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Symbravo
Used for Migraine
Used for Migraine
Symbravo (meloxicam / rizatriptan) is a combination migraine medication that contains an NSAID (meloxicam) and a triptan (rizatriptan). It’s FDA approved to treat a migraine attack with or without aura in adults. You take it as a single tablet by mouth when a migraine begins, but it’s not for prevention. Common side effects include dizziness and feeling sleepy.
What is Symbravo (meloxicam / rizatriptan)?
How Symbravo (meloxicam / rizatriptan) works
Symbravo (meloxicam / rizatriptan) is a combination migraine medication.
- Meloxicam is a nonsteroidal anti‑inflammatory medication (NSAID). It helps lower pain by certain blocking proteins in your body (COX‑1 and COX‑2) that make chemicals to drive inflammation and pain.
- Rizatriptan is a triptan. It works by tightening blood vessels in your brain and calming pain signals in the nerves involved in a migraine.
When does Symbravo (meloxicam / rizatriptan) start working?Time passed since treatment started:
Drug facts
| Common Brands | Symbravo |
|---|---|
| Drug Class | NSAID / Triptan |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
More on Symbravo (meloxicam / rizatriptan) essentials
Side effects of Symbravo (meloxicam / rizatriptan)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Sleepiness (2%)
- Dizziness (2%)
Symbravo (meloxicam / rizatriptan) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart problems: heart attack, dangerously high blood pressure, severe headache, chest pain, trouble breathing, irregular heartbeat, sudden weight gain, swelling
- Stroke: sudden weakness on one side of your body, headache, changes in your speech or vision, confusion
- Stomach ulcer: gnawing pain in the stomach, acid reflux, feel full quickly
- Stomach bleeding: feeling faint, vomiting blood, bloody or dark stools, severe stomach pain or discomfort
- Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness or twitching, uncoordinated movement, hallucinations
- Blood vessel tightening: bloody diarrhea, severe stomach pain, partial or permanent blindness, tightness/weakness/numbness of legs or feet, vision problems
- Liver problems: nausea, tiredness, itching, right‑upper‑belly tenderness, yellowing of the skin or eyes, dark urine
- Kidney problems: swelling, feeling tired, urinating less than usual, sudden weight gain
- Severe allergic reaction: trouble breathing, wheezing, swelling of face, lips, tongue, or throat, fainting, rash, peeling skin, fever
The following Symbravo (meloxicam / rizatriptan) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Burning, pain, tingling, or color changes in the hands, arms, legs, or feet
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- High potassium level—muscle weakness, fast or irregular heartbeat
- Increase in blood pressure
- Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Rash, fever, and swollen lymph nodes
- Raynaud syndrome—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Round red or dark patches on the skin that may itch, burn, and blister
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
- Vision loss
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dizziness
- Fatigue
- Headache
- Loss of appetite
- Nausea
- Upset stomach
Get your GoodRx coupon
$1437.21
GoodRx discount
$1110.27
Pros and cons of Symbravo (meloxicam / rizatriptan)
Pros
- Two medications in one pill that treat pain and migraine symptoms
- Can be taken with or without food
- Works within 30 minutes
Cons
- Can’t take more than one tablet in 24 hours
- Not for migraine prevention
- Interacts with many medications
Pharmacist tips for Symbravo (meloxicam / rizatriptan)
- Take Symbravo (meloxicam / rizatriptan) as soon as you feel a migraine starting. Taking it early can help it work better and faster.
- Swallow Symbravo (meloxicam / rizatriptan) whole with water, with or without food. Don’t crush, split, or chew the tablet.
- Don’t take Symbravo (meloxicam / rizatriptan) with other triptans or ergot medications within 24 hours. This can raise the risk of serious blood vessel problems.
- Avoid taking Symbravo (meloxicam / rizatriptan) with other NSAIDs (like ibuprofen or naproxen) unless your care team says it’s okay. Doubling up on NSAIDs can raise the risk of stomach bleeding and kidney problems.
- Tell your care team if you take an SSRI or SNRI for mood or anxiety before starting Symbravo (meloxicam / rizatriptan). This combination can rarely cause a serious condition called serotonin syndrome.
