Zolmitriptan

A selective serotonin receptor antagonist, Zolmitriptan stops pain signals from being sent to the brain.

Overview:

Adults who suffer from migraine headaches often find themselves struggling to get through their daily routine, leaving them temporarily debilitated by intense pain accompanied by sensitivity to light, feeling nauseous or vomiting, irritability and dizziness, among others. Migraine headaches can affect individual areas of the body, including the face, neck, vision and the gastrointestinal system or the whole body, producing a general feeling of malaise, dizziness or feeling lightheaded. Pain can range from an intense throbbing or pulsing to a dull ache. The headache may occur on one or both sides of the head. Sensory symptoms include aura and sensitivity to light and sound. Zolmitriptan is used to reduce or eliminate migraine headaches in adults and enable the patient to continue their daily activity. This medication is not taken daily, rather it is taken to stop a migraine. Zolmitriptan does not prevent future migraine headaches from occurring or decrease the amount of migraine headaches you get.

Zolmitriptan is a selective serotonin receptor antagonist. It works by narrowing the blood vessels around the brain; zolmitriptan stops pain signals from being sent to the brain and is also helpful with blocking certain substances that cause pain, nausea and other symptoms associated with migraines. Zolmitriptan is not effective in preventing migraine headaches or reducing the number of headaches. Zolmitriptan is used to stop or reduce the intensity of a migraine headache after it’s started.

The brand names available for zolmitriptan are Zomig and Zomig-ZMT. It is available by prescription only. Zolmitriptan comes as a tablet and an orally disintegrating tablet (that dissolves in the mouth upon contact with saliva) and may be taken with or without food. Zolmitriptan is taken at the first sign of a migraine headache; if the patient shows improvement but the migraine returns within two hours, a second dose may be taken. If there is no improvement after the first dose, all your doctor before taking a second dose. There is the chance of side effects and drug interactions with this medication. It is necessary to let your doctor or pharmacist know what other medications you are taking and if you are pregnant or breastfeeding before taking zolmitriptan.

Migraine headaches may be completely relieved in some patients while other people continue to have headaches with less intensity. This allows them to continue with their daily activities with minimal interruptions. Zolmitriptan relieves symptoms of migraine headaches such as vomiting, nausea, sensitivity to light and sensitivity to sound.

Zolmitriptan is prescribed for migraine headaches only and is not for use for other types of pain or headaches. This medication is prescribed to patients who are unable to experience relief with other pain relievers such as acetaminophen, aspirin and/ or ibuprofen.

Serious side effects have occurred in some patients who have taken Zolmitriptan. This has occurred more often in patients with diseases of the heart or blood vessels. While the use of Zolmitriptan is not limited in geriatric adults, they are more likely to have high blood pressure or heart disease and the use of Zolmitriptan can further compromise their health. Discuss the benefits and risks of taking Zolmitriptan with your doctor and weigh the pros and cons before deciding whether Zolmitriptan is a good choice for your migraine headaches.

Be sure to tell your doctor if you have had any adverse side effects or allergic reactions to Zolmitriptan or any other medication. Tell your doctor or pharmacist if you have other types of allergies. These include foods, dyes, animals, perfumes or preservatives.

Condition(s) Treated:

  • Migraine headaches

Type of Medicine:

  • Antimigraine
  • Selective serotonin receptor antagonist

Side Effects:

Zolmitriptan is prescribed because your doctor feels the benefits of the drug out weigh the possible side effects that may occur. While you may experience bothersome side effects that will lessen as your body adjusts to taking Zolmitriptan, some people experience serious or rare, life- threatening side effects that should be immediately reported to their doctor.

If you experience the following severe side effects call your doctor immediately. Severe side effects that are more common while taking Zolmitriptan include severe chest pain, a feeling of heaviness, pressure or tightness in the neck or chest and a burning sensation, heat, numbness, warmth, tingling or tightness throughout the body. These side effects can prove to be life-threatening and require immediate medical attention.

These severe side effects are considered less common while taking Zolmitriptan and include changes in the color of your facial skin, cough, diarrhea and irregular or racing heartbeat. Patients have also reported chills or fever, skin rash, hives, intense itching, loss of appetite, pain in your side or lower back and nausea. Other severe side effects that have been reported by patients while taking Zolmitriptan are less common and include; difficulty urinating, pain upon urination, weakness and allergic reaction, including itching or hives, swelling of the face or hands, swelling or tingling in your mouth or throat, tightness in your chest or trouble breathing. Although these severe side effects are not commonly reported by patients while taking Zolmitriptan, they still require medical attention and should be reported to your doctor or pharmacist immediately.

Rare, but serious side effects, reported by patients taking Zolmitriptan include blurred vision, confusion, difficulty swallowing, dizziness and fainting. Other rare, but serious, side effects reported by patients include increased urge to urinate, increase in volume of urine, headache, nervousness, pounding in ears, severe numbness on one side of face or body, slow heartbeat and unusual tiredness or weakness.

