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Rizact md should not be used within 24 hours of treatment with another 5-ht 1 agonist, or an ergotamine-containing or ergot-type medication like dihydroergotamine or methysergide.

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Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome.

The development of a potentially life-threatening serotonin syndrome may occur with triptansincluding rizatriptan treatmentparticularly during combined use with SSRIs or SNRIsIf concomitant treatment with rizatriptan and an SSRIe.gfluoxetineparoxetinesertralinefluvoxaminecitalopramescitalopramor SNRIe.gvenlafaxineduloxetineis clinically warrantedcareful observation of the patient is advisedparticularly during treatment initiation and dose increases or with addition of another serotonergic medicationSerotonin syndrome symptoms may include mental status changese.gagitationhallucinationsand comaautonomic instabilitye.gtachycardialabile blood pressureand hyperthermianeuromuscular aberrationse.ghyperreflexiaincoordinationand/or gastrointestinal symptomse.gnauseavomitingand diarrhoea

Cerebral haemorrhagesubarachnoid haemorrhagestroke and other cerebrovascular events have been reported in patients treated with 5-HT 1 agonistsand some have resulted in fatalitiesIn a number of casesit appears possible that the cerebrovascular events were primarythe agonist having been administered in the incorrect belief that the symptoms experienced were a consequence of migrainewhen they were notIt should be noted that patients with migraine may be at increased risk of certain cerebrovascular eventse.gstrokehaemorrhagetransient ischaemic attack

Cases of life-threatening serotonin syndrome have been reported during combined use of selective serotonin reuptake inhibitorsSSRIsor serotonin norepinephrine reuptake inhibitorsSNRIsand triptansThere have been reports describing patients with symptoms compatible with serotonin syndromeincluding altered mental statusautonomic instability and neuromuscular abnormalitiesfollowing the use of SSRIs or serotonin norepinephrine reuptake inhibitorsSNRIsand triptans.

5-HT 1 agonists may cause vasospastic reactions other than coronary artery vasospasmBoth peripheral vascular ischaemia and colonic ischaemia with abdominal pain and bloody diarrhoea have been reported with 5-HT 1 agonists.

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