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The undesirable effects observed with the administration of rizatriptan are dizzinesssomnolenceparaesthesiaheadachehypaesthesiadecreased mental acuitytremorhot flushes/flashespharyngeal discomfortdyspnoeapalpitationtachycardiapaintightness/pressure and/or heavy sensation in the chestneckthroat or jawregional heavinesspain in locations unspecifieddry mouthnauseavomitingdiarrhoeaflushingsweatingand asthenia/fatigue.

Patients with a Migraine AttackA migraine attack does not affect the pharmacokinetics of rizatriptan.

Current theories on the aetiology of migraine headache suggest that the symptoms are due to local cranial vasodilatation and/or to the release of vasoactive and pro-inflammatory peptides from sensory nerve endings in an activated trigeminal systemThe therapeutic activity of rizatriptan in migraine can most likely be attributed to agonist effects at 5-HT 1B/1D receptors on the extracerebralintracranial blood vesselswhich become dilated during a migraine attackand on nerve terminals in the trigeminal systemActivation of these receptors results in cranial vessel constrictioninhibition of neuropeptide release and reduced transmission in trigeminal pain pathways.

Serious cardiac eventsincluding some that have been fatalhave occurred following use of 5-HT 1 agonistsThese events are extremely rare and most have been reported in patients with risk factors predictive of CADEvents reported have included coronary artery vasospasmtransient myocardial ischaemiamyocardial infarctionventricular tachycardia and ventricular fibrillation.

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