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Comparison of Preference for Rizatriptan
10 mg. Tablet vs. Ergotamine/Caffeine in Migraine
Christie S, Gobel H., etal.
Posted September 2002
Headache 2002;42:392

Rizatriptan (Maxalt) provides rapid oral absorption and early onset of action in the acute treatment of migraine. This randomized double-blind crossover outpatient study assessed the preference for rizatriptan 10 mg tablets to two ergotamine 1 mg/caffeine 100 mg tablets in 439 patients treating a single migraine attack with each therapy. More than twice as many patients preferred rizatriptan to ergotamine/caffeine (69.9% vs. 30.1%). Faster relief of headache pain was the most important reason for preference, cited by 67.3% of patients preferring rizatriptan and 54.2% of patients who preferred ergotamine/caffeine. The co-primary endpoint of pain free at 2 hours was also in favor of rizatriptan. Forty-nine percent of patients were pain free 2 hours after rizatriptan, compared with 24.3% treated with ergotamine/caffeine, rizatriptan being superior within 1 hour of treatment. Headache relief at 2 hours was 75.9% for rizatriptan and 47.3% for ergotamine/caffeine, with rizatriptan being superior to ergotamine/ caffeine within 30 minutes of dosing. Almost 36% of patients taking rizatriptan were pain free at 2 hours and had no recurrence or need for additional medication, compared to 20% of patients on ergotamine/caffeine. Rizatriptan was also superior to ergotamine/caffeine in the proportions of patients with no nausea, phonophobia or photophobia, and for patients with normal function 2 hours after treatment intake. More patients were (completely, very or somewhat) satisfied 2 hours after treatment with rizatriptan (69.7%) than at 2 hours after treatment with ergotamine/caffeine (38.6%). Both active treatments were well tolerated. The most common adverse events after rizatriptan and ergotamine/ caffeine, respectively, were dizziness (6.7% and 5.3%), nausea (4.2% and 8.5%) and somnolence (5.5% and 2.3%).