What is the dosage for rizatriptan?

Rizatriptan Dosage for Acute Migraine Treatment

The standard dose of rizatriptan is 10 mg orally for adults, which can be repeated once after 2 hours if needed, with a maximum daily dose of 30 mg in 24 hours. 1

Standard Adult Dosing

• Initial dose: 5 mg or 10 mg orally 1

  • The 10 mg dose provides greater efficacy than 5 mg but carries slightly higher risk of adverse effects 1
  • Rizatriptan 10 mg offers the greatest early efficacy among oral triptans with best consistency (67% response in ≥2 of 3 attacks) 2

• Redosing interval: 2 hours minimum between doses 3, 1

  • If migraine returns after initial response, a second dose may be taken 2 hours after the first 1

• Maximum daily dose: 30 mg in any 24-hour period 4, 1

Pediatric Dosing (Ages 6-17 Years)

• Weight-based dosing: 1

  • <40 kg (88 lb): 5 mg single dose
  • ≥40 kg (88 lb): 10 mg single dose

• No redosing in pediatric patients - efficacy and safety of multiple doses within 24 hours has not been established in children 1

Critical Dosing Adjustments

Patients Taking Propranolol

Adults on propranolol: 1

• Use only 5 mg dose
• Maximum 3 doses in 24 hours (15 mg total)

Pediatric patients ≥40 kg on propranolol: 1

• Single 5 mg dose only (maximum 5 mg in 24 hours)
• Do NOT prescribe to propranolol-treated children <40 kg 1

Timing and Administration Strategy

• Take early when headache is still mild for maximum effectiveness 2
• Do NOT take during aura phase - no evidence of benefit 2
• Trial for 2-3 migraine episodes before abandoning rizatriptan as ineffective 2, 3

Formulation Options

• Standard tablets: 5 mg or 10 mg 1
• Orally disintegrating tablets (Maxalt MLT): beneficial when nausea/vomiting present 2, 3
  • Dissolves on tongue without water
  • Same dosing as standard tablets

Combination Therapy Enhancement

• Combine with fast-acting NSAID (naproxen sodium, ibuprofen lysine, or diclofenac potassium) if monotherapy insufficient 2

Common Pitfalls to Avoid

• Medication overuse: Do not exceed 4 headache treatments per 30-day period on average to avoid rebound headaches 3, 1
• Premature abandonment: Patients often switch medications too quickly; ensure trial of 2-3 episodes before declaring failure 2, 3
• Wrong timing: Taking during aura or waiting until severe pain reduces efficacy 2
• Propranolol interaction: Failure to dose-adjust leads to excessive rizatriptan exposure 1