Symbravo (meloxicam/rizatriptan) is a prescription drug approved to treat certain types of migraine. Symbravo comes as an oral tablet.
Specifically, doctors prescribe Symbravo for adults to treat migraine with or without aura (aura is a group of disturbances in the senses, such as vision). Symbravo was approved by the Food and Drug Administration (FDA) in 2025 and is:
- prescribed only when you’ve received the diagnosis of migraine
- not used to help prevent migraine
- not used to treat cluster headache
To learn more about Symbravo’s uses, see the “Uses for Symbravo” section.
Symbravo basics
Symbravo is a brand-name medication. A generic version of the drug isn’t currently available.
Symbravo contains the active ingredients meloxicam and rizatriptan. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID), and rizatriptan is a selective 5-HT1B/1D receptor agonist.
Symbravo has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see the “Symbravo precautions” section.
Migraine is a condition where you experience recurring headaches. The pain may range from moderate to severe and usually lasts several hours to a few days. It typically starts on one side of the head and may spread to both sides, causing symptoms such as:
- intense throbbing or pulsing headache pain
- vomiting
- nausea
- sensitivity to sound or light
Aura is a group of disturbances in the vision and other senses, movement, and speech, including:
Meloxicam blocks a certain enzyme and other factors that contribute to pain and inflammation. (Inflammation can include heat, pain, swelling, discoloration, and other symptoms.) Rizatriptan attaches to specific cells located on certain nerves and in the skull. The actions of the two drugs help reduce pain, inflammation, and fever.
Like most drugs, Symbravo may cause mild to serious side effects. The following lists contain some of the more common side effects Symbravo may cause, but they don’t include all side effects possible.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Symbravo. They can also suggest ways to help reduce side effects.
Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone. It gives doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Symbravo and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
Mild side effects
Mild side effects of Symbravo that have been reported include:
- dizziness
- sleepiness
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
To learn about other mild side effects, talk with your doctor or pharmacist or read Symbravo’s prescribing information.
Serious side effects
Serious side effects from Symbravo can occur. If you have serious side effects from Symbravo, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.
Some serious side effects were reported with Symbravo, and some additional ones occurred in studies of NSAIDs or rizatriptan. When a group of medications or a drug ingredient is included in a study, the FDA recommends disclosing those side effects with similar medications. Because Symbravo contains both an NSAID and rizatriptan, these additional possible side effects are also included here:
- life threatening changes in heart rhythm
- bleeding in the skull, bleeding between the skull and spine, and stroke
- feeling of tightness, pain, pressure, and heaviness in the throat, neck, jaw, and nearby area
- hypersensitivity reaction, which means you’re sensitive to a drug’s ingredients
- anaphylaxis, which is a life threatening allergic reaction
- reactions in the blood vessels, including Raynaud phenomenon, which is a restriction or interruption in blood flow
- increase in liver enzymes
- liver damage
- new onset of or worsening of high blood pressure
- heart failure and swelling, which is usually in the hands or feet but can occur in other parts
- increase in potassium in the blood
- kidney damage, including acute kidney failure
- serious skin adverse reactions, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, which can be fatal
- drug rash with eosinophilia and systemic symptoms, which is a severe reaction to a drug that can become life threatening or fatal
- anemia, which is low iron
- serotonin syndrome, which is a serious buildup of the chemical serotonin
- boxed warnings: increased risk of serious cardiovascular (heart and blood vessel) blood clotting events, including heart attack and stroke, increased risk of heart attack and stroke when taken after coronary artery bypass graft (CABG) surgery, increased risk of serious gastrointestinal adverse events
For more information about side effects related to boxed warnings, see the “Symbravo precautions” section.
Allergic reactionFor some people, Symbravo can cause an allergic reaction. This side effect wasn’t reported in the drug’s studies, but it has occurred after the drug became available.
In general, symptoms of an allergic reaction can be mild. But they could develop into a serious reaction. So you should be watchful.
Mild allergic reaction and what might helpIf you have mild symptoms of an allergic reaction, call your doctor right away. They may suggest a treatment to manage your symptoms. They can also determine whether you should continue Symbravo treatment.
Mild symptoms may include:
- rash
- light itching
- sneezing
Continue watching for any worsening of your allergic reaction symptoms or new ones that develop.
Serious allergic reaction and what might help
If you have symptoms of a severe allergic reaction, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care. Serious symptoms include:
- facial swelling
- wheezing
- difficulty breathing
- difficulty swallowing
- slurred speech
- weak pulse
- nausea
- confusion
Your doctor can confirm whether you’ve had a serious allergic reaction to Symbravo. If you have, they may switch you to a different treatment.
