Rizagrin

Introduction
Rizagrin is a prescription medicine used in the treatment of acute attack of migraine. It relieves the symptoms of migraine and prevents the attack from becoming worse. This medicine helps by narrowing the blood vessels, thereby relieving migraine headaches. Rizagrin may be taken with or without food. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Do not skip any doses and finish the full course of treatment even if you feel better and if you have missed a dose, take it as soon as you remember. You should continue to take this medicine for as long as doctor advises and do not stop taking it suddenly. Side effects associated with the use of this medicine include neck pain, dry mouth, sensation of heaviness, nausea, weakness, jaw pain, throat pain and paresthesia (tingling or pricking sensation). However, these are usually temporary and usually resolve on their own. Please consult your doctor if these do not subside or worry you. It may also cause sleepiness in the beginning of your treatment, so do not drive, operate machinery, until you know how this medicine affects you. This medicine may cause changes in your mood and you may feel depressed, therefore, regular monitoring of behavior is important. Pregnant or breastfeeding mothers should consult their doctor before taking this medicine. Inform your doctor if you are suffering from any heart problems, as the use of Rizagrin is contraindicated in some heart diseases. Regular monitoring of blood pressure is required while taking this medicine. Consult your doctor and stop this medicine if you develop severe chest or stomach pain, bloody diarrhea, or significantly high blood pressure, after taking this medicine.

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Uses of Rizagrin
Acute migraine headache
Side effects of Rizagrin
Common
Dizziness
Dryness in mouth
Heaviness
Jaw pain
Nausea
Neck pain
Sleepiness
Throat pain
Weakness
How to use Rizagrin
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Rizagrin may be taken with or without food, but it is better to take it at a fixed time.
How Rizagrin works
Migraine headaches are thought to result from the dilatation of blood vessels in the head. Rizagrin works by constricting (narrowing) these blood vessels, thereby relieving the migraine headaches.
Quick Tips
You have been prescribed Rizagrin for treatment of migraine headaches.
Some tips that may help avoid a migraine attack:
It may cause sleepiness. Don’t drive or do anything that requires mental focus until you know how it affects you.
Notify your doctor if your migraine occurs more often after starting the medication.
Notify your doctor if you have stomach pain, headache, bloody diarrhoea or worsening high blood pressure.
Inform your doctor if you have a history of heart disease or stroke.
This medication does not prevent migraine attacks from happening.
Brief Description
Indication
Acute migraine attacks
Administration
May be taken with or without food.
Adult Dose
Oral Acute migraine attacks Adult: Initially, 10 mg. If ineffective, 2nd dose should not be taken for the same attack. If symptoms recur after initial response, a further dose of 10 mg may be given. Doses should be separated by at least 2 hr. Max: 20 mg/24 hr. If patient is also taking propanolol, initiate with 5 mg. Max: 10 mg/24 hr. Ensure that the 2 drugs are separated by at least 2 hr. Hepatic Impairment For mild-moderate impairment, initate with 5 mg. Further dose of 5 mg may be taken after an interval of at least 2 hr. Max: 10 mg/24 hr. Avoid in severe impairment.

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Child Dose
Migraine Headache Acute treatment of migraine with or without aura <6 years: Safety and efficacy not established 6-17 years (<40 kg): 5 mg PO once q24hr 6-17 years: (40 kg or greater): 10 mg PO once q24hr Dosing considerations Efficacy and safety of treatment with more than 1 dose within 24 hours in pediatric patients has not been established 6-17 years (<40 kg) taking propranolol: Do not administer rizatriptan 6-17 years (>40 kg) taking propranolol: Limit dose to 5 mg PO once q24hr as necessary; not to exceed 5 mg/24hr

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Renal Dose
Renal Impairment For mild-moderate impairment, initate with 5 mg. Further dose of 5 mg may be taken after an interval of at least 2 hr. Max: 10 mg/24 hr. Avoid in severe impairment.

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Contraindication
History of MI, peripheral vascular disease, transient ishaemic attack, ischaemic heart disease or Prinzmetal’s angina; uncontrolled hypertension; basilar or hemiplegic migraine; severe hepatic or renal impairment. Adolescent <18 yr. _ Mode of Action Rizatriptan is a selective serotonin (5-HT1) agonist in cranial arteries responsible for vasoconstriction and reduction of inflammation associated with antidromic neuronal transmission. Precaution Elderly; mild to moderate hepatic or renal impairment; coronary artery disease; pregnancy, lactation. May cause drowsiness. History of seizures. Ensure an interval of at least 24 hr after stopping an ergotamine compound and starting a serotonin (5-HT1) agonist. Lactation: Unknown; use with caution in breastfeeding _ Side Effect >10% Drowsiness (13-30%, dose related),Fatigue (13-30%, dose related),Dizziness (11-15%) 1-10% Dizziness (4-9%),Somnolence (4-8%),Fatigue (4-7%; dose related),Nausea (4-6%),Asthenia (1-5%),Hot flashes (1-5%),Paresthesia (3-4%),Dry mouth (3%),Chest pain (2-3%),Pain/pressure in chest, neck, throat, jaw (<2%),Headache (<2%),Dyspnea (>1%),Hypoesthesia (>1%),Palpations (>1%),Skin flushing (>1%) <1% Tachycardia,Angioedema,Wheezing,Hypertensive crisis,Bradycardia,Hallucination,Epidermal necrolysis,Hearing impairment,Arrhythmias,Myocardial infarction and coronary artery vasospasm in patients with CAD risk factors Potentially Fatal: Toxic epidermal necrolysis. _ Interaction Increased serum concentrations with propranolol. Increased risk of vasospastic reactions when used with ergotamine and methysergide. Concurrent use with SSRIs may increase risk of serotonin syndrome. Potentially Fatal: Concurrent use with or within 2 wk of stopping MAOI treatment. _