United States - English - NLM (National Library of Medicine)

jubilant cadista pharmaceuticals inc. - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use - rizatriptan benzoate tablets should only be used where a clear diagnosis of migraine has been established. if a patient has no response for the first migraine attack treated with rizatriptan benzoate tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate tablets are administered to treat any subsequent attacks.  - rizatriptan benzoate tablets are not indicated for use in the management of hemiplegic or basilar migraine [see contraindications (4)] .  - rizatriptan benzoate tablets are not indicated for the prevention of migraine attacks.  - safety and effectiveness of rizatriptan benzoate tablets have not been established for cluster headache. rizatriptan benzoate is contraindicated in patients with: - ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent

United States - English - NLM (National Library of Medicine)

macleods pharmaceuticals limited - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use • rizatriptan benzoate orally disintegrating tablets should only be used where a clear diagnosis of migraine has been established. if a patient has no response for the first migraine attack treated with rizatriptan benzoate orally disintegrating tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate tablets are administered to treat any subsequent attacks. • rizatriptan benzoate orally disintegrating tablets are not indicated for use in the management of hemiplegic or basilar migraine [see contraindications (4)]. • rizatriptan benzoate orally disintegrating tablets are not indicated for the prevention of migraine attacks. • safety and effectiveness of rizatriptan benzoate orally disintegrating tablets have not been established for cluster headache. rizatriptan benzoate o

United States - English - NLM (National Library of Medicine)

mylan pharmaceuticals inc. - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use: rizatriptan benzoate orally disintegrating tablets are contraindicated in patients with: there are no adequate and well-controlled studies in pregnant women. rizatriptan benzoate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. in a general reproductive study in rats, birth weights and pre- and post-weaning weight gain were reduced in the offspring of females treated prior to and during mating and throughout gestation and lactation with doses of 10 and 100 mg/kg/day. in a pre- and post-natal developmental toxicity study in rats, an increase in mortality of the offspring at birth and for the first 3 days after birth, a decrease in pre- and post-weaning weight gain, and decreased performance in a passive avoidance test (which indicates a decrease in learning capa

United States - English - NLM (National Library of Medicine)

sandoz inc - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. information related to usage of rizatriptan benzoate in pediatric patients (6 to 17 years old) is approved for merck & co., inc.’s rizatriptan benzoate orally disintegrating tablets. however, due to merck & co., inc.’s marketing exclusivity rights, this drug product is not labeled with that pediatric patient (6 to 17 years old) usage information. limitations of use: rizatriptan benzoate orally disintegrating tablets are contraindicated in patients with: there are no adequate and well controlled studies in pregnant women. rizatriptan benzoate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. in a general reproductive study in rats, birth weights and pre- and post-weaning weight gain were reduced in the offspring of females treated prior to and during mating and throughout gestation

United States - English - NLM (National Library of Medicine)

heritage pharmaceuticals inc. - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use - rizatriptan benzoate tablets should only be used where a clear diagnosis of migraine has been established. if a patient has no response for the first migraine attack treated with rizatriptan benzoate tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate tablets are administered to treat any subsequent attacks. - rizatriptan benzoate tablets are not indicated for use in the management of hemiplegic or basilar migraine [see contraindications (4)] . - rizatriptan benzoate tablets are not indicated for the prevention of migraine attacks. - safety and effectiveness of rizatriptan benzoate tablets has not been established for cluster headache rizatriptan benzoate tablets are contraindicated in patients with: - ischemic coronary artery disease (angina pectoris, histo

United States - English - NLM (National Library of Medicine)

sandoz inc - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. information related to usage of rizatriptan benzoate in pediatric patients (6 to 17 years old) is approved for merck & co., inc.’s rizatriptan benzoate tablets. however, due to merck & co., inc.’s marketing exclusivity rights, this drug product is not labeled with that pediatric patient (6 to 17 years old) usage information. limitations of use rizatriptan benzoate tablets are contraindicated in patients with: pregnancy category c there are no adequate and well-controlled studies in pregnant women. rizatriptan benzoate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. in a general reproductive study in rats, birth weights and pre- and post-weaning weight gain were reduced in the offspring of females treated prior to and during mating and throughout gestation and lactation with doses of 10 and 100 mg/kg/d

