Migraine Medication Selector
Answer these key questions about your migraine patterns and medical history. The tool will recommend the most appropriate migraine medication based on the latest clinical evidence.
Quick Takeaways
- Rizact (rizatriptan) works fast (30‑45min) and lasts up to 12hours, making it ideal for moderate to severe migraines.
- Sumatriptan and Zolmitriptan have similar efficacy but may cause more nausea.
- Long‑acting triptans like Naratriptan are useful for prolonged attacks but have slower onset.
- CGRP antagonists (erenumab, fremanezumab) avoid triptan‑related vascular risks but are injectable and pricier.
- Cost in NewZealand varies: generic triptans are NZ$30‑50 per pack, while CGRP monoclonal antibodies exceed NZ$1,200 per year.
If you’re weighing Rizact against other migraine meds, you probably want to know which drug will stop the pain fastest, stay effective longest, and cause the few‑est side effects. Below you’ll find a plain‑English rundown that answers those questions and helps you pick the right pill (or shot) for your migraine pattern.
What Is Rizact?
Rizact is the brand name for rizatriptan, a selective serotonin (5‑HT1B/1D) receptor agonist approved for acute migraine treatment. First approved in the US in 1998, it’s now widely prescribed in NewZealand for attacks that last 4-72hours. The drug comes in 5mg and 10mg tablets, and a 1mg nasal spray for patients who can’t swallow pills.
How Rizact Works
Rizatriptan binds to 5‑HT1B receptors on cranial blood vessels, causing constriction, and to 5‑HT1D receptors on trigeminal nerve endings, blocking the release of inflammatory neuropeptides. The result is reduced vessel dilation and less pain signaling. Because it targets both vascular and neuronal pathways, Rizact usually stops a migraine before it peaks.
Key Metrics to Compare
When you stack Rizact against other options, focus on these six attributes:
- Onset time - how fast you feel relief after the dose.
- Duration of action - how long the effect lasts before the headache can return.
- Efficacy rate - proportion of patients achieving pain‑free status at 2hours.
- Side‑effect profile - nausea, dizziness, chest tightness, etc.
- Contraindications - cardiovascular disease, uncontrolled hypertension, etc.
- Cost & accessibility - retail price in NZ dollars and whether a generic is available.
Head‑to‑Head Comparison with Other Triptans
Below is a snapshot of how Rizact stacks up against the most commonly prescribed triptans.
| Drug | Class | Typical Dose | Onset | Duration | Common Side Effects | Retail Cost* (NZD) |
|---|---|---|---|---|---|---|
| Rizact (rizatriptan) | Triptan | 5mg or 10mg tablet; 1mg nasal spray | 30‑45min | 8‑12h | Nausea, dizziness, fatigue | NZ$35‑45 per pack (10 tablets) |
| Sumatriptan | Triptan | 25‑100mg tablet; 6mg subcutaneous injection | 45‑60min (tablet), 10‑15min (inj) | 4‑6h | Chest pressure, tingling, nausea | NZ$30‑55 per pack (10 tablets) |
| Zolmitriptan | Triptan | 2.5‑5mg tablet; 5mg nasal spray | 15‑30min | 6‑8h | Dry mouth, drowsiness, nausea | NZ$40‑50 per pack (10 tablets) |
| Naratriptan | Triptan (long‑acting) | 2.5mg tablet | ~2h | 12‑24h | Drowsiness, constipation, flushing | NZ$25‑35 per pack (10 tablets) |
| Eletriptan | Triptan | 40mg tablet | 30‑45min | 6‑12h | Fatigue, dizziness, jaw pain | NZ$45‑60 per pack (10 tablets) |
| Almotriptan | Triptan | 12.5mg tablet | 30‑45min | 6‑12h | Nausea, tingling, fatigue | NZ$30‑45 per pack (10 tablets) |
*Prices reflect typical retail rates at major NZ pharmacies in October2025; bulk or PBS‑subsidised pricing may differ.
Beyond Triptans: CGRP Antagonists and Other Options
For patients who can’t take triptans (e.g., uncontrolled hypertension, severe cardiovascular disease), newer calcitonin gene‑related peptide (CGRP) monoclonal antibodies have become the go‑to preventive options.
