Maxalt interactions

Maxalt interactions with other medications

Before you start treatment with Maxalt, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Maxalt interacts with supplements, herbs, or vitamins, see the “Maxalt and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Maxalt. Keep in mind that this table does not include all drugs that may interact with Maxalt. Some of these interactions are described in detail in “Drug interactions in depth” below.

* To learn more about the side effects of Maxalt, see this article.
† To learn more about this interaction, see “When to avoid Maxalt” below.

When to avoid Maxalt

Sometimes, certain factors or conditions could prevent your doctor from prescribing Maxalt due to the risk of harm. These are known as contraindications. The contraindications of Maxalt include:

Having certain cardiovascular conditions

Doctors typically won’t prescribe Maxalt for people with certain cardiovascular conditions. These include:

• coronary artery disease or coronary artery spasm, including heart attack or angina
• stroke or ministroke
• peripheral vascular disease
• high blood pressure that isn’t well-managed

This is because taking Maxalt may cause serious cardiovascular side effects. Examples include heart attack, stroke, and high blood pressure. Your risk of these side effects may be higher if you already have certain cardiovascular conditions.

If you have a cardiovascular condition, talk with your doctor before taking Maxalt. They can tell you whether your condition interacts with Maxalt and will prescribe a different treatment if needed.

Having ischemic bowel disease

Doctors typically won’t prescribe Maxalt for people with ischemic bowel disease. This is because Maxalt may cause problems with blood vessels or circulation, which may worsen this condition.

If you have ischemic bowel disease, talk with your doctor before taking Maxalt. They’ll likely prescribe a treatment other than Maxalt for your condition.

Having basilar or hemiplegic migraine

Doctors typically won’t prescribe Maxalt for people with basilar or hemiplegic migraine. This is because the risk of stroke may be higher if you take Maxalt while you have basilar or hemiplegic migraine.

If you have basilar or hemiplegic migraine, talk with your doctor before taking Maxalt. They’ll likely prescribe a treatment other than Maxalt for your condition.

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Maxalt in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI).

This is because taking Maxalt with an MAOI can increase your risk of serotonin syndrome. This condition may be due to a high level of serotonin in your body. (Serotonin is a chemical that helps manage your mood.) An increased serotonin level can cause symptoms such as nausea, excessive sweating, blood pressure changes, and diarrhea. Serotonin syndrome can be life threatening for some people.

Below are a few examples of MAOIs that can interact with Maxalt:

• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Emsam, Zelapar)
• methylene blue (Provayblue)
• isocarboxazid (Marplan)

Before you start treatment with Maxalt, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with Maxalt. Likewise, after you stop taking Maxalt, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Taking certain other migraine drugs

Doctors typically will not prescribe Maxalt in combination with certain other migraine drugs. This is because Maxalt and certain other migraine drugs may cause problems with blood vessels or circulation. Taking these drugs together may further increase your risk of these side effects.

Below are a few examples of other migraine drugs that can interact with Maxalt:

• dihydroergotamine (Migranal, Trudhesa)
• ergotamine (Ergomar)
• sumatriptan (Imitrex, Tosymra, others)
• zolmitriptan (Zomig)
• frovatriptan (Frova)

Before you start treatment with Maxalt, it’s important to tell your doctor if you take any of the migraine drugs above. They’ll likely have you wait at least 24 hours before starting treatment with Maxalt. Likewise, after you stop taking Maxalt, your doctor will typically have you wait at least 24 hours before starting treatment with any medication listed above.

Having had an allergic reaction to Maxalt or any of its ingredients

If you have had an allergic reaction to Maxalt or any of its ingredients, your doctor will likely not prescribe it. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before starting treatment with Maxalt, tell your doctor if these contraindications apply to you. They can determine whether to prescribe Maxalt.

Maxalt and alcohol

There aren’t any known interactions between Maxalt and alcohol.

However, drinking alcohol may trigger a migraine episode for some people. (Maxalt is used to treat migraine.) If alcohol triggers your migraine, your doctor may advise you to avoid or limit alcohol consumption during Maxalt treatment.

If you have questions about drinking alcohol while taking Maxalt, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Maxalt.

Propranolol

Doctors can prescribe propranolol (Hemangeol, Inderal LA and Inderal XL, Innopran XL) to treat high blood pressure and other heart-related conditions. They can also prescribe it to help prevent migraine episodes.

Interaction result. Taking Maxalt with propranolol can increase the risk of side effects from Maxalt.

Interaction explained. Taking Maxalt with propranolol may lead to higher levels of Maxalt in your system. Having a higher level of the drug in your body can raise your risk of side effects from Maxalt. (To learn more about the side effects of Maxalt, see this article.)

Steps you or your doctor may take. If you take propranolol, be sure to tell your doctor before starting treatment with Maxalt. They can determine whether it’s safe to take these medications together.

If you do take Maxalt with propranolol, your doctor will likely adjust your dosage of Maxalt. They may give you a lower dosage of the drug to help reduce your risk of side effects. To learn more about the dosage of Maxalt, see this article.

Certain opioids

Doctors can prescribe opioids, also known as narcotics, to relieve pain.

Interaction result. Taking Maxalt with certain opioids can increase the risk of serotonin syndrome.

Interaction explained. Serotonin syndrome is when you have a high level of serotonin (a chemical that helps manage your mood) in your body. Having a high level of serotonin can cause symptoms such as blood pressure changes, nausea, excessive sweating, and diarrhea. Serotonin syndrome may be life threatening in extreme cases.