United States - English - NLM (National Library of Medicine)

physicians total care, inc. - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 10 mg - rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. information related to usage of rizatriptan benzoate in pediatric patients (6 to 17 years old) is approved for merck & co., inc.’s rizatriptan benzoate orally disintegrating tablets. however, due to merck & co., inc.’s marketing exclusivity rights, this drug product is not labeled with that pediatric patient (6 to 17 years old) usage information. limitations of use: - rizatriptan benzoate orally disintegrating tablets should only be used where a clear diagnosis of migraine has been established. if a patient has no response for the first migraine attack treated with rizatriptan benzoate orally disintegrating tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate orally disintegrating tablets are administered to treat any subsequent attacks. - rizatriptan benzoate orally disintegrating tablets are not indic

United States - English - NLM (National Library of Medicine)

rising pharma holdings, inc. - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use - rizatriptan benzoate tablets should only be used where a clear diagnosis of migraine has been established. if a patient has no response for the first migraine attack treated with rizatriptan benzoate tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate tablets are administered to treat any subsequent attacks. - rizatriptan benzoate tablets are not indicated for use in the management of hemiplegic or basilar migraine [see contraindications (4)] . - rizatriptan benzoate tablets are not indicated for the prevention of migraine attacks. - safety and effectiveness of rizatriptan benzoate tablets have not been established for cluster headache. rizatriptan benzoate tablets are contraindicated in patients with: - ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia), or other significant underlying cardiovascular disease [see warnings and precautions (5.1)] . - coronary artery vasospasm including prinzmetal's angina [see warnings and precautions (5.1) ] . - history of stroke or transient ischemic attack (tia) [s ee warnings and precautions (5.4) ] . - peripheral vascular disease (pvd) [see warnings and precautions (5.5) ] . - ischemic bowel disease [see warnings and precautions (5.5) ] . - uncontrolled hypertension [see warnings and precautions (5.8) ] . - recent use (i.e., within 24 hours) of another 5-ht1 agonist, ergotamine-containing medication, or ergot-type medication (such as dihydroergotamine or methysergide) [see drug interactions (7.2 and 7.3) ] . - hemiplegic or basilar migraine [see indications and usage (1) ]. - concurrent administration or recent discontinuation (i.e., within 2 weeks) of a mao-a inhibitor [see drug interactions (7.5) and clinical pharmacology (12.3) ] . - hypersensitivity to rizatriptan or any of the excipients (angioedema and anaphylaxis seen) [see adverse reactions (6.2) ] . risk summary available human data on the use of rizatriptan benzoate in pregnant women are not sufficient to draw conclusions about drug-associated risk for major birth defects and miscarriage. in animal studies, developmental toxicity was observed following oral administration of rizatriptan during pregnancy (decreased fetal body weight in rats) or throughout pregnancy and lactation (increased mortality, decreased body weight, and neurobehavioral impairment in rat offspring) at maternal plasma exposures greater than that expected at therapeutic doses in humans [see animal data]. in the u.s. general population, the estimated background risk of major birth defects and of miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. the reported rate of major birth defects among deliveries to women with migraine range from 2.2% to 2.9% and the reported rate of miscarriage was 17%, which are similar to rates reported in women without migraine. clinical considerations disease-associated maternal and/or embryo/fetal risk in women with migraine, there is an increased risk of adverse perinatal outcomes in the mother, including pre-eclampsia and gestational hypertension. data human data the pregnancy registry for rizatriptan benzoate did not identify any pattern of congenital anomalies or other adverse birth outcomes over the period of 1998 to 2018. however, the lack of identification of any pattern should be viewed with caution, as the number of prospective reports with outcome information was low and did not provide sufficient power to detect an increased risk of individual birth defects associated with the use of rizatriptan benzoate. additionally, there was significant loss to follow-up in the prospective pregnancy reports, further complicating this assessment of