Rizatriptan Side Effects: What to Expect and When to Call Your Doctor

What Are the Most Common Side Effects of Rizatriptan?

Most people who take rizatriptan experience mild side effects that appear within an hour of taking the medication and resolve within a few hours. In clinical trials, adverse experiences were typically mild and short-lasting (2-3 hours). Here are the most common side effects:

Dizziness — A feeling of lightheadedness or spinning; very common, especially with the 10 mg dose

Drowsiness / Somnolence — Feeling sleepy or tired; can be helpful during a migraine since many patients benefit from rest; avoid driving until you know how rizatriptan affects you

Fatigue / Asthenia — A general sense of weakness or tiredness; common and usually resolves within a few hours

Nausea — Can occur both as a migraine symptom and as a side effect of rizatriptan; the ODT formulation may be preferred if nausea is a major concern

Dry mouth — Mild and transient; drink water after taking the medication

Chest tightness or pressure — A triptan sensation reported by some users; often described as a pressure or tightening in the chest, neck, or jaw. In most patients this is not cardiac in origin and resolves quickly — BUT see "Serious Side Effects" below for when this needs medical attention.

Paresthesia — Tingling or prickling sensations, usually in the face, neck, or extremities; generally harmless and transient

Serious Side Effects: When to Seek Emergency Help

Although rare, rizatriptan can cause serious and potentially life-threatening side effects.

Call 911 or go to the emergency room immediately if you experience:

Chest pain that is severe, crushing, or spreading to your arm or jaw — these could be signs of a heart attack

Sudden weakness or numbness on one side of your body — could indicate a stroke

Sudden severe headache unlike any you've had before — could be a sign of an intracranial emergency (rizatriptan should not be used for this type of headache)

Slurred speech, vision changes, or loss of coordination — possible stroke symptoms

Severe stomach pain or bloody diarrhea — may indicate ischemic colitis (a rare vascular side effect)

Serotonin Syndrome: A Special Warning

If you also take SSRIs (like sertraline, fluoxetine, or escitalopram), SNRIs (like duloxetine or venlafaxine), or MAO inhibitors, you are at increased risk of serotonin syndrome — a dangerous condition caused by too much serotonin activity in the nervous system.

Symptoms of serotonin syndrome include: agitation, rapid heart rate, fever, sweating, shivering, muscle rigidity, twitching, confusion, and loss of coordination. This is a medical emergency — call 911.

Important: Do NOT take rizatriptan within 14 days of stopping an MAO inhibitor — this combination is contraindicated.

Medication Overuse Headache (MOH): A Common Pitfall

Using any acute migraine medication — including rizatriptan — more than 10 days per month can paradoxically make your headaches more frequent. This is called medication overuse headache (MOH), or rebound headache.

The FDA recommends that rizatriptan not be used to treat more than 4 headaches in a 30-day period. If you find yourself needing it more often than that, talk to your doctor about starting a preventive migraine therapy.

Side Effects in Special Populations

Elderly patients: More likely to have underlying cardiovascular disease; rizatriptan should be used with caution and may require a thorough cardiovascular evaluation first.

Children (ages 6-17): Rizatriptan is FDA-approved for this age group; dosing is weight-based (5 mg for <40 kg, 10 mg for ≥40 kg). Safety of more than one dose in 24 hours has not been established in pediatric patients.

Pregnancy: Use during pregnancy is not recommended. Discuss alternatives with your OB/GYN if you develop migraines during pregnancy.

Breastfeeding: Data on rizatriptan in breast milk are limited. Generally, it is recommended to avoid breastfeeding for at least 24 hours after taking a dose.

Tips to Reduce Common Side Effects

Start with the 5 mg dose if you are sensitive to medications — the 10 mg dose is more effective but has a higher rate of side effects.

Take rizatriptan at the onset of headache pain, not during the aura — it's less effective if you wait.

Lie down in a dark, quiet room after taking rizatriptan — this helps both the medication work faster and reduces the sensation of dizziness.

Avoid driving for several hours after taking rizatriptan if you feel drowsy or dizzy.

For a full list of drug interactions and what to avoid when taking rizatriptan, see: Rizatriptan Drug Interactions: What to Avoid and What to Tell Your Doctor

If you're having trouble filling your rizatriptan prescription, medfinder can help you locate it quickly at pharmacies near you.