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Meloxicam/rizatriptan, sold under the brand name Symbravo, is a fixed-dose combination medication used for the treatment of migraine. [1] It is a combination of meloxicam , a nonsteroidal anti-inflammatory medication ; and rizatriptan (as rizatriptan benzoate), a serotonin (5-HT) 1B/1D receptor agonist ( triptan ). [ 1 ]
Rizatriptan was patented in 1991 and came into medical use in 1998. [5] [6] It is available as a generic medication. [4] In 2022, it was the 190th most commonly prescribed medication in the United States, with more than 2 million prescriptions. [7] [8] Rizatriptan is available in combination with meloxicam as meloxicam/rizatriptan.
Cipriani noted that, “despite their effectiveness, triptans are underused,” as, “according to European population-based data, only 3.4–22.4% of people with migraine are using triptans.”
The most common adverse effect is recurrence of migraine. A systematic review found that "rizatriptan 10 mg was the only triptan with a recurrence rate greater than that of placebo". [24] There is a theoretical risk of coronary spasm in patients with established heart disease, and cardiac events after taking triptans may rarely occur. [25]
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They show activity at serotonin 5-HT 1-2, dopamine D2-like and alpha1/alpha2-adrenoreceptors. [4] Their lack of selectivity leads to more adverse effects, making them second line compared to triptans. [4] However, they have been shown to prevent recurrence better than triptans. [5] Adverse effects include nausea, vomiting, paresthesia, and ...
The main structural difference of the triptans is the position of the sulfonamide and the side chain attached to it (see figure 1 and table 1). ... 25, 50, 100 5, 20 ...
A meta-analysis of 53 clinical trials has shown that all triptans are effective for treating migraine at marketed doses and that naratriptan, although less effective than sumatriptan and rizatriptan was more effective than placebo in reducing migraine symptoms at two hours [3] and efficacy was demonstrated in almost two thirds of subjects after four hours of treatment.
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