Rizamig 5 Tablet contains Rizatriptan Benzoate INN equivalent to Rizatriptan 5 mg. It is manufactured by Healthcare Pharmaceuticals Ltd. in Bangladesh.

Indications:

Rizamig is indicated for the acute treatment of migraine attacks with or without aura in adults. It is also indicated for the acute treatment of migraine with or without aura in pediatric patients aged 6 to 17 years.

Pharmacology:

Rizatriptan is a selective agonist for serotonin 5-HT₁B and 5-HT₁D receptors. Activation of these receptors on intracranial blood vessels leads to vasoconstriction, which is thought to contribute to the relief of migraine headache. Rizatriptan also inhibits the release of vasoactive neuropeptides from trigeminal nerve endings, further contributing to its antimigraine effect.

Dosage and Administration:

• Adults: The recommended starting dose is either 5 mg or 10 mg. The 10 mg dose may be more effective but may also have a higher risk of adverse reactions. Doses should be separated by at least 2 hours, and no more than 30 mg should be taken in any 24-hour period.
  • Patients receiving propranolol: The 5 mg dose should be used, up to a maximum of 3 doses in any 24-hour period.
• Pediatric Patients (6 to 17 years): Dosage is based on body weight.
  • Weight less than 40 kg: 5 mg as a single dose.
  • Weight 40 kg or more: 10 mg as a single dose.
  • The safety and efficacy of treating more than one headache within 24 hours in pediatric patients have not been established.
  • Pediatric patients taking propranolol: Rizamig should not be prescribed to propranolol-treated pediatric patients who weigh less than 40 kg. For those weighing 40 kg or more, the recommended single dose is 5 mg.

Rizamig tablets can be taken with or without food. Orally disintegrating tablets (ODT) are available; they should be placed on the tongue where they will dissolve and be swallowed with saliva. Do not remove the ODT blister from the outer pouch until just prior to dosing.

Side Effects:

Common side effects may include:

• Drowsiness
• Fatigue
• Dizziness
• Nausea

Less common side effects can include paresthesia (tingling or numbness), headache, dry mouth, chest pain or pressure, and neck pain.

Precautions:

• Rizatriptan should only be used if a clear diagnosis of migraine has been established.
• It should not be given to patients with ischemic heart disease, coronary artery vasospasm, uncontrolled hypertension, or a history of stroke or transient ischemic attack.
• Caution should be used in patients with mild to moderate hepatic or renal insufficiency.
• Drugs in this class may cause coronary artery vasospasm. Patients experiencing signs or symptoms suggestive of angina following dosing should be evaluated for the presence of CAD or a predisposition to Prinzmetal's variant angina before receiving additional doses.  
• Rizatriptan may cause drowsiness; patients should exercise caution while driving or operating machinery.

Contraindications:

Rizamig is contraindicated in patients with:  

• Ischemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or other significant underlying cardiovascular disease.  
• Coronary artery vasospasm, including Prinzmetal's angina.  
• History of stroke or transient ischemic attack (TIA).  
• Peripheral vascular disease.  
• Ischemic bowel disease.
• Uncontrolled hypertension.
• Hypersensitivity to rizatriptan or any of its inactive ingredients.
• Concurrent administration or recent discontinuation (within 2 weeks) of a monoamine oxidase (MAO-A) inhibitor.
• Use within 24 hours of ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) or other 5-HT₁ agonists.

Drug Interactions:

• Propranolol: May increase rizatriptan plasma concentrations. Use the 5 mg dose of Rizatriptan in patients taking propranolol.
• Ergot-containing drugs: Contraindicated within 24 hours due to increased risk of vasospastic reactions.
• Other 5-HT₁ agonists: Not recommended within 24 hours due to potentially additive vasospastic effects.
• MAO-A inhibitors: Contraindicated due to increased systemic exposure of rizatriptan.
• SSRIs and SNRIs: May increase the risk of serotonin syndrome.

Pregnancy and Lactation:

Rizamig should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Caution should be exercised when administering rizatriptan to breastfeeding women.   

Storage:

Store in a cool and dry place below 30°C, protected from light. Keep out of reach of children.

Important Note: This information is for general knowledge and informational purposes only and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication. They can assess your individual medical condition and provide the most appropriate advice.