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Serious cardiac eventsincluding some that have been fatalhave occurred following use of 5-HT 1 agonistsThese events are extremely rare and most have been reported in patients with risk factors predictive of CADEvents reported have included coronary artery vasospasmtransient myocardial ischaemiamyocardial infarctionventricular tachycardia and ventricular fibrillation.
Rizatriptanshould not be given to patients with ischemic or vasospastic coronary artery diseaseThere have been rare reports of serious cardiac adverse reactionsincluding acute myocardial infarctionoccurring within a few hours following administration of rizatriptanSome of these reactions occurred in patients without known coronary artery diseaseCAD5-HT1 agonistsincluding rizatriptanmay cause coronary artery vasospasmPrinzmetal’s Anginaeven in patients without a history of CAD.
In a study evaluating subjects undergoing cardiac catheterizationan 18increase in mean pulmonary artery pressure was seen following dosing with another 5-HT 1 agonist.
Undesirable effects may be more common during concomitant use of triptans5-HT 1B1D agonistsand herbal preparations containing StJohn’s wort.
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