an association between rizatriptan benzoate and any pattern of congenital anomalies or other adverse birth outcomes. in a study using data from the swedish medical birth register, live births to women who reported using triptans or ergots during pregnancy were compared with those of women who did not. of the 157 births with first-trimester exposure to rizatriptan, 7 infants were born with malformations (relative risk 1.01 [95% ci: 0.40 to 2.08]). a study using linked data from the medical birth registry of norway to the norwegian prescription database compared pregnancy outcomes in women who redeemed prescriptions for triptans during pregnancy, as well as a migraine disease comparison group who redeemed prescriptions for triptans before pregnancy only, compared with a population control group. of the 310 women who redeemed prescriptions for rizatriptan during the first trimester, 10 had infants with major congenital malformations (or 1.03 [95% ci: 0.55 to 1.93]), while for the 271 women who redeemed prescriptions for rizatriptan before, but not during, pregnancy, 12 had infants with major congenital malformations (or 1.48 [95% ci: 0.83 to 2.64]), each compared with the population comparison group. animal data when rizatriptan (0, 2, 10, or 100 mg/kg/day) was administered orally to pregnant rats throughout organogenesis, a decrease in fetal body weight was observed at the highest doses tested. at the mid dose (10 mg/kg/day), which was a no-effect dose for adverse effects on embryofetal development, plasma exposure (auc) was approximately 15 times that in humans at the maximum recommended human dose (mrhd) of 30 mg/day. when rizatriptan (0, 5, 10, or 50 mg/kg/day) was administered orally to pregnant rabbits throughout organogenesis, no adverse fetal effects were observed. plasma exposure (auc) at the highest dose tested was 115 times that in humans at the mrhd. placental transfer of drug to the fetus was demonstrated in both species. oral administration of rizatriptan (0, 2, 10, or 100 mg/kg/day) to female rats prior to and during mating and continuing throughout gestation and lactation resulted in reduced body weight in offspring from birth and throughout lactation at all but the lowest dose tested (2 mg/kg/day). plasma exposure (auc) at the no-effect dose (2 mg/kg/day) for adverse effects on postnatal development was similar to that in humans at the mrhd. oral administration of rizatriptan (0, 5, 100, or 250 mg/kg/day) throughout organogenesis and lactation resulted in neonatal mortality, reduced body weight (which persisted into adulthood), and impaired neurobehavioral function in offspring at all but the lowest dose tested. plasma exposure (auc) at the no-effect dose for adverse effects on postnatal development (5 mg/kg/day) was approximately 8 times that in humans at the mrhd. risk summary there are no data on the presence of rizatriptan or any active metabolites in human milk, or on the effects of rizatriptan on the breastfed infant, or on milk production. rizatriptan was excreted in rat milk, with levels in milk approximately 6 times those in maternal plasma. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for rizatriptan benzoate and any potential adverse effects on the breastfed infant from rizatriptan benzoate or from the underlying maternal condition. data following oral administration of rizatriptan to lactating rats at a dose of 100 mg/kg/day, drug  concentrations of rizatriptan in milk samples exceeded maternal plasma drug concentrations by approximately 6-fold. safety and effectiveness in pediatric patients under 6 years of age have not been established. the efficacy and safety of rizatriptan benzoate in the acute treatment of migraine in patients aged 6 to 17 years was established in an adequate and well-controlled study [see clinical studies (14.2)] . the incidence of adverse reactions reported for pediatric patients in the acute clinical trial was similar in patients who received rizatriptan benzoate to those who received placebo. the adverse reaction pattern in pediatric patients is expected to be similar to that in adults. clinical studies of rizatriptan benzoate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients.  although the pharmacokinetics of rizatriptan were similar in elderly (aged ≥65 years) and in younger adults (n=17), in general, dose selection for an elderly patient should be cautious, starting at the low end of the dosing range. this reflects the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. geriatric patients who have other cardiovascular risk factors (e.g., diabetes, hypertension, smoking, obesity, strong family history of coronary artery disease) should have a cardiovascular evaluation prior to receiving rizatriptan benzoate [see warnings and precautions (5.1)] .