Most medications carry the risk of side effects that prove bothersome and may require the patient to discontinue the medication if they worsen and do not go away. However, most side effects do lessen or dissipate altogether as your body becomes used to the medication. The following side effects prove to cause discomfort but generally do not require medical attention. Speak with your healthcare professional about how to lessen or alleviate your side effects while continuing Zolmitriptan if the side effects become increasingly bothersome.

The following side effects do not require immediate medical attention. You may want to bring them to your doctor or pharmacist’s attention if they are a cause for concern or do not go away. The following side effects are the most common side effects reported by patients taking Zolmitriptan; they include loss of strength, unusual drowsiness and warm or cold sensation. Dry mouth, dizziness, feeling like you are constantly moving, and a spinning sensation are less common side effects reported by patients.

The following side effects are considered rare but have been reported by patients taking Zolmitriptan. These rare, but non-threatening, side effects include anxiety, emotional reactivity or over reactivity, crying, rapid mood swings and depersonalization. Other less reported side effects from patients taking Zolmitriptan are memory problems, depression, dysphoria, euphoria, welts and hyperventilation. Paranoia, shaking, irritability, memory loss, skin redness and feeling, hearing, seeing things that are not there have also been reported. Insomnia was also reported among a limited number of adults taking Zolmitriptan.

If you or someone you know has taken Zolmitriptan and has difficulty breathing or has passed out, call 911. If you suspect over dose, call 911 or your local poison control center at 1-800-222-1222.

Dosage:

The dosage of Zolmitriptan varies dependent on the patient. Your doctor will prescribe the amount that is best for your body based on the strength of the medication and your condition. On average, patients who use the oral tablets, adults begin with a dosage of 1.25 or 2.5 milligrams as a single dose. For those patients prescribed the 1.25 milligram dosage, the 2.5 milligram tablet may be broken in half.

Patients may have relief from their migraine headache, only to have it return. If this happens, a second dose may be taken if it has been at least 2 hours since the first dose of Zolmitriptan was ingested. No more than 5 milligrams may be taken in a single dose and no more than 10 milligrams of Zolmitriptan should be taken in a 24-hour period. The use of Zolmitriptan is not recommended for children and should not be used.

The oral disintegrating Zolmitriptan tablets are placed on the top of the tongue. This tablet comes in a blister pack and the tablet should be removed with clean, dry hands when you are ready to take the medication. Once removed from the blister pack, if you do not take the medication, then it should be discarded. Adults should allow the 2.5 milligram disintegrating tablet to dissolve on their tongue. Once their migraine headache is relieved, another single disintegrating tablet may be taken if the migraine returns after two hours has passed since the first dose was taken. The patient should not exceed 5milligrams in a single dose or 10 milligrams in a 24-hour period.

Avoid taking too much Zolmitriptan; taking it for longer periods than prescribed or taking it more often than prescribed can increase the chances of unwanted, and possibly serious, side effects. Only take Zolmitriptan when your migraine headache begins. It should not be used for other symptoms, such as aura. Zolmitriptan is for the treatment of migraine headache only.

Major Drug Interactions:

Zolmitriptan may interact with other prescription and non-prescription drugs. It is important to tell your doctor of any prescription and non-prescription drugs or supplements you are taking so your doctor can make an informed decision regarding the use of Zolmitriptan for your migraine headaches. Your doctor is aware of drugs and supplements that may never be combined with Zolmitriptan as well as drugs that might cause an interaction when taken with Zolmitriptan but are in the best interests of the patient to be taken together. If prescribed Zolmitriptan while taking another prescription drug, additional precautions should be taken.

The following medications listed below should not be taken with Zolmitriptan. If you are currently taking any of these medications, your doctor will not prescribe Zolmitriptan or discontinue or change your current medication regimen to avoid life-threatening interactions.

This is not an exhaustive list of medications you should avoid while taking Zolmitriptan. It is recommended that the following medications should not be taken if you are taking Zolmitriptan:

  • Almotriptan
  • Cisapride
  • Isocarboxazid
  • Levomethadyl
  • Linezolid
  • Mesoridazine
  • Methylene Blue
  • Phenelzine
  • Rizatriptan
  • Sumatriptan
  • Terfenadine
  • Thioridazine
  • Tranylcypromine

The following medications are generally not recommended for use while taking Zolmitriptan, but you and your doctor will weigh the pros and cons before deciding if the benefits outweigh the risks when taking the medication together and if it is in the best interests for your health. If Zolmitriptan is prescribed with one of the medications listed below, your doctor may alter your dose or change the amount that you use on or both medications.

