, Peng Y, McCarroll K et al. Rizatriptan 5 mg for the acute treatment of migraine in adolescents: results from a double-blind, single-attack study and two open-label, multiple-attack studies. Headache. 2004;44:891-9. PubMed
  6. Bell CF, Foley KA, Barlas S, Solomon G, Hu XH. Time to pain freedom and onset of pain relief with rizatriptan 10 mg and prescription usual-care oral medications in the acute treatment of migraine headaches: a multicenter, prospective, open-label, two-attack, crossover study. Clin Ther. 2006;28:872-80. PubMed
  7. Franconi F, Finocchi C, Allais G, Omboni S, Tullo V, Campesi I et al. Gender and triptan efficacy: a pooled analysis of three double-blind, randomized, crossover, multicenter, Italian studies comparing frovatriptan vs other triptans. Neurol Sci. 2014;35 Suppl 1:99-105. PubMed
  8. Maxalt (rizatriptan). DailyMed [www]. US National Library of Medicine. [updated 2013-01-01, cited 2014-06-17]. länk
  9. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-29] länk
  10. Dahlöf C, Linde M. One-year prevalence of migraine in Sweden: a population-based study in adults. Cephalalgia. 2001;21:664-71. PubMed

Authors: Linnéa Karlsson Lind, Desirée Loikas

Reviewed by: Mia von Euler

Approved by: Karin Schenck-Gustafsson