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Undesirable effects may be more common during concomitant use of triptans5-HT 1B/1D agonistsand herbal preparations containing St John’s wortHypericum perforatum
Serotonin syndromeincluding altered mental statusautonomic instability and neuromuscular abnormalitieshas been reported following concomitant treatment with triptans and selective serotonin reuptake inhibitorsSSRIsor serotonin noradrenaline reuptake inhibitorsSNRIsThese reactions can be severeIf concomitant treatment with rizatriptan and an SSRI or SNRI is clinically warrantedappropriate observation of the patient is advisedparticularly during treatment initiationwith dose increasesor with addition of another serotonergic medicationsee section 4.5
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