The contraindications of Rizatatriptan involve specific population, food, and medication restrictions that must be strictly followed to avoid serious adverse reactions. The following provides a detailed explanation from three aspects: taboo populations, taboo foods, and medication restrictions.

1. Taboo population

(1) Cardiovascular disease patients

Patients with coronary heart disease, uncontrolled hypertension, and ischemic heart disease are prohibited from using the medication as it may cause coronary artery spasm or myocardial infarction.

(2) Individuals with cerebrovascular abnormalities

Patients with a history of stroke, TIA, or hemiplegic migraine should avoid medication as it may increase the risk of cerebral vasoconstriction.

(3) Severe liver and kidney dysfunction

Patients with Child Pugh C-grade liver damage or eGFR<30mL/min are contraindicated as metabolic clearance disorders can lead to drug accumulation and poisoning.

2. Forbidden foods

(1) Foods containing casein

Fasting on aged cheese, pickled products, etc. may lead to hypertensive crisis, especially when used in combination with MAOI, with a higher risk.

(2) Grapefruit products

Grapefruit juice can inhibit CYP3A4 enzyme, leading to a 2-fold increase in blood drug concentration and an increased risk of adverse reactions.

(3) Alcoholic beverages

Avoiding alcohol consumption during medication may exacerbate central inhibitory effects, leading to drowsiness or respiratory depression.

3. Medication restrictions

(1) Medication frequency

Within 24 hours, no more than 2 doses are allowed, and the monthly usage frequency should not exceed 10 days to prevent medication overdose headaches.

(2) Combination taboos

Do not use in combination with MAOIs, SSRIs/SNRIs, with a minimum interval of 14 days to avoid serotonin syndrome.

(3) Special physiological state

Pregnant women are prohibited (animals show embryotoxicity), and breastfeeding should be suspended until 48 hours after discontinuation of medication.