Rizatriptan Treatment for Migraine

Special Considerations

When nausea or vomiting are significant components of migraine attacks, consider a non-oral route of administration and add an antiemetic, as recommended by the American Academy of Family Physicians 1, 2
Rizatriptan should be taken early in an attack for optimal effectiveness, although the strength of evidence is not specified 3

For mild to moderate migraine attacks, start with NSAIDs as first-line treatment, as suggested by the American Academy of Family Physicians and the American College of Physicians 1, 4
For moderate to severe attacks or when NSAIDs are ineffective, use rizatriptan, following guidelines from the American Academy of Family Physicians and the American College of Physicians 1, 4
Limit acute treatments to no more than twice weekly to prevent medication-overuse headache, according to the American Academy of Family Physicians and the American College of Physicians 1, 5

Triptans, including rizatriptan, should not be used in patients with uncontrolled hypertension, basilar or hemiplegic migraine, as advised by the American Academy of Family Physicians 1, 2
Patients with ischemic heart disease or significant cardiovascular disease should avoid triptans, as recommended by the American Heart Association, although the specific guideline society is not mentioned 6

Track progress with a daily headache diary to assess treatment response and identify triggers, as suggested by the American Academy of Family Physicians 1
Consider preventive therapy if acute treatments are needed more than twice weekly, according to the American Academy of Family Physicians and the American College of Physicians 1, 5