United States - English - NLM (National Library of Medicine)

rising pharma holdings, inc. - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use - rizatriptan benzoate orally disintegrating tablets should only be used where a clear diagnosis of migraine has been established. if a patient has no response for the first migraine attack treated with rizatriptan benzoate orally disintegrating tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate orally disintegrating tablets are administered to treat any subsequent attacks. - rizatriptan benzoate orally disintegrating tablets are not indicated for use in the management of hemiplegic or basilar migraine [see contraindications (4)] . - rizatriptan benzoate orally disintegrating tablets are not indicated for the prevention of migraine attacks. - safety and effectiveness of rizatriptan benzoate orally disintegrating tablets have not been established for cluster headache. rizatriptan benzoate orally disintegrating tablets are contraindicated in patients with: - ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia), or other significant underlying cardiovascular disease [see warnings and precautions (5.1)] . - coronary artery vasospasm including prinzmetal’s angina [see warnings and precautions (5.1)] . - history of stroke or transient ischemic attack (tia) [s ee warnings and precautions (5.4) ] . - peripheral vascular disease (pvd) [see warnings and precautions (5.5) ] . - ischemic bowel disease [see warnings and precautions (5.5) ] . - uncontrolled hypertension [see warnings and precautions (5.8) ] . - recent use (i.e., within 24 hours) of another 5-ht1 agonist, ergotamine-containing medication, or ergot-type medication (such as dihydroergotamine or methysergide) [see drug interactions (7.2 and 7.3) ] . - hemiplegic or basilar migraine [see indications and usage (1) ]. - concurrent administration or recent discontinuation (i.e., within 2 weeks) of a mao-a inhibitor [see drug interactions (7.5) and clinical pharmacology (12.3) ] . - hypersensitivity to rizatriptan or any of the excipients (angioedema and anaphylaxis seen) [see adverse reactions (6.2) ] . risk summary   available human data on the use of rizatriptan benzoate in pregnant women are not sufficient to draw conclusions about drug-associated risk for major birth defects and miscarriage. in animal studies, developmental toxicity was observed following oral administration of rizatriptan during pregnancy (decreased fetal body weight in rats) or throughout pregnancy and lactation (increased mortality, decreased body weight, and neurobehavioral impairment in rat offspring) at maternal plasma exposures greater than that expected at therapeutic doses in humans [see animal data] .                                            in the u.s. general population, the estimated background risk of major birth defects and of miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. the reported rate of major birth defects among deliveries to women with migraine range from 2.2% to 2.9% and the reported rate of miscarriage was 17%, which are similar to rates reported in women without migraine. clinical considerations disease-associated maternal and/or embryo/fetal risk in women with migraine, there is an increased risk of adverse perinatal outcomes in the mother, including pre-eclampsia and gestational hypertension. data human data the pregnancy registry for rizatriptan benzoate did not identify any pattern of congenital anomalies or other adverse birth outcomes over the period of 1998 to 2018. however, the lack of identification of any pattern should be viewed with caution, as the number of prospective reports with outcome information was low and did not provide sufficient power to detect an increased risk of individual birth defects associated with the use of rizatriptan benzoate. additionally, there was significant loss to follow-up in the prospective pregnancy reports, further complicating this assessment of an association between rizatriptan benzoate and any pattern of congenital anomalies or other adverse birth outcomes. in a study using data from the swedish medical birth register, live births to women who reported using triptans or ergots during pregnancy were compared with those of women who did not. of the 157 births with first-trimester exposure to rizatriptan, 7 infants were born with malformations (relative risk 1.01 [95% ci: 0.40 to 2.08]). a study using linked data from the medical birth registry of norway to the norwegian prescription