Erenumab is a monthly subcutaneous injection that blocks the CGRP receptor. It doesn’t treat acute attacks but can reduce migraine days by 40‑50% in trials. Cost is high - roughly NZ$1,300 per year - but many insurers cover it after failed preventive therapy.
Fremanezumab works similarly but targets the CGRP ligand itself. It’s available as a monthly or quarterly injection. Clinical data show comparable efficacy to erenumab, with a slightly better side‑effect tolerance (injection site reactions are the most common). Price sits around NZ$1,200‑1,400 annually.
Other non‑triptan acute treatments include:
- NSAIDs (ibuprofen, naproxen) - helpful for mild attacks, risk of GI bleed.
- Ditans (lasmiditan) - serotonin 5‑HT1F agonist, no vasoconstriction, but can cause driving‑impairing sedation.
- Gepants (ubrogepant, rimegepant) - oral CGRP receptor antagonists, safe for cardiovascular patients, cost NZ$60‑80 per dose.
Choosing the Right Medication for Your Migraine Profile
Here’s a quick decision flow you can use:
- Do you have cardiovascular risk? If yes, avoid triptans and look at gepants, ditans, or CGRP antibodies.
- How fast do you need relief? For rapid relief (≤30min), Zolmitriptan nasal spray or Sumatriptan injection win.
- Is your attack long‑lasting? For >12h attacks, consider Naratriptan (slow onset but long duration) or add a rescue NSAID.
- Do you need preventive therapy? If you average >4 migraine days/week, discuss CGRP monoclonal antibodies with your doctor.
- Budget matters? Generic triptans (e.g., Rizact, Almotriptan) cost under NZ$50 per pack, while CGRP drugs exceed NZ$1,000 per year.
Most patients find a single triptan works best for them. Switching between triptans can be worthwhile if you experience nausea or insufficient pain‑free rates.
Practical Tips for Using Rizact Effectively
- Take the tablet as soon as migraine aura starts; the earlier, the better.
- If you have severe nausea, the 1mg nasal spray provides similar absorption without upsetting the stomach.
- Don’t exceed 30mg within 24hours (max two 10mg tablets).
- Combine with an NSAID (e.g., ibuprofen 400mg) if pain isn’t fully controlled after 2hours.
- Store tablets at room temperature, away from moisture.
Frequently Asked Questions
Can I take Rizact with other migraine meds?
Rizact can be combined with an NSAID such as ibuprofen for added relief, but you should avoid stacking two triptans together. Mixing with ergot derivatives or MAO‑inhibitors is also contraindicated due to increased risk of serotonin syndrome.
What’s the biggest difference between Rizact and Zolmitriptan?
Zolmitriptan has a faster nasal‑spray onset (15‑30min) compared with Rizact’s 30‑45min oral onset. However, Rizact’s longer duration (up to 12h) can be an advantage for prolonged attacks, whereas Zolmitriptan may wear off sooner.
Are there any long‑term safety concerns with Rizact?
Long‑term use of triptans, including Rizact, is generally safe for most patients. The primary caution is cardiovascular risk; if you have coronary artery disease, uncontrolled hypertension, or a history of stroke, triptans should be avoided.
How does the cost of Rizact compare to CGRP antibodies?
A typical 10‑tablet pack of Rizact costs NZ$35‑45, while a year’s supply of erenumab or fremanezumab runs over NZ$1,200. For occasional acute attacks, Rizact is far more budget‑friendly. CGRP antibodies are mostly used for preventive therapy when triptans fail.
Can I use Rizact if I’m pregnant?
Triptans cross the placenta and are classified as Category C in many regions. The safest approach is to discuss alternatives with your obstetrician; many clinicians recommend acetaminophen or non‑pharmacologic measures during pregnancy.
Remember, migraine treatment is highly personal. Talk with your GP or neurologist about your attack frequency, cardiovascular health, and budget. With the right choice-whether it’s Rizact, another triptan, or a newer CGRP therapy-you can reclaim those days that migraine would otherwise steal.
Rizact? Overhyped, same old triptan nonsense!!!