Medical Assessment - Maxalt Melt 10mg

About You
Are you aged between 18-65?
Your Symptoms
Do you experience migraines for more than 10 days a month?
Do your migraines last less than 4 hours without treatment or last longer than 24 hours?
Do your migraines follow a broadly similar pattern each time?
Are you experiencing any of the following along with your migraine?
  • unilateral motor weakness
  • double vision
  • clumsiness or uncoordinated movements
  • tinnitus (ringing in the ears)
  • reduced level of consciousness
  • seizure-like movements (fits)
  • a recent rash with a headache
  • headache confined to the back of the head
  • recent marked deterioration in migraine (duration, severity or frequency of attacks)
Your Health
Have you previously been diagnosed with migraines by your GP and have you experienced relief when taking medication containing 'triptans' such as Imigran (Sumatriptan), Rizatriptan (Maxalt), Zomig (Zolmitriptan) ?
When you have taken a ‘triptan’ medication in the past, within the first few hours of taking it have you experienced sensations such as heaviness, pressure or tightness in the body (especially chest or throat), or have you experienced palpitations, flushing, dizziness, rash, a feeling of weakness, worsening nausea and vomiting or a temporary rise in your blood pressure?
Are you breastfeeding or pregnant or possibly pregnant?
Do you have an allergy (hypersensitivity) to Imigran/Sumatriptan, Maxalt/rizatriptan, Zomig/zolmitriptan?
Have you been diagnosed with any of the following?
  • Heart disease or heart problems such as narrowing of the arteries (ischaemic heart disease) or chest pains (angina), or have already had a heart attack
  • Stroke or a mini-stroke (also called a transient ischaemic attack or TIA)
  • High blood pressure
  • Coronary Vasospasm (including Prinzmetal’s angina)
  • Wolff-Parkinson-White Syndrome (a type of abnormal heartbeat)
  • Peripheral Vascular Disease
  • Previous Gastrointestinal or Splenic infarction
  • Ischaemic Colitis
  • Epilepsy or history of seizures
  • Liver problems
  • Kidney problems
  • Allergy or sensitivity to antibiotics called sulphonamides (e.g. trimethoprim)
  • Any serious medical condition which may require immediate hospitalisation
Your Medication
Are you currently taking any medication (including over the counter, prescription or recreational drugs)?
Do you agree to the following?
  • You will read the patient information leaflet supplied with your medication
  • You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment.
  • The treatment is solely for your own use
  • You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.

Complete our 2 minute questionnaire
We’re almost done!
Dr Oliver Large
To make sure this treatment is safe for you to take, we just need you to answer a few questions.
Dr Oliver Large
Confidential & Secure
  • Our prescribers will review your details in complete confidence
  • Your medication will be delivered in plain unlabelled packaging
  • Appears on your statement as “Mexpress”
  • All data is securely encrypted with 128bit SSL
Need help? If you need help with this medical assessment, contact our helpline:
0208 123 0508
or email us: