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    Before using this medicationtell your doctor or pharmacist your medical historyespecially ofblood circulation problemsfor examplein your legsarms/handsor stomachcertain types of headacheshemiplegic or basilar migraineheart problemssuch as chest painirregular heartbeatprevious heart attackliver diseaseseizurestroke ormini-stroketransient ischemic attack

    Stop using rizatriptan and call your doctor at once if you have a serious side effect such as:

    Selective Serotonin Reuptake InhibitorsSSRIsSerotonin Norepinephrine Reuptake InhibitorsSNRIsand Serotonin SyndromeThere have been reports describing patients with symptoms compatible with serotonin syndromeincluding altered mental order emsam cost statusautonomic instability and neuromuscular abnormalitiesfollowing the use of selective serotonin reuptake inhibitorsSSRIsor serotonin noradrenaline reuptake inhibitorsSNRIsand triptanssee section 4.4

    Patients with a migraine attackA migraine attack does not affect the pharmacokinetics of rizatriptan.

    Serotonin syndromeincluding altered mental statusautonomic instability and neuromuscular abnormalitieshas been reported following concomitant treatment with triptans and selective serotonin reuptake inhibitorsSSRIsor serotonin noradrenaline reuptake inhibitorsSNRIsThese reactions can be severeIf concomitant treatment with rizatriptan and an SSRI or SNRI is clinically warrantedappropriate observation of the patient is advisedparticularly during treatment initiationwith dose increasesor with addition of another serotonergic medicationsee section 4.5

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