Maxalt dosage, forms, and strengths

Maxalt (rizatriptan benzoate) is prescribed for acute treatment of migraine with or without aura. Maxalt is typically taken as a 5 mg or 10 mg tablet by mouth at the onset of a migraine. Maxalt is also available as an orally disintegrating tablet (Maxalt MLT) that is placed on the tongue and dissolves. More than 37 million women, men, and children in the United States experience the disabling condition of migraine. Fortunately, medications are available to prevent or treat migraines, and the list of meds is growing. Maxalt belongs to a group of medications called triptans that are only used to treat migraines. Other triptans include Imitrex (sumatriptan), Relpax (eletriptan), and Zomig (zolmitriptan).

Maxalt forms and strengths

• Tablets: 5 mg, 10 mg

• Orally disintegrating tablets: 5 mg, 10 mg

Maxalt dosage for adults

Maxalt is FDA-approved for adults who have migraines with or without aura. Twenty-five percent to 30% of people with migraine experience migraine with aura, according to the American Migraine Foundation. Maxalt works by constricting the blood vessels in the brainstem and reducing inflammatory substances in the body that can trigger migraine symptoms.

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Maxalt dosage for acute treatment of migraine

Migraines typically consist of a severe throbbing pain on either one or both sides of the head. Migraine attacks can last between four and 72 hours. People who have aura with migraines may have visual disturbances, sensory changes, or speech problems. These sensory disturbances can happen shortly before a migraine attack and usually last 20 to 60 minutes. Migraine symptoms vary by person and sometimes vary by each attack.

Typically, people will take a single dose of Maxalt at the onset of a migraine. If the migraine headache returns, a second dose may be taken two hours after the first dose. As an acute/abortive migraine treatment, Maxalt is used “on-demand” when a person starts to have a migraine. People may be prescribed a 5 mg or a 10 mg dose. The 10 mg dose may provide a greater effect than the 5 mg dose, but may have a greater risk of adverse reactions. It’s important to not take too much Maxalt. No more than 30 mg should be taken in any 24-hour period for adults.

RELATED: Migraine medications and treatments

Maxalt dosage for children

Maxalt is FDA-approved for children 6 to 17 years of age who have migraines with or without aura. According to the American Migraine Foundation, 1 in 10 children experience migraines. Maxalt dosing for children is based on body weight. It’s important to note that unlike adult dosing, the efficacy and safety of taking more than one dose of Maxalt within 24 hours in children 6 to 17 years of age have not been determined.

Maxalt dosage restrictions

Propranolol, a medication used for conditions such as high blood pressure and migraine prevention, can increase the amount of Maxalt in the body. Note the following dose adjustment for people taking propranolol:

• For adults, only the 5 mg Maxalt is recommended and up to 15 mg in a 24-hour period 

• For children 6 to 17 years of age who weigh equal to or more than 40 kg (88 lbs), only the 5 mg Maxalt is recommended and up to 5 mg in a 24-hour period

• For children 6 to 17 years of age who weigh less than 40 kg (88 lbs), Maxalt should not be used

Additionally, Maxalt MLT contains phenylalanine (not for use in people with phenylketonuria).

How to take Maxalt

Maxalt is a medication that is only taken when it is needed and should not be taken daily. It’s important to determine if the dosage form of Maxalt is tablets or orally disintegrating tablets (Maxalt MLT) to ensure proper administration.

• A doctor will determine how much medicine to use. Do not use more than directed. Use Maxalt only when having a migraine. 

• If the headache improves but then comes back, a second dose may be taken. Wait at least two hours before taking the second dose. The prescribing doctor should be called if the headache does not improve at all after the first dose.

• Read and follow the patient instructions and drug information that come with this medicine. Talk to the prescribing doctor or pharmacist for additional medical advice.

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

• Inform the prescribing healthcare professional about all prescription medications, over-the-counter medications, and supplements before starting Maxalt.

• This medication can be taken with or without food and at any time of the day.

• Tablet: Swallow whole with a glass of water. Do not crush, break, or chew it.

• Orally disintegrating tablet: Make sure hands are dry before handling the disintegrating tablet. Do not remove the blister from the outer aluminum pouch until ready to use. Peel back the foil from the blister pack, then remove the tablet. Do not push the tablet through the foil. Place the tablet on the tongue in the mouth. After it has dissolved, a drink of water may be taken if needed.

Maxalt dosage FAQs

Maxalt vs. Maxalt MLT: What’s the difference?

Maxalt is the tablet form of rizatriptan benzoate and Maxalt MLT is the orally disintegrating tablet form of rizatriptan benzoate. Maxalt MLT dissolves on the tongue and does not require drinking liquids, chewing, or swallowing. The disintegrating tablet form can be useful for children or older adults who have difficulty swallowing tablets. Additionally, Maxalt ODT can be beneficial for people on-the-go who don’t have easy access to a glass of water when a migraine attack happens.

How long does it take Maxalt to work?

Most people will experience migraine relief within two hours after taking the medication. Maxalt MLT has a slightly slower absorption than Maxalt by 0.7 hour.

How long does Maxalt stay in your system?

Maxalt has a half-life of two to three hours. This means after two to three hours, about half of the active medication is still in the body.