database compared pregnancy outcomes in women who redeemed prescriptions for triptans during pregnancy, as well as a migraine disease comparison group who redeemed prescriptions for triptans before pregnancy only, compared with a population control group. of the 310 women who redeemed prescriptions for rizatriptan during the first trimester, 10 had infants with major congenital malformations (or 1.03 [95% ci: 0.55 to 1.93]), while for the 271 women who redeemed prescriptions for rizatriptan before, but not during, pregnancy, 12 had infants with major congenital malformations (or 1.48 [95% ci: 0.83 to 2.64]), each compared with the population comparison group. animal data when rizatriptan (0, 2, 10, or 100 mg/kg/day) was administered orally to pregnant rats throughout organogenesis, a decrease in fetal body weight was observed at the highest doses tested. at the mid dose (10 mg/kg/day), which was a no-effect dose for adverse effects on embryofetal development, plasma exposure (auc) was approximately 15 times that in humans at the maximum recommended human dose (mrhd) of 30 mg/day. when rizatriptan (0, 5, 10, or 50 mg/kg/day) was administered orally to pregnant rabbits throughout organogenesis, no adverse fetal effects were observed. plasma exposure (auc) at the highest dose tested was 115 times that in humans at the mrhd. placental transfer of drug to the fetus was demonstrated in both species. oral administration of rizatriptan (0, 2, 10, or 100 mg/kg/day) to female rats prior to and during mating and continuing throughout gestation and lactation resulted in reduced body weight in offspring from birth and throughout lactation at all but the lowest dose tested (2 mg/kg/day). plasma exposure (auc) at the no-effect dose (2 mg/kg/day) for adverse effects on postnatal development was similar to that in humans at the mrhd. oral administration of rizatriptan (0, 5, 100, or 250 mg/kg/day) throughout organogenesis and lactation resulted in neonatal mortality, reduced body weight (which persisted into adulthood), and impaired neurobehavioral function in offspring at all but the lowest dose tested. plasma exposure (auc) at the no-effect dose for adverse effects on postnatal development (5 mg/kg/day) was approximately 8 times that in humans at the mrhd. risk summary there are no data on the presence of rizatriptan or any active metabolites in human milk, or on the effects of rizatriptan on the breastfed infant, or on milk production. rizatriptan was excreted in rat milk, with levels in milk approximately 6 times those in maternal plasma. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for rizatriptan benzoate orally disintegrating tablets and any potential adverse effects on the breastfed infant from rizatriptan benzoate orally disintegrating tablets or from the underlying maternal condition. data following oral administration of rizatriptan to lactating rats at a dose of 100 mg/kg/day, drug concentrations of rizatriptan in milk samples exceeded maternal plasma drug concentrations by approximately 6-fold. safety and effectiveness in pediatric patients under 6 years of age have not been established. the efficacy and safety of rizatriptan benzoate in the acute treatment of migraine in patients aged 6 to 17 years was established in an adequate and well-controlled study [see clinical studies (14.2)] . the incidence of adverse reactions reported for pediatric patients in the acute clinical trial was similar in patients who received rizatriptan benzoate to those who received placebo. the adverse reaction pattern in pediatric patients is expected to be similar to that in adults. clinical studies of rizatriptan benzoate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients.  although the pharmacokinetics of rizatriptan were similar in elderly (aged ≥65 years) and in younger adults (n=17), in general, dose selection for an elderly patient should be cautious, starting at the low end of the dosing range. this reflects the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. geriatric patients who have other cardiovascular risk factors (e.g., diabetes, hypertension, smoking, obesity, strong family history of coronary artery disease) should have a cardiovascular evaluation prior to receiving rizatriptan benzoate [see warnings and precautions (5.1)] . rizatriptan benzoate orally disintegrating tablets contain phenylalanine (a component of aspartame). the 5 mg and 10 mg orally disintegrating tablets contain 1.05 mg and 2.1 mg phenylalanine, respectively.

