Symbravo (meloxicam/rizatriptan) - Uses, Side Effects, and More

What are the most common side effects of Symbravo?

The most common side effects of Symbravo are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Dizziness
• Drowsiness

There may be other side effects of Symbravo that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Symbravo?

While less common, the most serious side effects of Symbravo are described below, along with what to do if they happen.

Severe Allergic Reactions. Symbravo may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Itching, skin rash, or pale red bumps on the skin called hives
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Shortness of breath, trouble swallowing, or throat tightness
• Swelling in your feet, ankles, or legs
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain
• Dark-colored pee
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Chest Pain, Heart Attack, and Stroke. Symbravo can increase your risk of chest pain as well as pain, pressure, or tightness in your chest, throat, jaw, or neck. This can be a symptom of a heart attack. Symbravo may also increase your risk of a heart attack or stroke that can lead to death. These risks are higher in people who already have heart disease and with longer use and higher doses of Symbravo. Do not take Symbravo if you have had a recent heart attack without talking to your healthcare provider first. This could increase your risk of having another heart attack. Symbravo may also increase your risk of bleeding in the brain or a transient ischemic attack. Stop taking Symbravo and get emergency help if you have any of the following symptoms of a heart attack or stroke.

• Chest discomfort that lasts longer than a few minutes or gets better and then worse
• Fast or abnormal heartbeat
• Trouble breathing or shortness of breath
• Severe pain, heaviness, tightness, or pressure in your jaw, throat, neck, or chest
• Sweating, upset stomach, vomiting, or dizziness
• Sudden weakness on one side of your body
• Sudden and severe headache or breaking into a cold sweat
• Slurred speech or trouble understanding speech

Stomach Bleeding. Symbravo can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, bleeding problems, take higher doses of Symbravo or take it for longer than directed, have poor health, are age 60 or older, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop taking Symbravo and get emergency help if you have any of the following symptoms.

• Vomit blood
• Black or tarry poop
• Stomach pain that does not go away
• Upset stomach
• Feel faint

Heart Rhythm Changes. Symbravo may cause heart rhythm problems that can lead to an irregular heartbeat and fainting. In rare cases, this may cause the heart to suddenly stop beating (cardiac arrest). Get emergency help if you have any of the following signs of heart rhythm changes.

• Chest pain
• Shortness of breath
• Feeling dizzy, lightheaded, or fainting
• Changes in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat

Blood Flow Problems. Symbravo can reduce blood flow to many areas of the body, which can be serious. Get emergency medical help if you have any of the following signs of circulation problems.

• Pain or cramping in the hips or legs
• Leg muscle tightness or heaviness
• Burning or aching pain in the feet or toes
• Weakness, numbness, cold feeling, or tingling in the legs
• Changes in color or sensation in your fingers and toes (Raynaud’s syndrome)
• Sudden or severe stomach pain, constipation, diarrhea, nausea, or vomiting
• Bloody diarrhea
• Sudden and unexplained weight loss

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Symbravo. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop or diarrhea
• Dark-colored urine (pee)
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Symbravo may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heartbeats

Heart Failure and Fluid Retention (Edema). Symbravo can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Symbravo may also increase your risk of heart failure. Tell your healthcare provider right away if you have any of the following symptoms.

• Shortness of breath or trouble breathing, especially while lying down
• Swelling in your feet, ankles, or legs
• Stretched or shiny skin
• Unusually fast weight gain
• Unusual tiredness

Kidney Damage. Kidney damage can happen when taking Symbravo. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs
• Weakness or unusual tiredness
• Difficulty catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

High Potassium Levels (Hyperkalemia). Symbravo can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your healthcare provider may check your potassium levels, especially if you take certain other medicines. Call your healthcare provider right away if you have any of the following symptoms of a high potassium level. 

• Muscle weakness or unusual tiredness
• Slow heartbeat or feeling of skipped heartbeats
• Nausea or vomiting
• Trouble breathing
• Abnormal heart rhythm

Severe Skin Reactions. Symbravo can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or generalized bullous fixed drug eruption (GBFDE). These reactions can lead to death if not treated. If you develop a rash, stop Symbravo and call your healthcare provider right away. Get emergency help if you have any of the following symptoms.

• Painful red or purple skin that looks burned and peels off
• Flat red rash or blisters on your skin, mouth, nose, and genitals
• Red, painful, watery eyes
• Flu-like symptoms including fever, chills, and muscle aches

Anemia. Symbravo may cause anemia, which is when you have low levels of red blood cells. Tell your healthcare provider if you have any of the following symptoms of anemia.

• Unusual weakness or tiredness
• Cold hands and feet
• Fast or abnormal heartbeat
• Pale or yellowish skin 
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Shortness of breath

Bleeding. Symbravo can increase your risk of bleeding, especially if you have a bleeding disorder or take other medicines that increase your risk for bleeding. Tell your healthcare provider right away if you notice any signs of bleeding, including easy bruising or bleeding, red or black stools (poop), or vomiting or coughing up blood or what looks like coffee grounds.

Medicine Overuse Headache. Taking Symbravo or other migraine medicines more often than prescribed may cause your headaches to happen more often or get worse. This is called medicine overuse headache or rebound headache. Tell your healthcare provider if your headaches are getting worse.

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Symbravo can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

• Sweating, fever, or flushing
• Confusion
• Feeling agitated or restless
• Seeing or hearing unusual things
• Dizziness
• Fast or racing heartbeat
• Nausea, vomiting, or diarrhea
• Muscle twitching, stiffness, or tremor
• Seizures