- If you’re taking blood pressure medications, you might want to check your blood pressure more regularly. Symbravo (meloxicam / rizatriptan) can raise blood pressure or blunt some blood pressure medications, so checking at home helps catch problems early.
- Don’t take Symbravo (meloxicam / rizatriptan) if you take propranolol. This can raise the level of the medication in your body and cause side effects.
- Talk with your care team if headaches become more frequent while taking Symbravo (meloxicam / rizatriptan). Taking migraine medications for 10 or more days each month can lead to worse headaches (known as medication overuse headaches).
- Be careful with driving or tasks that need focus when taking Symbravo (meloxicam / rizatriptan) since the medication can make you feel sleepy or dizzy.
- You might feel temporary chest tightness, pressure, or pain in the chest, throat, jaw, or neck after taking Symbravo (meloxicam / rizatriptan). These symptoms are very similar to those of a heart attack or other heart problems. If you notice that these symptoms are worsening or don't go away, get medical help right away.
- Pregnancy: If you’re pregnant or planning pregnancy, talk with your care team before taking Symbravo (meloxicam / rizatriptan). NSAIDs like meloxicam can harm an unborn baby after about 20 weeks, and you should avoid them after about 30 weeks. Your team can help you choose safer options.
- Storage: Keep Symbravo (meloxicam / rizatriptan) in its original bottle at room temperature.
More on Symbravo (meloxicam / rizatriptan) tips
Risks and warnings for Symbravo (meloxicam / rizatriptan)
Symbravo (meloxicam / rizatriptan) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of heart attack and stroke
- Risk factors: History of heart problems | Having risk factors for heart problems | Recent heart attack | Taking Symbravo (meloxicam / rizatriptan) for a long time | Recent or planned heart surgery
NSAIDs like meloxicam in Symbravo (meloxicam / rizatriptan) can raise your risk of blood clots. Some blood clots can lead to a serious heart attack or stroke.
If you have heart problems, a recent heart attack, or recent or upcoming heart surgery, talk to your care team before taking Symbravo (meloxicam / rizatriptan). Your risk of serious problems is higher in these situations, and your prescriber can help decide if it’s safe for you.
To lower your risk, take the lowest dose of Symbravo (meloxicam / rizatriptan) for the shortest time needed. Call 911 right away if you have signs of a heart attack (like chest pain spreading to your arm or neck, shortness of breath, or sweating) or signs of a stroke (like severe headache, weakness on one side, drooping face, or trouble speaking or walking).
Risk of stomach bleeding and stomach ulcers
- Risk factors: Older adults | History of peptic ulcer disease | History of stomach bleeding | Bleeding problems | Liver problems | Taking other medications that raise your risk of bleeds | Taking Symbravo (meloxicam / rizatriptan) for a long time | Drinking alcohol | Smoking
Symbravo (meloxicam / rizatriptan) can raise your risk of stomach problems. This can include inflammation, stomach ulcers, and bleeding. These can happen at any time while taking this medication and can be serious or life-threatening.
Your risk is higher if you’ve had stomach ulcers or bleeding before, are an older adult, drink alcohol, smoke, or take certain medications like steroids, blood thinners, or antidepressants. To lower your risk, take the lowest dose for the shortest time.
Tell your care team right away if you have symptoms like stomach pain, black or bloody stools, or vomiting blood. You might need to stop Symbravo (meloxicam / rizatriptan) and get medical care right away.
Heart rhythm problems
Symbravo (meloxicam / rizatriptan) can rarely cause serious heart rhythm problems, including fast or irregular heartbeats that can be life-threatening. These can happen within a few hours after taking the medication. Stop taking Symbravo (meloxicam / rizatriptan) and get medical help right away if you notice a fast, pounding, or irregular heartbeat.
Stroke and brain bleeds
Symbravo (meloxicam / rizatriptan) can rarely cause serious brain problems like stroke or bleeding in the brain. Some of these cases have been life-threatening.
Stop taking Symbravo (meloxicam / rizatriptan) and get medical help right away if you have signs like sudden weakness, trouble speaking, vision changes, or a severe headache that feels different from your usual migraines.