The Symbravo dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re taking Symbravo to treat
- your age
- other medical conditions you may have
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Form and strength
Symbravo is available as an oral tablet in one strength: 20 milligrams (mg) meloxicam and 10 mg rizatriptan per tablet.
Recommended dosage for migraine with or without aura
Your doctor will likely prescribe 1 tablet as needed for the treatment of migraine with or without aura. The recommended maximum daily dosage is 1 tablet.
Your doctor will prescribe the dosage of Symbravo that’s right for you.
About taking Symbravo
The following are some common questions about taking Symbravo.
- Can Symbravo be chewed, crushed, or split? No, you should not chew, crush, or split Symbravo tablets. You should swallow them whole. If you have difficulty doing so, you can get tips on how to swallow pills or ask your doctor or pharmacist for advice.
- Should I take Symbravo with food? You can take Symbravo with or without food.
- Will I need to take Symbravo long term? Symbravo has numerous warnings concerning long-term use, so you should take it only for the shortest duration possible. Your doctor may prescribe 1 tablet as needed, and the recommended maximum daily dosage is 1 tablet. This means you should take it only for short-term treatment of migraine with or without aura. (Symbravo is not taken to help prevent migraine or to treat cluster headache.)
- How long does Symbravo take to work? Symbravo begins to work soon after you take a dose. If you don’t feel relief in your symptoms, call your doctor immediately. The recommended maximum daily dosage is 1 tablet.
Overdose
Do not take more Symbravo than your doctor prescribes, as this can lead to harmful effects. Some symptoms of overdose may occur as a result of one ingredient or the other in Symbravo or both.
Symptoms caused by an overdose can include:
- lethargy (sluggishness)
- drowsiness
- nausea or vomiting or both
- abdominal pain
- gastrointestinal bleeding, which can cause symptoms of blood in the urine or stools, dizziness, or fatigue
- fainting
- dizziness
- bradycardia (slowed heart rate), including third-degree heart block
- incontinence
In rare cases, overdose of Symbravo may cause the following symptoms:
- high blood pressure
- acute kidney failure
- respiratory depression, which is slowed, shallow breathing
- coma
What to do in case of overdose
Call your doctor if you think you’ve taken too much Symbravo. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Symbravo can interact with several other medications. It is not known to interact with foods, supplements, or vaccines.
Symbravo does not have an interaction with lab tests. But the way it works in the body may conceal early symptoms of infection. Your doctor can offer guidance based on your specific health condition and any potential risks or benefits involved.
Before taking Symbravo, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, or supplements you take. Interactions with vitamins, herbs, and supplements may not be known currently. But sharing this information can help you avoid potential interactions that could become known later.
Interactions with medications
The following list highlights medications that can interact with Symbravo. This list contains some medications and examples, but it does not contain all that may interact with Symbravo.
- 5-HT1 agonists, such as sumatriptan and almotriptan
- angiotensin converting enzyme inhibitors, such as enalapril (Vasotec) and lisinopril (Zestril)
- angiotensin receptor blockers, such as valsartan and losartan
- beta-blockers, such as propranolol
- CYP2C9 (an enzyme) inhibitors, such as amiodarone and fluconazole
- diuretics (commonly known as water pills, which increase urine output), such as furosemide (Lasix)
- drugs containing ergot, such as dihydroergotamine and methysergide
- blood thinners, such as warfarin
- monoamine oxidase inhibitors (MAOIs), such as selegiline and phenelzine (Nardil)
- NSAIDs and salicylates, such as diflunisal and salsalate
- selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa) and sertraline (Zoloft)
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor XR)
- aspirin
- cyclosporine
- lithium
- methotrexate
- pemetrexed
If you have questions about interactions that may affect you, ask your doctor or pharmacist.
Symbravo and alcohol
Alcohol is not known to interact with Symbravo. But drinking alcohol during Symbravo treatment can increase some risks for certain people. These risks are higher in people who have a history of peptic ulcer disease or gastrointestinal bleeding or both. The risks include:
- gastrointestinal bleeding
- ulcer
- perforation (hole or tear) in the stomach or intestines
If you have questions about the safety of drinking alcohol while taking Symbravo, talk with your doctor or pharmacist.
Whether or not you have health insurance, cost may be a factor when you’re considering Symbravo. What you’ll pay for Symbravo may depend on several things, such as your treatment plan and the pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also check the SYMBRAVO On My Side Savings Program, which may be available to help with the cost of Symbravo.
