Key takeaways:
Symbravo is an oral medication that’s FDA approved to treat migraines with or without aura in adults. The tablets combine two active ingredients: meloxicam and rizatriptan.
Symbravo works quickly to provide migraine relief. It typically reaches its highest levels in your bloodstream within 1 hour of taking a dose, which means you’ll likely feel some relief within 2 hours.
The most common Symbravo side effects are dizziness, weakness, and feeling tired. In rare cases, serious side effects, including heart problems, stomach problems, and serious skin reactions, can occur.
There are ways to save on Symbravo. If you’re eligible, a manufacturer copay savings card could help you access Symbravo for as little as $0 per month. GoodRx savings are also available.
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When a migraine attack strikes, the goal is often quite simple: Stop the pain and get back to living your life. Migraine medications are a common tool to make this happen.
Symbravo is an FDA-approved, prescription-only medication that treats migraine with or without aura in adults. It combines two medications: meloxicam, a nonsteroidal anti-inflammatory drug (NSAID), and rizatriptan, a triptan. Together, these medications work by blocking pain signals and narrowing blood vessels in the brain, which lessens migraine symptoms.
Here, we’ll answer seven common questions related to how long Symbravo takes to work for migraine relief and what to expect when starting treatment.
1. How long does Symbravo take to work?
Symbravo starts working fairly quickly. It reaches its highest levels in your bloodstream within 1 hour after taking a dose.
Aside from headache pain, migraines often cause nausea and sensitivity to light and sound. You’ll likely start to feel relief from these common migraine symptoms within 2 hours of taking Symbravo.
Symbravo typically works faster than taking meloxicam and rizatriptan separately, too. This is due to a manufacturing process that helps the medication dissolve and absorb more quickly in the body.
2. How long does it take for Symbravo to be fully effective?
How long it takes to feel the full effects of Symbravo varies from person to person. Many people start to experience migraine relief within a couple of hours. But, for some, it may take longer.
In one study, people who took Symbravo were more likely to be free of headache pain and their worst migraine symptoms after 2 hours than those who took a placebo. Most people who took Symbravo also experienced pain relief for up to 24 hours, and the majority didn’t need another migraine medication for relief.
Another study found that, when compared to a placebo, Symbravo helped more adults stay pain-free for up to 24 hours without needing other medications.
3. Are there factors that can affect how Symbravo works?
Some drug interactions can alter Symbravo levels in the body and increase the risk of unwanted side effects. Symbravo can also affect how other medications work or increase their risks.
One medication that interacts with Symbravo is the blood pressure medication propranolol (Inderal). Propranolol may raise levels of rizatriptan in the body, which can cause side effects. Because of this interaction, it’s not recommended to take these medications together.
Other medications that may interact with Symbravo include fluconazole (Diflucan) and amiodarone (Pacerone). These medications, along with others, may affect how well the liver can break down the meloxicam component of Symbravo. This may lead to higher levels of meloxicam in the body. It's best to avoid these medications while taking Symbravo.
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You should also be careful about taking Symbravo with a blood thinner, such as warfarin (Coumadin, Jantoven) or aspirin. Combining these medications can increase the risk of bleeding.
This list isn’t comprehensive. Let your prescriber and pharmacist know about all of the medications and supplements you're taking. They'll be able to check for any possible drug interactions with Symbravo.
4. What should you expect when starting Symbravo?
Side effects are an important consideration when you start taking any medication, including Symbravo.
Symbravo is well tolerated overall. But common side effects of Symbravo include dizziness, weakness, and feeling tired. If you experience any of these side effects, you shouldn't drive or engage in other tasks that require mental alertness. If the side effects become bothersome at any point, let your healthcare team know.