Severe allergic reactions and skin reactions
- Risk factors: Allergy to NSAIDs | Allergy to triptans | Aspirin-sensitive asthma
Symbravo (meloxicam / rizatriptan) can cause serious allergic reactions, including swelling of your face or a life-threatening reaction called anaphylaxis. It can also cause a rare reaction called drug reaction with eosinophilia and systemic symptoms (DRESS), which can happen with or without a rash. If you're allergic to aspirin or other NSAIDs, talk to your prescriber before taking Symbravo (meloxicam / rizatriptan).
In rare cases, Symbravo (meloxicam / rizatriptan) can cause severe skin reactions like Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These can lead to rash, blisters, or peeling skin.
Get medical help right away if you have a rash, swelling of your face, lips, or tongue, or trouble breathing after taking Symbravo (meloxicam / rizatriptan). Stop the medication and call 911 if you notice unusual skin changes.
Blood vessel tightening
Symbravo (meloxicam / rizatriptan) can cause blood vessels to tighten in parts of your body outside the heart. This can lead to problems like poor blood flow to your arms, legs, stomach, or other organs, which can cause pain, numbness, or changes in skin color.
Tell your care team right away if you have symptoms like severe stomach pain, bloody diarrhea, cold or numb fingers or toes, or color changes in your skin after taking Symbravo (meloxicam / rizatriptan). You might need to stop the medication.
Rare cases of vision problems, including partial or complete vision loss, have also been reported. If you notice any changes in your vision, get medical help right away.
Liver problems
Although rare, some people taking NSAIDs like meloxicam in Symbravo (meloxicam / rizatriptan) can have higher liver enzyme levels, which can be a sign of liver damage. In very rare cases, this can lead to serious problems like liver failure.
Get medical help right away if you have swelling or pain in the upper right side of your stomach, yellowing of your skin or eyes, dark urine, or unusual tiredness. Also watch for nausea or changes in your stool, such as black, tarry, or bloody stools.
High blood pressure
Symbravo (meloxicam / rizatriptan) can raise your blood pressure or make it worse if you already have high blood pressure. In rare cases, it can cause very high blood pressure that could harm your organs. Your care team might recommend you check your blood pressure when you start Symbravo (meloxicam / rizatriptan) and during treatment.
Heart failure and swelling
Symbravo (meloxicam / rizatriptan) can cause your body to hold onto extra fluid, which can lead to swelling in your legs or feet. Too much fluid can also put you at risk of heart failure.
Tell your prescriber if you have heart problems or heart failure before taking Symbravo (meloxicam / rizatriptan). This medication can also affect how well some heart medications work, so your prescriber can help decide if it’s safe for you.
Let your care team know if you notice swelling, shortness of breath, chest pain with activity, sudden weight gain, or unusual tiredness. These can be signs of heart failure.
Kidney problems
- Risk factors: Older adults | Kidney problems | Liver problems | Heart failure | Dehydrated | Taking diuretics (water pills) | Taking other medications that can harm the kidneys | Taking Symbravo (meloxicam / rizatriptan) for a long time
NSAIDs like meloxicam in Symbravo (meloxicam / rizatriptan) can harm your kidneys, especially if you take it for a long time. In many cases, kidney problems improve after stopping the medication.
Before starting Symbravo (meloxicam / rizatriptan), tell your prescriber if you have kidney or liver problems. Also let them know if you take other medications that can harm the kidneys, like certain diuretics (water pills). Your care team might check your kidney function during treatment, especially if you’re at higher risk.
Tell your care team right away if you notice changes in how much you urinate, swelling, tiredness, or shortness of breath. These can be signs of kidney problems.
High potassium levels
Some people taking NSAIDs like meloxicam in Symbravo (meloxicam / rizatriptan) have had high potassium levels, even if they don't have kidney problems.
Look out for signs of high potassium levels. This can include nausea, muscle weakness, or tingling or numbness. Tell your care team if you notice these symptoms while taking Symbravo (meloxicam / rizatriptan). High potassium can be dangerous, so your care team might check your levels.
