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I just remembered the other day, I saw a prescription for Maxalt Melt (Rizatriptan) for migraine. It was 5mg. One of my collegues brought up the issue to me that patient recently had 6 Maxalt on 26th July, Frovatriptan on 29th July, and 6 Maxalt again on 2nd Aug. This issue was definately worth looking into.

Anyone should not take 2 different anti-migraine treatments at the same time. However, bearing in mind the dates she had these tablets, they were 3days apart. With the Maxalt, maximum daily dose is 20mg, and for frovatriptan, up to 2 tablets a day. So she probably had several episodes within the last 7 days.

When the carer came, I managed to find out what was actually going on. So, patient had 6 episodes of migraine in the last 10 days. She started off with maxalt, then frovatriptan, now back to maxalt, maxalt melts in the tongue, thus work faster, I guess thats why she is given these instead of frovatriptan. The doctor has also started patient on Amitriptyline, which can be used as prophylactic treatment for migraine.

I did give out the maxalt melt this time, but I made sure carer was aware that she shouldnt take 2 treatments at the same time, and not exceed stated dose. If 1st tablet doesnt give any improvement, a second dose shouldnt be taken. Hopefully the amitriptyline will help to reduce the frequency of migraine in the future. One point to remember, overdosing on anti-migraine drugs ie. Triptans, can cause drug related headaches.