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As with other 5-HT1 agonistssensations of tightnesspainpressureand heaviness in the precordiumthroatneck and jaw commonly occur after treatment with rizatriptan and are usually noncardiac in originHoweverif a cardiac origin is suspectedpatients should be evaluatedPatients shown to have CAD and those with Prinzmetal’s variant angina should not receive 5-HT1 agonists.

There are no adequate and well-controlled studies in pregnant womenthereforerizatriptan should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.

RacePharmacokinetic data revealed no significant differences between African-American and Caucasian subjects.

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.

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