The following is important information to consider and discuss with your doctor or pharmacist before taking Symbravo.
Pregnancy and Symbravo
NSAIDs, like Symbravo, pose some risks if you take them during pregnancy. But if left untreated, migraine during pregnancy also poses certain risks. (Symbravo is used for treating migraine.) Doctors should tailor migraine treatment during pregnancy to each patient.
The manufacturer of Symbravo recommends limiting the use of Symbravo in certain weeks of pregnancy due to risk of fetal harm. For that same reason, it also recommends avoiding the use of Symbravo in specific weeks of pregnancy. Your doctor can discuss this with you in more detail.
If you’re planning a pregnancy or can become pregnant, talk with your doctor about potential treatments for migraine during pregnancy. Together, you can consider the risks and benefits of treatment options and decide whether you should take Symbravo during pregnancy.
Symbravo and breastfeeding
It’s not known whether Symbravo should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before starting this drug.
This section describes the warnings and precautions for Symbravo.
FDA warnings
Symbravo has multiple boxed warnings, described here. A boxed warning is the most serious warning from the FDA about drug effects that may be dangerous.
Increased risk of serious cardiovascular (heart and blood vessel) blood clotting events, including heart attack and stroke: Symbravo, like other NSAIDs, may increase the risk of serious cardiovascular events, including heart attack and stroke. These could be fatal.
The risk may occur early in treatment, increase with higher doses, and increase as long as Symbravo is taken. The risk is also higher in people with cardiovascular disease or risk factors for it.
Some symptoms of heart attack are:
- chest pain or discomfort
- upper body pain
- shortness of breath
- difficulty breathing
Some symptoms of stroke are:
- difficulty speaking or understanding others
- slurred speech
- difficulty walking
- loss of balance or coordination
This article provides more information on symptoms of heart attack and stroke.
Due to this risk, your doctor will prescribe the lowest effective dose for the shortest amount of time possible. They also will monitor you for any developing factors or symptoms. If you notice any of the symptoms listed in the table, call your doctor right away.
Increased risk of heart attack and stroke when taken after coronary artery bypass graft (CABG) surgery: Symbravo increases the risk of heart attack and stroke if taken within 10 to 14 days after CABG surgery. Due to this risk, your doctor will not prescribe Symbravo near the time of a planned CABG surgery.
Increased risk of serious gastrointestinal (GI) adverse events: Symbravo, like other NSAIDs, may increase the risk of serious GI events. These include the following:
- inflammation
- bleeding
- ulcer
- perforation (hole or tear) in the stomach or intestines
These events can occur at any time during treatment and without warning symptoms. Certain people are at increased risk of these events. They include people ages 65 years and older and those with a history of peptic ulcer disease, GI bleeding, or both. This risk can occur with short-term or long-term use of Symbravo.
Due to this risk, your doctor will prescribe the lowest effective dose for the shortest amount of time possible. They also will monitor you for any developing factors or symptoms.
You should avoid the use of other NSAIDs during treatment with Symbravo. If you take low dose aspirin to prevent certain heart problems, your doctor will monitor you more closely during Symbravo treatment.
If you have any unexplained symptoms during Symbravo treatment, call your doctor right away.
Ask your doctor if you have questions about any of these boxed warnings.
Other precautions
Before taking Symbravo, discuss your health history with your doctor. Symbravo may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- take other NSAIDs
- take SSRIs, SNRIs, tricyclic antidepressants, and MAOIs
- take other migraine medications
- take blood thinners
- history of heart problems
- heart failure and swelling
- arrhythmia
- coronary artery disease
- Prinzmetal’s angina
- past heart attack
- past stroke or transient ischemic attack (ministroke)
- history of blood clots or other bleeding problems
- GI problems, including peptic ulcer disease
- liver damage
- high blood pressure
- kidney damage
- unexplained bleeding
- skin conditions, such as a rash or sensitivity
- low iron
- asthma, including aspirin-sensitive asthma
- sensitivity to meloxicam, rizatriptan, or both
- recent or upcoming surgery
- past allergic reaction to this or a similar drug
- pregnancy
- breastfeeding
Note: For more information about the potential negative effects of Symbravo, see the “Side effects of Symbravo” section.
Other drugs are available that can treat your condition. Treximet (sumatriptan and naproxen) is similar to Symbravo. If you’d like to explore this alternative to Symbravo, talk with your doctor.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.