Patient Medication Information: uses, side effects, how to take - Maxalt
ABOUT THIS MEDICATION
The name of your medicine is MAXALT®. It can only be obtained by prescription from your physician. The decision to use MAXALT® is one that you and your physician should make jointly, taking into account your individual preferences and medical circumstances. If you have risk factors for heart disease (such as high blood pressure, high cholesterol, obesity, diabetes, smoking, strong family history of heart disease, or you are a post-menopausal female, or a male over 40), tell your physician. Your physician should evaluate you for heart disease in order to determine whether MAXALT® is appropriate for you.
What the medication is used for
MAXALT® is intended to relieve your migraine headache and other associated symptoms of a migraine attack in adults. MAXALT® should not be used continuously to prevent or reduce the number of attacks you experience. Use MAXALT® only to treat an actual migraine headache attack.
What it does:
Migraine headache is believed to be caused by a widening of the blood vessels in the head. MAXALT® narrows the vessels and relieves the pain and other symptoms of migraine headache.
When it should not be used
Do not take MAXALT® if you:
are allergic to any of the ingredients (see What the
nonmedicinal ingredients are section)
- have uncontrolled or severe high blood pressure
- have heart disease or history of heart disease
- have severe liver disease
- have had a stroke or transient ischemic attack (TIA)
have or have had blood vessels problems, including ischemic
bowel disease
- take monoamine oxidase (MAO) inhibitors such as moclobemide, phenelzine, tranylcypromine, or pargyline, or have taken MAO inhibitors within the last two weeks.
MAXALT® should not be used to relieve pain other than that associated with migraine headache.
MAXALT® should not be used within 24 hours of treatment with another 5-HT1 agonist such as sumatriptan (Imitrex*), naratriptan (Amerge*) or zolmitriptan (Zomig*), or ergotamine-type medications such as ergotamine, dihydroergotamine or methysergide.
Please also see WARNINGS AND PRECAUTIONS.
What the medicinal ingredient is:
rizatriptan benzoate
What the nonmedicinal ingredients are:
Tablets
Ferric oxide (red), lactose monohydrate, magnesium stearate, microcrystalline cellulose and pregelatinized starch.
Wafers
Aspartame, gelatin, glycine, mannitol and peppermint flavor.
What dosage forms it comes in:
Tablets
MAXALT® (rizatriptan benzoate) is available as a 5 mg or 10 mg pale pink tablet containing either 5 mg or 10 mg of rizatriptan.
Wafers
MAXALT RPD® is available as white to off-white round wafer containing 5 or 10 mg rizatriptan, from rizatriptan benzoate.
WARNINGS AND PRECAUTIONS
If the answer to any of the following questions is YES or if you do not know the answer, then please speak with your physician before you take any MAXALT®.
Are you pregnant? Do you think you might be pregnant? Are you trying to become pregnant? Are you using inadequate contraception? Are you breast feeding?
- Do you or have you ever experienced any pain or tightness in the chest, (which may or may not spread to your neck, jaw, or upper arm), shortness of breath, rapid heartbeats or irregular heartbeats? Do you have angina?
- Have you ever had heart or blood vessel disease? Have you had a heart attack or stroke?
- Do you have risk factors for heart disease, such as: high blood pressure, high cholesterol, smoking, obesity, diabetes, or strong family history of heart disease? Are you post-menopausal, or a male over 40?
- Have you ever had to stop taking this or any other medication because of an allergy or other problems?
Are you taking any other migraine 5-HT1 agonist medications
such as Imitrex* (sumatriptan succinate/sumatriptan) or Amerge* (naratriptan as naratriptan hydrochloride), Zomig* (zolmitriptan) or migraine medications containing ergotamine, dihydroergotamine, or methysergide?
Are you taking any medications for depression such as
selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram oxalate, and fluoxetine or serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, duloxetine, or monoamine oxidase inhibitors (MOIs)?
Have you ever experienced numbness on one side of your body
when you have a headache?
- Have you ever had, or do you have epilepsy or seizures?
