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Open Access 17-06-2024 | Rizatriptan | REVIEW

Rizatriptan as an Over-the-Counter Triptan in the Treatment of Migraine Attacks

Authors: Carl H. Göbel, Axel Heinze, Anna Cirkel, Hartmut Göbel

Published in: Pain and Therapy | Issue 4/2024

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Abstract

Around 91% of migraine patients use over-the-counter medicines to treat attacks, often without further treatment or medical consultation. This therapeutic principle is established in most countries, regardless of how the healthcare system is otherwise structured or financed. Using Germany as an example, the basis for an expansion of attack therapy with rizatriptan as an over-the-counter triptan is described. To achieve the best possible tolerability and safety in the context of self-medication, the lowest possible dose should be selected to provide the most favourable tolerability and safety profile in the context of self-medication through low dosages. The lowest approved dose of rizatriptan is 5 mg. This was investigated in three randomized controlled trials with 752 patients. The results show that rizatriptan at a dose of 5 mg is more effective than the triptans naratriptan 2.5 mg, almotriptan 12.5 mg and sumatriptan 50 mg, which were previously available for self-medication in Germany. There was no significant difference in the frequency of adverse events with rizatriptan 5 mg compared to placebo. Rizatriptan 5 mg does not have a higher side effect potential than sumatriptan 50 mg, which is already exempt from the prescription requirement. The reasons given show that rizatriptan in a dose of 5 mg for the treatment of acute migraine attacks fulfils the requirements for a transfer from prescription to pharmacy-only status at least as well as sumatriptan 50 mg, naratriptan 2.5 mg and almotriptan 12.5 mg. From a clinical care perspective, it is desirable for affected patients to have other options available for self-medication. Non-responders to other substances also have a further treatment option with rizatriptan 5 mg, with the same or even better risk–benefit profile, to treat migraine attacks safely, effectively and in a tolerable manner as part of self-medication.
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Metadata
Title
Rizatriptan as an Over-the-Counter Triptan in the Treatment of Migraine Attacks
Authors
Carl H. Göbel
Axel Heinze
Anna Cirkel
Hartmut Göbel
Publication date
17-06-2024
Publisher
Springer Healthcare
Published in
Pain and Therapy / Issue 4/2024
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI
https://doi.org/10.1007/s40122-024-00625-2

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