United States - English - NLM (National Library of Medicine)

glenmark pharmaceuticals inc., usa - rizatriptan benzoate (unii: wr978s7qhh) (rizatriptan - unii:51086hbw8g) - rizatriptan 5 mg - rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. limitations of use rizatriptan benzoate orally disintegrating tablets are contraindicated in patients with: risk summary available human data on the use of rizatriptan benzoate in pregnant women are not sufficient to draw conclusions about drug-associated risk for major birth defects and miscarriage. in animal studies, developmental toxicity was observed following oral administration of rizatriptan during pregnancy (decreased fetal body weight in rats) or throughout pregnancy and lactation (increased mortality, decreased body weight, and neurobehavioral impairment in rat offspring) at maternal plasma exposures greater than that expected at therapeutic doses in humans [see animal data] . in the u.s. general population, the estimated background risk of major birth defects and of miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. the reported rate of major birth defects among deliveries to women with migraine range from 2.2% to 2.9% and the reported rate of miscarriage was 17%, which are similar to rates reported in women without migraine. clinical considerations disease-associated maternal and/or embryo/fetal risk in women with migraine, there is an increased risk of adverse perinatal outcomes in the mother, including pre-eclampsia and gestational hypertension. data human data the pregnancy registry for rizatriptan benzoate did not identify any pattern of congenital anomalies or other adverse birth outcomes over the period of 1998 to 2018. however, the lack of identification of any pattern should be viewed with caution, as the number of prospective reports with outcome information was low and did not provide sufficient power to detect an increased risk of individual birth defects associated with the use of rizatriptan benzoate. additionally, there was significant loss to follow-up in the prospective pregnancy reports, further complicating this assessment of an association between rizatriptan benzoate and any pattern of congenital anomalies or other adverse birth outcomes. in a study using data from the swedish medical birth register, live births to women who reported using triptans or ergots during pregnancy were compared with those of women who did not. of the 157 births with first-trimester exposure to rizatriptan, 7 infants were born with malformations (relative risk 1.01 [95% ci: 0.40 to 2.08]). a study using linked data from the medical birth registry of norway to the norwegian prescription database compared pregnancy outcomes in women who redeemed prescriptions for triptans during pregnancy, as well as a migraine disease comparison group who redeemed prescriptions for triptans before pregnancy only, compared with a population control group. of the 310 women who redeemed prescriptions for rizatriptan during the first trimester, 10 had infants with major congenital malformations (or 1.03 [95% ci: 0.55 to 1.93]), while for the 271 women who redeemed prescriptions for rizatriptan before, but not during, pregnancy, 12 had infants with major congenital malformations (or 1.48 [95% ci: 0.83 to 2.64]), each compared with the population comparison group. animal data when rizatriptan (0, 2, 10, or 100 mg/kg/day) was administered orally to pregnant rats throughout organogenesis, a decrease in fetal body weight was observed at the highest doses tested. at the mid dose (10 mg/kg/day), which was a no-effect dose for adverse effects on embryofetal development, plasma exposure (auc) was approximately 15 times that in humans at the maximum recommended human dose (mrhd) of 30 mg/day. when rizatriptan (0, 5, 10, or 50 mg/kg/day) was administered orally to pregnant rabbits throughout organogenesis, no adverse fetal effects were observed. plasma exposure (auc) at the highest dose tested was 115 times that in humans at the mrhd. placental transfer of drug to the fetus was demonstrated in both species. oral administration of rizatriptan (0, 2, 10, or 100 mg/kg/day) to female rats prior to and during mating and continuing throughout gestation and lactation resulted in reduced body weight in offspring from birth and throughout lactation at all but the lowest dose tested (2 mg/kg/day). plasma exposure (auc) at the no-effect dose (2 mg/kg/day) for adverse effects on postnatal development was similar to that in humans at the mrhd. oral administration of rizatriptan (0, 5, 100, or 250 mg/kg/day) throughout organogenesis and lactation resulted in neonatal mortality, reduced body weight (which persisted into adulthood), and impaired neurobehavioral function in offspring at all but the lowest dose tested. plasma exposure (auc) at the no-effect dose for adverse effects on postnatal development (5 mg/kg/day) was approximately 8 times that in humans at the mrhd. risk summary there are no data on the presence of rizatriptan or any active metabolites in human milk, or on the effects of rizatriptan on the breastfed infant, or on milk production. rizatriptan was excreted in rat milk, with levels in milk approximately 6 times those in maternal plasma. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for rizatriptan benzoate tablets or rizatriptan benzoate orally disintegrating tablets and any potential adverse effects on the breastfed infant from rizatriptan benzoate tablets or rizatriptan benzoate orally disintegrating tablets or from the underlying maternal condition. data following oral administration of rizatriptan to lactating rats at a dose of 100 mg/kg/day, drug concentrations of rizatriptan in milk samples exceeded maternal plasma drug concentrations by approximately 6-fold. safety and effectiveness in pediatric patients under 6 years of age have not been established. the efficacy and safety of rizatriptan benzoate in the acute treatment of migraine in patients aged 6 to 17 years was established in an adequate and well-controlled study [see clinical studies (14.2)]. the incidence of adverse reactions reported for pediatric patients in the acute clinical trial was similar in patients who received rizatriptan benzoate to those who received placebo. the adverse reaction pattern in pediatric patients is expected to be similar to that in adults. clinical studies of rizatriptan benzoate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients. although the pharmacokinetics of rizatriptan were similar in elderly (aged ≥65 years) and in younger adults (n=17), in general, dose selection for an elderly patient should be cautious, starting at the low end of the dosing range. this reflects the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. geriatric patients who have other cardiovascular risk factors (e.g., diabetes, hypertension, smoking, obesity, strong family history of coronary artery disease) should have a cardiovascular evaluation prior to receiving rizatriptan benzoate [see warnings and precautions (5.1)] . rizatriptan benzoate orally disintegrating tablets contain phenylalanine (a component of aspartame). the 5 mg and 10 mg orally disintegrating tablets contain 2.24 and 4.49 mg phenylalanine, respectively.