This article describes possible interactions with rizatriptan oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Rizatriptan comes as a tablet that you’ll swallow. It’s also available as a film and tablet that dissolve in your mouth.
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Other drugs and rizatriptan
The drugs in the list below may interact with rizatriptan oral tablet. This article doesn’t include all drugs that may interact with rizatriptan.
Drug classes or drugs that may interact with rizatriptan oral tablet include:
- ergot alkaloids:*
- drug examples: dihydroergotamine (Migranal, Trudhesa), ergotamine (Ergomar)
- what might happen: can increase the risk of side effects of rizatriptan and the ergot alkaloid
- monoamine oxidase inhibitors (MAOIs):*
- other triptans:*
- drug examples: sumatriptan, eletriptan (Relpax)
- what might happen: can increase the risk of side effects of rizatriptan and the triptan drug
- selective serotonin reuptake inhibitors (SSRIs):
- drug examples: sertraline, citalopram
- what might happen: can increase the risk of serotonin syndrome as a side effect of rizatriptan and the SSRI
- serotonin and norepinephrine reuptake inhibitors (SNRIs):
- drug examples: venlafaxine (Effexor XR), duloxetine (Cymbalta)
- what might happen: can increase the risk of serotonin syndrome as a side effect of rizatriptan and the SNRI
- lithium (Lithobid):
- what might happen: can increase the risk of serotonin syndrome as a side effect of rizatriptan and lithium
- mirtazapine (Remeron):
- what might happen: can increase the risk of serotonin syndrome as a side effect of rizatriptan and mirtazapine
- propranolol (Inderal LA, Innopran XL):
- what might happen: can increase the risk of side effects of rizatriptan
- nefazodone:
- what might happen: can increase the risk of serotonin syndrome as a side effect of rizatriptan and nefazodone
* This is also a contraindication of rizatriptan. For more details, see the “When to avoid section” below.
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Health factors and rizatriptan
Certain medical conditions or other health factors may increase the risk of interactions with rizatriptan oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking rizatriptan, tell your doctor about your health history. They’ll discuss any rizatriptan warnings and precautions and determine whether rizatriptan is right for you.
These health conditions or other factors might interact with rizatriptan oral tablet:
* This is also a contraindication of rizatriptan. For more details, see the “When to avoid section” below.
Questions about rizatriptan and interactions
Here you’ll find answers to some common questions about rizatriptan and possible interactions.
Does rizatriptan interact with ibuprofen?
No, rizatriptan isn’t reported to interact with ibuprofen.
Rizatriptan is prescribed to treat a migraine episode once it occurs. Your doctor may also recommend taking ibuprofen to treat pain or headache related to a migraine episode. These medications are generally considered safe to take together.
However, ibuprofen has other interactions that may affect you. For this reason, talk with your doctor or pharmacist before taking ibuprofen to make sure it’s safe for you.
Is there an interaction between rizatriptan and caffeine?
No, there’s no known interaction between rizatriptan and caffeine.
However, according to the American Migraine Foundation, caffeine or caffeine withdrawal can be a migraine trigger in some people. For this reason, it may be best to avoid caffeine once migraine symptoms appear. But for other people, caffeine may help relieve a headache.
Talk with your doctor to learn more about identifying your migraine triggers, and the best way to treat both mild headaches and migraine episodes.
Does rizatriptan oral tablet have different interactions than rizatriptan oral film?
No, for the most part. Interactions of rizatriptan oral tablet and rizatriptan oral film are expected to be the same. (Rizatriptan oral film dissolves on your tongue, making it easier to take if you have trouble swallowing pills.)
However, if you need to take both propranolol and rizatriptan, your doctor may prescribe a lower dose of rizatriptan oral tablet instead of rizatriptan oral film. (Propranolol is used to treat high blood pressure and other heart-related conditions.) This is because rizatriptan oral film only comes in one dose, which may cause side effects if taken with propranolol. If you need to take both propranolol and rizatriptan, your doctor will likely prescribe a lower dose of rizatriptan oral tablet to lower the risk of an interaction occurring.
Talk with your doctor or pharmacist if you have questions about interactions of different forms of rizatriptan.
When to avoid rizatriptan
Certain health conditions or other factors could increase some risks with rizatriptan oral tablet. Because of this, doctors may not prescribe rizatriptan in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for rizatriptan oral tablet:
- If you take or have recently taken a MAOI drug: Taking rizatriptan if you currently take or have recently taken an MAOI drug increases your risk of serotonin syndrome as a side effect. (Serotonin syndrome is a serious condition that’s caused by high levels of serotonin in your body.)