How long can you take Maxalt?

Maxalt is used as needed, however, the manufacturer states the safety of treating, on average, more than four headaches in a 30-day period has not been established. If a person is experiencing an increase in need for acute/abortive migraine treatment, a preventative migraine medicine should be considered.

What is the maximum dosage for Maxalt?

For adults, the maximum daily dose should not exceed 30 mg in any 24-hour period. For children 6 to 17 years of age who weigh equal to or more than 40 kg (88 lbs), the maximum dose is up to 5 mg in a 24-hour period. For children 6 to 17 years of age who weigh less than 40 kg (88 lbs), Maxalt should not be used.

Can you overdose on Maxalt?

Maxalt overdose is possible and reports include symptoms of dizziness, fainting, slowed heartbeat, vomiting, and incontinence (loss of bladder control). If an overdose is suspected, call 9-1-1 and seek emergency medical help immediately.

What interacts with Maxalt?

It’s important to review all medications with a doctor before starting Maxalt to make sure there aren’t any drug interactions. There are some migraine medications that cannot be taken with Maxalt.

• Triptans: Medications in the same class as Maxalt must be avoided. These medications include almotriptan, eletriptan, frovatriptan, naratriptan, sumatriptan, and zolmitriptan.

• Ergot derivatives: Some of these medications are used as migraine treatment and must not be used with Maxalt. These medications include dihydroergotamine, ergotamine, and methylergonovine (used for uterine contractions/bleeding).

• Monoamine oxidase/MAO Inhibitors: MAOIs are used as depression treatment. The medications that should be avoided are isocarboxazid, phenelzine, tranylcypromine, and selegiline transdermal. People are at an increased risk of serotonin syndrome if Maxalt is combined with these medications. 

• Certain antidepressants: Serotonin syndrome can also occur if Maxalt is combined with other antidepressants including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs).

• Isoniazid: This medicine used to treat tuberculosis must be avoided with Maxalt.

• Linezolid: This antibiotic must be avoided with Maxalt.

• Procarbazine: This cancer treatment must be avoided with Maxalt.

• Yohimbe: This natural, over-the-counter product must be avoided with Maxalt.

What are the most common side effects of Maxalt?

Maxalt is generally well-tolerated by most people. The 10 mg tablets may have more side effects than the 5 mg tablets. The most common side effects include fatigue, asthenia (weakness), sleepiness, a pain/pressure-like sensation, dry mouth, and dizziness. These adverse effects are often mild and only last for a short period of time.

The pain/pressure-like sensation that happens is referred to as triptan sensations. These sensations can occur with all triptan medications including Maxalt. The sensation can be described as a tingling, numbness, warmth, and pressure or tightness in the chest and neck. Chest pain is the most alarming symptom for people. Triptan sensations occur more commonly in women and younger people. This may be reduced by switching to a different triptan or route of administration. 

Who should not take Maxalt?

Maxalt is not the best acute migraine treatment for everyone and has some contraindications with certain medical conditions. People with certain heart problems, arrhythmias, heart disease, and cardiovascular disease have risk factors for serious side effects with Maxalt.

Maxalt is contraindicated in the following people who have:

• Ischemic coronary artery disease (angina pectoris, history of heart attack, or documented silent ischemia)

• Coronary artery vasospasm including prinzmetal’s angina

• History of stroke or transient ischemic attack

• Peripheral vascular disease

• Ischemic bowel disease

• Uncontrolled hypertension (high blood pressure)

• Hemiplegic or basilar migraine

• Recent use of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication 

• Concurrent administration or recent discontinuation (i.e., within two weeks) of a MAO-A inhibitor

What is medication overuse headache?

Medication overuse headache can happen when a person uses acute migraine medication, like Maxalt, too often. A person may have daily headaches or an increased frequency of migraine-like headaches. Medication overuse headache can be stopped if the overused migraine medication is discontinued and different acute migraine medications are used to manage a possible withdrawal headache.

What happens when you mix Maxalt and alcohol?

Maxalt does not interact with alcohol. However, alcohol can be a trigger for a migraine attack. It’s important for people to limit or avoid alcohol if it can lead to migraine headaches.

RELATED: Alcohol and migraine meds

Is it safe to take Maxalt during pregnancy?

There are no adequate and well-controlled studies in pregnant women. Maxalt should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. The decision to use Maxalt during pregnancy will be decided between the doctor and the patient. 

Is it safe to take Maxalt while breastfeeding?

It is not known if Maxalt passes into breast milk. Other agents are preferred for the treatment of migraine in breastfeeding women. The decision to use Maxalt while nursing will be decided between the doctor and the patient

Related resources for Maxalt dosages:

• Maxalt prescribing information, FDA/Merck

• The true pain of migraine misconceptions, American Migraine Foundation 

• Understanding migraine with aura, American Migraine Foundation

• Maxalt, migraine.com

• Adult dosing, Epocrates

• Migraine in children, American Migraine Foundation

• Pediatric dosing, Epocrates

• Maxalt MLT dosing, Epocrates

• Guidance for industry orally disintegrating tablet, FDA

• Drug interactions, Epocrates

• Side effects, Epocrates

• An overview of generic triptans for migraine, U.S. Pharmacist