Triptosig Disper 10 mg

/.../ belongs to a class of medicines called selective serotonin 5-HT1B/1D receptor agonists.

Your doctor has prescribed /.../ to treat the headache phase of your migraine attack.

Treatment with /.../ reduces swelling of blood vessels surrounding the brain. This swelling results in the headache pain of a migraine attack.

Do not take /.../ if:

• you are allergic (hypersensitive) to rizatriptan benzoate or any of the other ingredients of /.../ (see section 6 for a list of ingredients)
• you have moderately severe or severe high blood pressure, or mild high blood pressure that is not controlled by medication
• you have or have ever had heart problems including heart attack or pain on the chest (angina) or you have experienced heart disease related signs
• you have severe liver or severe kidney problems
• you have had a stroke (cerebrovascular accident CVA) or mini stroke (transient ischaemic attack TIA)
• you have blockage problems with your arteries (peripheral vascular disease)
• you are taking monoamine oxidase (MAO) inhibitors such as moclobemide, phenelzine, tranylcypromine, or pargyline (drugs against depression), or linezolid (an antibiotic), or if it has been less than two weeks since you stopped taking MAO inhibitors
• you are now taking ergotamine-type medications, such as ergotamine or dihydro-ergotamine to treat your migraine or methysergide to prevent a migraine attack
• you are taking any other drug in the same class, such as sumatriptan, naratriptan or zolmitriptan to treat your migraine (see “Taking other medicines” below)

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking /.../.

Take special care with /.../

Before you take /.../, tell your doctor or pharmacist, if:

• you have any of the following risk factors for heart disease: high blood pressure, diabetes, you smoke or you are using nicotine substitution, your family has a history of heart disease, you are a man over 40 years of age, or you are a post-menopausal woman
• you have kidney or liver problems
• you have a particular problem with the way your heart beats (bundle branch block)
• you have or have had any allergies
• your headache is associated with dizziness, difficulty in walking, lack of co-ordination or weakness in the leg and arm
• you use herbal preparations containing St. John’s wort (may increase the risk of side effects).
• you have had allergic reaction like swelling of the face, lips, tongue and/or throat which may cause difficulty breathing and/or swallowing (angioedema)
• you are taking selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram oxalate, and fluoxetine or serotonin noradrenaline reuptake inhibitors (SNRIs) such as venlafaxine, and duloxetine for depression
• you have had short lived symptoms including chest pain and tightness.

If you take /.../ too often this may result in you getting a chronic headache. In such cases you should contact your doctor as you may have to stop taking /.../.

Please tell your doctor or pharmacist about your symptoms. Your doctor will decide if you have migraine. You should take /.../ only for a migraine attack. /.../ should not be used to treat headaches that might be caused by other, more serious conditions.

Please tell your doctor if you are taking or have recently taken or plan to take, any other medicines including medicines obtained without a prescription. This includes herbal medicines and those you normally take for a migraine. This is because /.../ can affect the way some medicines work. Other medicines can also affect /.../.

Taking other medicines

Do not take /.../:

• if you are already taking a 5HT1B/1D agonist (sometimes referred to as ‘triptans’), such as sumatriptan, naratriptan or zolmitriptan.
• if you are taking a monoamine oxidase (MAO) inhibitor such as moclobemide, phenelzine, tranylcypromine, linezolid, or pargyline or if it has been less than two weeks since you stopped taking an MAO inhibitor.
• if you use ergotamine-type medications such as ergotamine or dihydro-ergotamine to treat your migraine
• if you use methysergide to prevent a migraine attack.

The above listed medicines when taken with /.../ may increase the risk of side effects.

You should wait at least 6 hours after taking /.../ before you take ergotamine-type medications such as ergotamine or dihydro-ergotamine or methysergide.

You should wait at least 24 hours after taking ergotamine-type medications before taking /.../.

Ask your doctor for instructions and the risks about taking /.../

• if you are taking propranolol (see section 3: How to take /.../)
• if you are taking SSRIs such as sertraline, escitalopram oxalate, and fluoxetine or SNRIs such as venlafaxine, and duloxetine for depression

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Taking /.../ with food and drink:

/.../ can take longer to work if it is taken after food. Although it is better to take it on an empty stomach, you can still take it if you have eaten.

Pregnancy and breast-feeding

It is not known whether /.../ is harmful to an unborn baby when taken by a pregnant woman.

Talk to your doctor before taking this medicine if you are pregnant, planning to get pregnant or are breastfeeding. Breastfeeding should be avoided for 24 hours after treatment.

Ask your doctor or pharmacist for advice before taking any medicine.

Use in children

There is no experience with the use of /.../ in children under 18 years of age, therefore children should not be given /.../.

Use in patients older than 65 years

There have been no full studies to look at how safe and effective /.../ is amongst patients older than 65 years.

Driving or using machines

You may feel sleepy or dizzy while taking /.../. If this happens, do not drive or use any tools or machines.

Important information about some of the ingredients of /.../

Phenylketonuric patients: Contains a source of phenylalanine. May be harmful for people with phenylketonuria (a genetic metabolism disorder). Each /.../ 5 mg orodispersible tablet contains 4.4 mg aspartame (which contains phenylalanine). Each /…/ 10 mg orodispersible tablet contains 8.8 mg aspartame (which contains phenylalanine).

/.../ is used to treat migraine attacks. Take /.../ as soon as possible after your migraine headache has started. Do not use it to prevent an attack.

Always take /.../ exactly as your doctor has told you. You should check with your doctor or your pharmacist if you are not sure.

The usual dose is 10 mg (one /…/ 10 mg orodispersible tablet).

