• Patient Product Information
• Prescribing Information
• For Health Care Providers

Stages of a Migraine Attack

Before, during, and after migraine.

Preheadache

Many migraine sufferers experience preheadache (prodrome) as an early warning sign hours or days before migraine. Symptoms of preheadache can include:

• Food cravings (eg, chocolate and other sweets)
• Mood changes
• Muscle stiffness (especially in the neck)
• Yawning/fatigue

Aura

Usually following the preheadache phase, aura is a temporary disturbance of brain function. It's most commonly visual, but can also occur in other ways. Auras can be:

• Visual (flickering lights, wavy lines, blurred vision, or spots in your vision)
• Sensory (tingling or numbness of the face, arms, or legs)
• Motor (temporary weakness and/or clumsiness)

Headache

Usually the most disabling aspect of migraine. The pain is often so intense that it's difficult to comprehend by those who haven't experienced it. Headache can last from a couple of hours to several days. Symptoms of headache can include:

• Moderate to severe pain on one side of the head, or both sides (worsened by activity)
• Nausea and vomiting
• Sensitivity to light (also called photophobia)
• Sensitivity to sound (also called phonophobia)

Postheadache

Postheadache (postdrome) begins when the headache pain recedes. It can last hours, or even days, often leaving sufferers feeling "woozy" or "drained." Although this is sometimes attributed to migraine medication, it may actually be due to the migraine itself. Symptoms of postheadache can include:

• Fatigue
• Decreased concentration
• Depressed mood levels/irritability
• Feelings of well-being and euphoria

Watch a video to learn more about the early stages of migraine.

MAXALT is a prescription medicine for the treatment of migraine attacks in adults. Only your health care professional can determine if MAXALT is right for you.

Important Safety Information

• You should not take MAXALT if you have uncontrolled high blood pressure, heart disease or history of heart disease, or if you are taking or have taken MAO inhibitors within the last 2 weeks, or are taking certain other medications.
• Tell your doctor about all medications you are taking.
• Talk to your doctor about any history of chest pain, shortness of breath, or stroke.
• If you have risk factors for heart disease, such as high blood pressure, diabetes, high cholesterol, obesity, smoking, are postmenopausal, or are a male over 40, you should be evaluated by your doctor before taking MAXALT.
• Do not take MAXALT if you are pregnant or nursing.
• As with other drugs in this class, there have been very rare reports of heart attack and stroke generally occurring in patients with risk factors for heart and blood vessel disease.
• In clinical studies with MAXALT, the most common side effects reported were dizziness, sleepiness, tiredness, fatigue, and pain or pressure sensation (eg, in the chest or throat). Ask your doctor to discuss with you the more complete list of side effects reported with MAXALT.

Phenylketonurics: MAXALT-MLT contains phenylalanine. Please read the Patient Product Information (PDF: 43KB, 6 pages).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the Patient Product Information (PDF: 43KB, 6 pages) and discuss it with your doctor. The physician Prescribing Information (PDF: 112KB, 14 pages) is also listed.

Having trouble paying for your Merck medicine? Merck may be able to help. Visit www.merck.com/merckhelps.

For general health information

MIGR-1005002-0000 07/11