Have you ever had, or do you have liver disease or kidney
disease?
- Is this headache different from your usual migraine attacks?
- Are you over 65 years of age?
Phenylketonuric patients:
You should be aware that this product contains phenylalanine (a component of aspartame). Each 5 mg MAXALT RPD® wafer contains 1.05 mg phenylalanine and each 10 mg MAXALT RPD® wafer contains 2.10 mg phenylalanine.
Continuous use of Maxalt®:
If you take MAXALT too often, this may result in you getting chronic headaches or marked increases in the frequency of your migraine attacks. In such cases, you should contact your doctor, as you may have to stop taking MAXALT®.
If you are not sure whether you should take MAXALT®, contact your physician or pharmacist.
MAXALT® use during pregnancy:
Do not use MAXALT® if you are pregnant, think you might be pregnant, are trying to become pregnant or are using inadequate contraception, unless you have discussed this with your physician.
INTERACTIONS WITH THIS MEDICATION
If you are taking any other migraine medication, check with your physician first before taking MAXALT® and inform your physician of any other medications you may be taking, including those obtained without a prescription.
Do not take MAXALT® or MAXALT RPD® if you take monoamine oxidase (MAO) inhibitors such as moclobemide, phenelzine, tranylcypromine, or pargyline, or have taken MAO inhibitors within the last two weeks.
Ask your physician for instructions about taking MAXALT® or MAXALT RPD® if you are taking selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram oxalate, and fluoxetine or serotonin norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, duloxetine for depression. A life-threatening
condition called serotonin syndrome can happen when medicines called triptans, such as MAXALT®, and medicines used to treat depression and mood disorders called SSRIs and SNRIs are used together. Signs and symptoms of serotonin syndrome include the following: restlessness, diarrhea, hallucinations, coma, loss of coordination, nausea, fast heartbeat, vomiting, increased body temperature, changes in blood pressure and overactive reflexes.
PROPER USE OF THIS MEDICATION
REMEMBER: this medicine was prescribed only for YOU. Only a physician knows who can use it safely. Never give it to someone else. It may harm them, even if their symptoms are the same as yours.
Usual dose
For adults, the usual dosage is 5 or 10 mg, as recommended by your physician. The dose should be taken as soon as your migraine appears, but it may be taken at any time during your migraine headache.
If you are taking a tablet, swallow your dose with water.
If you are using MAXALT RPD®, leave the wafer in its package until you are ready to take it. Remove the blister from the foil pouch. Do not push the wafer through the blister; rather, peel open the blister pack with dry hands and place the wafer on your tongue. The wafer will dissolve rapidly and be swallowed with your saliva. No liquid is needed to take the wafer.
A second dose may be taken if your headache returns. Repeat doses cannot be taken any sooner than 2 hours following the first dose. Do not take more than 20 mg in any 24-hour period.
For any attack where you have no response to the first dose, do not take a second dose without first consulting your physician.
Overdose:
In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
Although the vast majority of MAXALT® users have not experienced any significant problems, you should be aware of the following side effects:
Common side effects
- Sensations of pain, pressure or tightness in the chest, neck, throat, jaw or arms. If this happens to you, then discuss it with your physician before using any more MAXALT®. If the chest pain is severe (may resemble an angina attack) or does not go away, stop taking drug and call your physician immediately.
Tingling, heat, heaviness or pressure, dizziness, tiredness, or
feeling sick. Tell your physician if you have any of these symptoms.
Drowsiness. Do not drive or operate machinery until you are
sure that you are not drowsy.
Irregular or rapid heartbeats. If this happens to you, stop taking
drug and then discuss it with your physician before using any more MAXALT®.
Uncommon side effects
Rapid onset of numbness or weakness on one side of the body
(often beginning in one arm). If this occurs, stop taking drug and call your physician immediately.
Muscle pain. If this occurs, stop taking drug and call your
physician immediately.
Rare side effects
Shortness of breath, wheeziness, heart throbbing, swelling of
the eyelids, face, tongue or lips; or a skin rash or skin lumps or hives or spasms of blood vessels of the extremities including coldness and numbness of the hands and feet. These effects happen rarely, but if any do occur, do not take any more MAXALT® and contact your physician immediately.
Sudden or severe abdominal pain. If this occurs, stop taking
drug and call your physician immediately.
Very rare side effects
There have been very rare reports of seizures. If this occurs,
stop taking drug and call your physician immediately.
Spasm of the blood vessels of the colon (large bowel). If this
occurs, stop taking drug and call your physician immediately.
If you feel unwell in any other way or have symptoms that you do not understand or find distressing, you should contact you physician immediately.
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY | ||||||
| HAPPEN AND WHAT TO DO ABOUT THEM | ||||||
| Symptom / effect | Talk with your physician or pharmacist | Stop taking drug and call your physician or pharmacist | ||||
| Only if severe | In all cases | |||||
| Common | Sensations of pain, pressure or tightness in the chest, neck, throat, jaw or arms | ✓ | ||||
| Tingling, heat, heaviness or pressure in any part of the body | ✓ | |||||
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY | ||||||
| HAPPEN AND WHAT TO DO ABOUT THEM | ||||||
Symptom / effect Headache, dizziness, tiredness, nausea, vomiting, dry mouth, drowsiness Irregular or rapid heartbeats | Talk with your physician or pharmacist | Stop taking drug and call your physician or pharmacist | ||||
| Only if severe | In all cases | |||||
| ✓ | ||||||
| ✓ | ||||||
| Uncommon | Rapid onset of numbness or weakness on one side of the body (often beginning in one arm) | ✓ | ||||
| Muscle pain | ✓ | |||||
| Rare | Shortness of breath, wheeziness, heart throbbing, swelling of the eyelids, face, tongue or lips; or a skin rash or skin lumps or hives or spasms of blood vessels of the extremities | ✓ | ||||
| Sudden or severe abdominal pain | ✓ | |||||
| Very rare | Seizures | ✓ | ||||
| Spasm of the blood vessels of the colon (large bowel) | ✓ | |||||
This is not a complete list of side effects. For any unexpected effects while taking MAXALT® or MAXALT RPD®, contact your physician or pharmacist.
HOW TO STORE IT
Keep your medicine in a safe place where children cannot reach it. MAXALT® could be harmful to children. Store your medication between 15°C and 30°C, away from direct heat. If you are storing MAXALT RPD® Wafers, do not remove the blister from the outer aluminum pouch until you are ready to take the medicine inside.
If your physician decides to stop your treatment, do not keep any leftover medicine unless your physician tells you to do so.
If your medicine has expired, do not use it. It is recommended to take leftover medication to a pharmacy for proper disposal.
REPORTING SUSPECTED SIDE EFFECTS
You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways:
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- Report online at www.healthcanada.gc.ca/medeffect
- Call toll-free at 1-866-234-2345
Complete a Canada Vigilance Reporting Form and: -Fax toll-free to 1-866-678-6789, or -Mail to: Canada Vigilance Program Health Canada
Postal Locator 0701E
Ottawa, Ontario
K1A 0K9
Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffect™ Canada Web site at
www.healthcanada.gc.ca/medeffect.
or at Merck Canada Inc. by one of the following 2 ways:
- Call toll-free at 1-800-567-2594
Complete a Canada Vigilance Reporting Form and:
-Fax toll-free to 1-800-369-3090, or
-Mail to: Merck Canada Inc.
Pharmacovigilance
P.O. Box 1005
Pointe-Claire – Dorval, QC H9R 4P8
NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program or Merck does not provide medical advice.
MORE INFORMATION
This document plus the full product monograph, prepared for health professionals can be found at:
http://www.merck.ca
or by contacting the sponsor, Merck Canada Inc., at: 1-800-567-2594.
Last revised: May 8, 2013
® Registered trademarks of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Used under license.
* All other trademarks are the property of their respective owner(s).
©2011, 2013 Merck Canada Inc., a subsidiary of Merck & Co., Inc. All rights reserved.