If you are currently taking propranolol or have kidney or liver problems you should use a 5 mg dose of /.../. You should leave at least 2 hours between taking propranolol and /.../ up to a maximum of 2 doses in a 24-hour period.

/.../ (rizatriptan benzoate) is available as 5 mg and 10 mg orodispersible tablets that dissolve in the mouth.

• Open the /.../ blister pack with dry hands.
• The orodispersible tablet should be placed on your tongue, where it dissolves and can be swallowed with the saliva.
• The orodispersible tablets can be used in situations in which liquids are not available, or to avoid the nausea and vomiting that may accompany the ingestion of tablets with liquids.

If migraine returns within 24 hours

In some patients, migraine symptoms can return within a 24-hour period. If your migraine does return you can take an additional dose of /.../. You should always wait at least 2 hours between doses.

If after 2 hours you still have a migraine

If you do not respond to the first dose of /.../ during an attack, you should not take a second dose of /.../ for treatment of the same attack. It is still likely, however, that you will respond to /.../ during the next attack.

Do not take more than 2 doses of /.../ in a 24-hour period, (for example, do not take more than two 10 mg or 5 mg orodispersible tablets in a 24-hour period). You should always wait at least 2 hours between doses.

If your condition worsens, seek medical attention.

If you take more /.../ than you should:

If you take more /.../ than you should, talk to your doctor or pharmacist straight away. Take the medicine pack with you.

Signs of overdosage can include dizziness, drowsiness, vomiting, fainting and slow heart rate. If you have any further questions on the use of this product, ask your doctor or pharmacist.

Like all medicines, /.../ can cause side effects, although not everybody gets them.

In studies, the most common side effects reported were dizziness, sleepiness and tiredness.

Common (affects less than 1 in 10 people)

• tingling (paraesthesia), headache, decreased sensitivity of skin (hypoesthesia), decreased mental sharpness, tremor,
• fast or irregular heart beat (palpitation), very fast heartbeat (tachycardia),
• flushing (redness of the face lasting a short time), hot flushes, sweating,
• throat discomfort, difficulty breathing (dyspnoea),
• feeling sick (nausea), dry mouth, vomiting, diarrhoea,
• feeling of heaviness in parts of the body,
• pain in abdomen or chest

Uncommon (affects less than 1 in 100 people)

• unsteadiness when walking (ataxia), dizziness (vertigo), blurred vision,
• confusion, insomnia, nervousness,
• high blood pressure (hypertension); thirst, indigestion (dyspepsia),
• itching and lumpy rash (hives),
• neck pain, feeling of tightness in parts of the body, stiffness, muscle weakness

Rare (affects less than 1 in 1000 people)

• bad taste in your mouth,
• fainting (syncope), a syndrome called “serotonin syndrome” that may cause side effects like coma, unstable blood pressure, extremely high body temperature, lack of muscle co-ordination, agitation, and hallucinations
• facial pain, wheezing
• allergic reaction like swelling of the face, lips, tongue and/or throat which may cause difficulty breathing and/or swallowing (angioedema); rash, severe shedding of the skin including accompanied by fever (toxic epidermal necrolysis)
• heart attack, spasm of blood vessels of the heart, stroke. They generally occur in patients with risk factors for heart and blood vessel disease (high blood pressure, diabetes, smoking, use of

nicotine substitution, family history of heart disease or stroke, man over 40 years of age, post- menopausal women, particular problem with the way your heart beats [bundle branch block]).

Frequency not known:

• seizure (convulsions/fits)
• spasm of blood vessels of the extremities including coldness and numbness of the hands or feet

Tell your doctor right away if you have symptoms of allergic reactions, serotonin syndrome, heart attack or stroke.

In addition, tell your doctor if you experience any symptoms that suggest an allergic reaction (such as a rash or itching) after taking /.../.

If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Keep /.../ out of the reach and sight of children.

Do not use /.../ after the expiry date which is stated on the pack and blister after EXP. The expiry date refers to the last day of the month.

This medicinal product does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose medicines no longer required. These measures will help to protect the environment.

What /.../ contains

The active substance of /.../ orodispersible tablets is rizatriptan. One /…/ 5 mg orodispersible tablet contains 5 mg rizatriptan as 7.265 mg of rizatriptan benzoate. One /…/ 10 mg orodispersible tablet contains 10 mg rizatriptan as 14.53 mg of rizatriptan benzoate.

The other ingredients of /.../ orodispersible tablets are: mannitol (E421), microcrystalline cellulose, calcium silicate, crospovidone type A (E1202), aspartame (E951), colloidal anhydrous silica, peppermint flavour and magnesium stearate (E470b).

What /.../ looks like and contents of pack

/…/ 5 mg orodispersible tablets are white, round, 7 mm in diameter, flat, bevel-edged tablets, with “IZ 5” engraved on one side.

/…/ 10 mg orodispersible tablets are white, round, 9 mm in diameter, flat, bevel-edged tablets, with “IZ 10” engraved on one side.

OPA/Aluminium/PVC-Aluminium blister packs with push-through foil.

Pack sizes:

2, 3, 6, 12 and 18 orodispersible tablets.

Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Sigillata Limited

Suite 23, Park Royal House,

23 Park Royal Road

London NW10 7JH

United Kingdom

Manufacturer

Actavis Ltd.

BLB 016 Bulebel Industrial Estate

Zejtun ZTN 3000

Malta

Marketing authorisation numbers

Triptosig Disper 5 mg: 107550

Triptosig Disper 10 mg: 107552

This medicinal product is authorised in the Member States of the EEA under the following names:

This leaflet was last approved in

August 2011