Serious Symbravo side effects are rare, but they can happen. These include:
Stomach problems, including bleeding, stomach ulcers, and holes in the stomach or gut
High blood pressure
Swelling
Liver problems
Kidney problems
Low red blood cells
Serious skin reactions
Worsening asthma in people who have asthma
Heart problems including heart attack, abnormal heart rhythms, and heart failure
Stroke
You should avoid taking Symbravo if you have had coronary artery bypass graft (CABG) surgery, stomach bleeding, or peptic ulcer disease. In these cases, heart and stomach issues from Symbravo can be life-threatening. Be sure to discuss your medical history with your prescriber.
Contact your healthcare team right away if you think you’re experiencing any serious side effects from Symbravo. Call 911 or go to the nearest ER right away if you experience symptoms of a heart attack or stroke, including chest pain or tightness, shortness of breath, or slurred speech.
5. How long do you need to take Symbravo?
Symbravo is meant to be taken only when you need it for migraine relief. You should take 1 tablet when needed for a migraine attack, but don’t exceed more than 1 tablet a day. It’s not known if taking more than 1 dose per day is safe. Each tablet contains 20 mg of meloxicam and 10 mg of rizatriptan.
You also shouldn’t take Symbravo for more than seven headaches in a month, since its safety with more frequent use hasn’t been established. Use it only as needed and for the shortest amount of time possible to help manage your symptoms. If you find yourself needing to take it more often than recommended, talk to your prescriber.
6. Can you combine Symbravo with other migraine medications?
You can likely take Symbravo with other migraine medications that work in a different way. Just don’t combine it with migraine products that have similar ingredients.
Symbravo contains meloxicam, which is an NSAID. So it's not recommended to take other NSAIDs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), at the same time. Symbravo also contains rizatriptan, a common triptan. Avoid other triptan medications, like sumatriptan (Imitrex), eletriptan (Relpax), and more, while taking Symbravo.
It's also good to avoid any migraine medications that contain ergotamine, such as dihydroergotamine (Migranal). Taking Symbravo with an ergotamine-containing medication may raise your risk of vasospastic reactions, or tightening of your blood vessels, which can cause symptoms like chest pain, heart attack, or stroke.
Be sure to talk to your healthcare team about your options for treating migraines. They will help you make sure all of your medications are safe to take with Symbravo, if needed.
7. Is there a difference between taking Symbravo early in a migraine attack versus later?
When you take Symbravo may make a difference. Taking Symbravo at the first sign of a migraine might make it work more effectively. But it can still help if you take it later, when your pain is worse.
Symbravo could also be a good option if other migraine treatments haven’t done the trick and you’re looking for an alternative option.
How to save on Symbravo
There are ways to save on Symbravo, which is only available as a brand-name medication. GoodRx can help you navigate between copay savings cards and GoodRx discounts to save money on your prescription:
Save with a copay savings card. If you have commercial insurance, you may be able to reduce your out-of-pocket costs with a copay savings card through the Symbravo On My Side Savings Program. If you’re eligible, you could pay as little as $0 per month for the medication.
Save with GoodRx. Symbravo’s price at certain pharmacies may be as low as $1123.08 for 9 tablets with a free GoodRx coupon.
The bottom line
Symbravo (meloxicam / rizatriptan) is a prescription-only medication used to treat migraine with or without aura in adults. It generally starts to work within a couple of hours after taking a dose. It’s recommended to take 1 tablet as needed for a migraine, but it’s not clear whether taking more than 7 doses a month is safe.
Symbravo side effects are generally mild and include dizziness, weakness, and feeling tired. Serious side effects, including heart problems, kidney problems, and serious skin reactions, are rare but can happen.
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References
Axsome Therapeutics. (2025). Symbravo - meloxicam, rizatriptan tablet [package insert].
Jones, A., et al. (2022). Efficacy and safety of AXS-07 (MoSEIC meloxicam-rizatriptan) for the acute treatment of migraine: Results from the INTERCEPT phase 3, randomized, double-blind, placebo-controlled trial (P14-2.004). Neurology.
Symbravo. (n.d.). Savings and support. Axsome Therapeutics.