- If you take or have recently taken certain other drugs for migraine: Rizatriptan should not be taken with certain other migraine medications, including ergot alkaloids and other triptans. (Rizatriptan is a triptan drug.) Taking rizatriptan with these drugs raises your risk of serotonin syndrome as a side effect.
- If you have coronary artery disease or coronary artery spasms: If you have these conditions, you may have a higher risk of serious heart-related side effects if you take rizatriptan. This includes if you’ve had a heart attack in the past.
- If you have hemiplegic or basilar migraine: Rizatriptan is not approved to treat hemiplegic or basilar migraine. It’s not known if the drug is safe or effective for treating these types of migraine.
- If you have high blood pressure that isn’t managed: Rizatriptan can increase blood pressure as a side effect. If you have unmanaged high blood pressure, this increase could be serious and lead to other heart-related side effects, including a hypertensive emergency.
- If you have ischemic bowel disease: If you have ischemic bowel disease, you may have a higher risk of digestive side effects from taking rizatriptan. Rizatriptan could also worsen symptoms of your condition.
- If you have peripheral vascular disease: If you have peripheral vascular disease, you may have a higher risk of certain side effects of rizatriptan. Rizatriptan could also worsen symptoms of your condition.
- If you’ve had a stroke or transient ischemic attack: Rarely, stroke and certain types of bleeding in the brain have happened in people taking triptan drugs, such as rizatriptan. If you’ve ever had a stroke or transient ischemic attack, also called “ministroke,” you may have a higher risk of these side effects with rizatriptan treatment.
- Past allergic reaction to rizatriptan: If you’ve ever had an allergic reaction to rizatriptan oral tablet, taking it again may cause another allergic reaction.
Before you start taking rizatriptan, tell your doctor if anything listed above relates to you. They can recommend whether you should take rizatriptan.
Alcohol and rizatriptan
There aren’t known interactions between rizatriptan oral tablet and alcohol.
However, alcohol can be a trigger for migraine symptoms in some people. It could also worsen symptoms of a migraine episode that’s already occurring.
If you drink alcohol, talk with your doctor about whether it’s safe to consume it while taking rizatriptan oral tablet.
Other interactions and rizatriptan
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether rizatriptan oral tablet has these interactions.
The information below doesn’t include all other possible interactions with rizatriptan.
Rizatriptan and supplements
Before taking rizatriptan oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
In addition to interactions discussed below, rizatriptan can interact with tryptophan supplements. Tryptophan is an amino acid that people may take in supplement form for certain health benefits, such as to improve sleep quality.
Taking rizatriptan and using a tryptophan supplement increases the risk of serotonin syndrome. Because of this risk, your doctor will likely suggest avoiding tryptophan supplements if you’re taking rizatriptan.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Rizatriptan interactions and herbs
Rizatriptan oral tablet isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before using any of these products while taking rizatriptan oral tablet.
Rizatriptan interactions and vitamins
Rizatriptan oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before using any of these products while taking rizatriptan oral tablet.
Rizatriptan and food
Rizatriptan oral tablet isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking rizatriptan oral tablet.
Note: Rizatriptan can interact with tryptophan supplements. Tryptophan is an amino acid also found in certain foods, including fish and soy. However, rizatriptan isn’t expected to interact with tryptophan found in food, as the amount is lower than what is usually found in supplements.
Rizatriptan and vaccines
Rizatriptan oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking rizatriptan oral tablet.
Rizatriptan and lab tests
Rizatriptan oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking rizatriptan oral tablet.
Rizatriptan and cannabis or CBD
Rizatriptan oral tablet isn’t known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this doesn’t mean interactions can’t happen or won’t be identified later.
As with any drug or supplement, tell your doctor before taking cannabis with rizatriptan.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Preventing rizatriptan interactions
You may be able to help avoid certain interactions with rizatriptan oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking/using rizatriptan oral tablet.
Taking rizatriptan exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about rizatriptan and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does rizatriptan have similar interactions as other triptans, such as sumatriptan?
- Are there other migraine medications available that don’t interact with heart conditions?
- If I develop a heart problem while taking rizatriptan, will my treatment be stopped?
- Are there other treatments for migraine that are safe to take with rizatriptan?
- If I’m taking an SSRI and I’m prescribed rizatriptan, how will I be monitored for serotonin syndrome?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