Examples of opioid drugs. Here are some opioids that may interact with Maxalt:

• fentanyl (Actiq, Fentora, Sublimaze)
• tramadol (Conzip, Qdolo)
• oliceridine (Olinvyk)

Steps you or your doctor may take. If you take an opioid, be sure to tell your doctor before starting treatment with Maxalt. They can tell you whether it’s safe to take these medications together.

If you do take Maxalt with certain opioids, watch for symptoms of serotonin syndrome. If you have symptoms of this condition, tell your doctor right away. If your symptoms seem life threatening, contact 911 or a local emergency number immediately.

Amphetamines

Doctors prescribe amphetamines for conditions such as narcolepsy and attention deficit hyperactivity disorder (ADHD).

Interaction result. Taking Maxalt with amphetamines can increase the risk of serotonin syndrome.

Interaction explained. With serotonin syndrome, a high level of serotonin may lead to certain symptoms. (Serotonin is a chemical that helps manage your mood.) These symptoms include diarrhea, nausea, blood pressure changes, and excessive sweating. In extreme cases, serotonin syndrome can be life threatening.

Examples of amphetamines. Here are some amphetamines that may interact with Maxalt:

• methamphetamine (Desoxyn)
• amphetamine/dextroamphetamine (Adderall, Adderall XR)
• dextroamphetamine (Dexedrine)

Steps you or your doctor may take. If you take an amphetamine, talk with your doctor before you take Maxalt. They can tell you if it’s safe to take these medications together.

If you do take Maxalt with an amphetamine, watch for symptoms of serotonin syndrome. Tell your doctor right away if you have symptoms of this condition. But if your symptoms seem life threatening, immediately contact 911 or a local emergency number.

Maxalt and other interactions

Maxalt may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Maxalt.

Maxalt interactions with supplements

Before you start treatment with Maxalt, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Maxalt interactions with herbs

It’s possible for Maxalt to interact with an herb called St. John’s wort. Some people take this herb to ease symptoms of depression and other conditions.

Taking St. John’s wort during Maxalt treatment may increase the risk of serotonin syndrome. This condition may be due to a high level of serotonin in your body. (Serotonin is a chemical that helps manage your mood.) High serotonin levels can cause symptoms such as diarrhea, blood pressure changes, excessive sweating, and nausea. This condition can be life threatening for some people.

Due to this risk, a doctor may suggest a treatment option other than St. John’s wort that does not interact with Maxalt.

Before taking any herbal supplements with Maxalt, talk with your doctor or pharmacist.

Maxalt and vitamins

There are no reports of vitamins interacting with Maxalt. However, that does not mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Maxalt.

Maxalt and food

There are no reports of food interactions with Maxalt. If you’d like to learn more about eating certain foods during treatment with Maxalt, talk with your doctor.

Maxalt and vaccines

There are no known interactions between Maxalt and vaccines. Talk with your doctor or pharmacist to see whether you are due for any vaccines.

Maxalt and lab tests

Maxalt is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

MAXALT AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Maxalt. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Maxalt. The impact of cannabis may affect how well you stick to your Maxalt treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Maxalt and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Maxalt. These are known as Maxalt (rizatriptan) warnings. Before you take this drug, be sure to talk with your doctor about your health history. Maxalt may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Maxalt include:

• Certain cardiovascular conditions. Doctors typically won’t prescribe Maxalt for people with certain cardiovascular conditions. These include heart attack and stroke, among others. To learn more, see the “When to avoid Maxalt” section above.
• Ischemic bowel disease. Doctors typically won’t prescribe Maxalt for people with ischemic bowel disease. To learn more, see the “When to avoid Maxalt” section above.
• Basilar or hemiplegic migraine. Doctors typically won’t prescribe Maxalt for people with basilar or hemiplegic migraine. To learn more, see the “When to avoid Maxalt” section above.
• Phenylketonuria (PKU). Maxalt-MLT orally disintegrating tablets contain phenylalanine as an ingredient. For this reason, your doctor may not prescribe Maxalt-MLT if you have PKU. They may prescribe Maxalt oral tablets instead. If you have questions about this, talk with your doctor or pharmacist.
• Allergic reaction. If you’ve had an allergic reaction to Maxalt or any of its ingredients, your doctor will likely not prescribe Maxalt. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding. It’s not known whether it’s safe to use Maxalt while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Maxalt may have on a child who is breastfed. If you are breastfeeding or planning to, talk with your doctor before using Maxalt. They can talk with you about treatment options and ways to feed your child.
• Pregnancy. There haven’t been enough clinical trials to determine whether Maxalt is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Maxalt. They can advise you on the right treatment plan for you.

Preventing interactions

You can take certain steps to help prevent interactions with Maxalt. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Maxalt label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Maxalt does not come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Maxalt by taking it exactly as your doctor prescribes.

Other resources

Besides learning about interactions, you may want to find out more about Maxalt. These resources might help:

• Overview of Maxalt. For a general overview of Maxalt, you can see this article.
• Side effects. If you’re interested in the side effects of Maxalt, see this article. Another option is to refer to the Maxalt prescribing information.
• Dosage specifics. To learn about the dosage of Maxalt, see this article.
• Facts about your condition. To learn more about migraine, see our headache and migraine hub and list of related articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.