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Prolonged use of any painkiller for headaches can make them worseIf this situation is experienced or suspectedmedical advice should be obtained and treatment should be discontinuedThe diagnosis of MOH should be suspected in patients who have frequent or daily headaches despiteor because ofthe regular use of headache medications.

Ergot-containing drugs have been reported to cause prolonged vasospastic reactionsBecause there is a theoretical basis that these effects may be additiveuse of ergotamine-containing or ergot-type medicationslike dihydroergotamine or methysergideand rizatriptan within 24 hours is contraindicatedDue to an additive effectthe concomitant use of rizatriptan and ergotamine/ergot derivativesincluding methysergideincreases the risk of coronary artery vasoconstriction and hypertensive effectsThis combination is contraindicated.

The efficacy and safety of treatment with more than one dose of RIZACT Tablets within 24 hours in pediatric patients 6 to 17 years of age have not been established.

Cytochrome P450 isoformsRizatriptan is not an inhibitor of the activities of human liver cytochrome P450CYP450isoforms3A4/51A22C92C19 or 2E1rizatriptan is a competitive inhibitorKi=1,400 nMof CYP450 2D6but only at highclinically irrelevant concentrations.

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