Harm to an unborn baby
Symbravo (meloxicam / rizatriptan) can harm an unborn baby, especially if taken during the second half of pregnancy (after week 20). It can raise the risk of serious problems, including heart and kidney issues.
If you’re pregnant, talk to your prescriber or OB-GYN before taking Symbravo (meloxicam / rizatriptan). They can help you weigh the risks and suggest safer options.
Anemia and bleeding risk
- Risk factors: Taking with blood thinners, like aspirin or warfarin | Taking other medications that raises the risk for bleeding | Blood clotting problems
Symbravo (meloxicam / rizatriptan) can sometimes cause anemia (low red blood cells). Tell your care team if you feel very weak, dizzy, short of breath, or notice your skin looks paler than usual. They can check your blood to make sure everything is okay.
Symbravo (meloxicam / rizatriptan) can also raise your risk of bleeding. Be careful if you take other medications that raise bleeding risk, such as blood thinners. Tell your care team if you bruise easily or have bleeding that takes longer to stop.
Worsening asthma in certain people
- Risk factors: Asthma, including aspirin-sensitive asthma | Asthma with rhinitis (runny or stuffy nose), with nasal polyps | Allergic to aspirin or other NSAIDs
If you have asthma, tell your prescriber before taking Symbravo (meloxicam / rizatriptan). Also let them know if you're allergic to aspirin or other NSAIDs, since this medication might not be safe for you.
Some people with these conditions have had severe asthma attacks while taking NSAIDs. Get medical help right away if you have trouble breathing or feel your throat tightening after taking Symbravo (meloxicam / rizatriptan).
Medication overuse headache
Taking Symbravo (meloxicam / rizatriptan) or other migraine medications (e.g., ergotamine medications, triptans, opioids) too often (10 or more days per month) can make your headaches worse. You might start having more frequent headaches or even daily headaches, called medication overuse headaches.
If this happens, your care team might have you stop or reduce the medication. Headaches might get worse at first, but this usually improves over time.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels in your brain
A rare, but potentially life-threatening condition called serotonin syndrome can happen in people taking Symbravo (meloxicam / rizatriptan). This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome goes up if you use Symbravo (meloxicam / rizatriptan) with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, pain medications, and migraine medications.
Tell your prescriber about all the medications you take before starting Symbravo (meloxicam / rizatriptan), as well as any medications you plan to take. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. These symptoms can start quickly, within minutes to hours. Get medical help right away if you have any of these symptoms.
Symbravo (meloxicam / rizatriptan) dosage
The average cost for 9 tablets of 20mg/10mg of Symbravo (meloxicam / rizatriptan) is $1,110.27 with a free GoodRx coupon. This is 22.75% off the average retail price of $1,437.21. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg/10mg | 9 tablets | $1,110.27 | $123.36 |
Typical dosage for Symbravo (meloxicam / rizatriptan)
The typical dose is 20 mg/10 mg (meloxicam/rizatriptan) by mouth when you have a migraine attack. The maximum dose is one tablet in a 24-hour period.
How much does Symbravo (meloxicam / rizatriptan) cost?
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Symbravo (brand)
$1,110.27
Symbravo (meloxicam / rizatriptan) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Symbravo (meloxicam / rizatriptan) will not be safe for you to take.
- Coronary artery disease
- Coronary artery vasospasm
- Use around the time of coronary bypass (CABG) surgery
- History of stroke or transient ischemic attack ("mini-stroke")
- History of hemiplegic or basilar migraines
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled high blood pressure
- Use of propranolol
- Use of ergot-containing or ergot-type medications like dihydroergotamine or other triptans in the last 24 hours
- Currently take or have taken a monoamine oxidase inhibitor (MAOI), such as selegiline, in the last 14 days
- History of asthma, hives, or other allergic reaction after taking aspirin or other NSAIDs
- Moderate-to-severe kidney problems
What are alternatives to Symbravo (meloxicam / rizatriptan)?
There are a number of medications that your doctor can prescribe in place of Symbravo (meloxicam / rizatriptan). Compare a few possible alternatives below.
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Symbravo (meloxicam / rizatriptan) images