The following medications are usually not recommended when taking Zolmitriptan:

  • Acecainide
  • Ajmaline
  • Alfentanil
  • Amiodarone
  • Aprindine
  • Azimilide
  • Benzphetamine
  • Bretylium
  • Chloroquine
  • Citalopram
  • Codeine
  • Dibenzepin
  • Dihydrocodeine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Doxepin
  • Droperidol
  • Duloxetine
  • Erythromycin
  • Escitalopram
  • Fentanyl
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluvoxamine
  • Foscarnet
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Hydrocodone
  • Hydromorphone
  • Hydroquinidine
  • Ibutilide
  • Imipramine
  • Isradipine
  • Levomilnacipran
  • Levorphanol
  • Lidoflazine
  • Lisdexamfetamine
  • Lorcainide
  • Lorcaserin
  • Mefloquine
  • Nefazodone
  • Nortriptyline
  • Octreotide
  • Pentamidine
  • Pirmenol
  • Pixantrone
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Protriptyline
  • Quinidine
  • Reboxetine
  • Remifentanil
  • Sematilide
  • Sertraline
  • Sibutramine
  • Sotalol
  • Spiramycin
  • Tedisamil
  • Tramadol
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Vasopressin
  • Ziprasidone

Using the following medication (s) with Zolmitriptan may increase the risk of certain side effects but may be prescribed if your doctor feels it is the best option for you. Your doctor may change your dose or the times that you take one or both of your medications.:

  • Cimetidine

Warnings:

Patients should see their doctor on a regular basis while taking Zolmitriptan. Regular visits with your doctor will enable your doctor to check if the medication is working the way it is intended to, if the dosage should be changed or if you should discontinue it. You should not take Zolmitriptan if you have taken any other triptan or ergot-type migraine headaches within the last 24 hours. Examples of other types of triptan medications include almotriptan (Axert), eletriptan (Relpax) and naratriptan (Amerge). Some ergot-type migraine medications include ergotamine (Bellergal, Cafergot, Ergomar and Wigraine) and methysergide (Sansert). Avoid this medication if you have taken an MAO inhibitor, such as phenelzine or tranylcypromine, within the last two weeks. Contact your doctor if your migraines become worse or you have migraines that go away only to keep recurring a short time later.

Inform your doctor if you or a close family member have heart disease, you have diabetes, are a smoker or have high blood pressure as this is more likely to lead to having a heart attack or stroke. Tell your doctor immediately if you develop warning signs of a possible heart issue including pain or pressure in the chest, a fluctuating heartbeat, throwing up or feeling nauseous, excessive perspiration, difficulty breathing or pain or pressure in the shoulders, arms, jaw, neck or back. If you have confusion, difficulty talking, headache, double vision, slow speech or inability to talk or are unable to move your arms, legs or facial muscles, call your doctor immediately or dial 911, as these symptoms might indicate a stroke which requires immediate medical attention to prevent irreversible effects or death.

Zolmitriptan may cause blurred vision or difficulty reading. Inform your doctor to gain a referral to an ophthalmologist to have your vision checked. Also inform your doctor of any gastrointestinal side effects, such as sudden or severe pain or diarrhea.

Zolmitriptan may interact with other medications. Inform your doctor or pharmacist of the medications you are currently taking to avoid life- threatening interactions. Is helping you with your migraines. In some patients, the number of headaches increased after taking Zolmitriptan. If you feel dizzy or drowsy after taking Zolmitriptan, avoid driving or operating a vehicle or machinery.

Consider keeping a headache diary to determine whether the medication. Some people report worsening of migraines after starting Zolmitriptan. Alcoholic beverages might increase or worsen migraine headaches. Avoid alcohol while taking Zolmitriptan.

If you have been diagnosed with other medical problems, the use of this medicine may affect you differently. It is important that you inform your doctor if you have been diagnosed with other medical problems, especially those in the following list:

  • Plaque build-up in the arteries
  • Arrhythmia, irregular heartbeat or heart rhythm problem
  • History of migraine accompanied by vision and hearing problems
  • History of heart attack
  • Heart or blood vessel disease
  • History migraine with some paralysis
  • high blood pressure
  • Diabetes
  • Angina or chest pain
  • TIA or mini-stroke
  • Stroke
  • Wolff-Parkinson-White Syndrome (heart rhythm problem)
  • Family history of coronary artery disease
  • Bowel disease that involves constricted arteries that supply the intestines
  • Hypertension (high blood pressure)
  • Obesity
  • Raynaud's syndrome
  • Heart rhythm problems (for example: ventricular fibrillation or ventricular tachycardia)
  • Moderate to severe liver disease
  • Phenylketonuria (PKU)

Patients with Raynaud’s syndrome may be at an increased risk of side effects when using Zolmitriptan. Use this medication with caution and watch for side effects. Report side effects to your doctor or pharmacist so that they may monitor the effectiveness and benefits of Zolmitriptan and decide if it is the right prescription drug for you. Patients with heart rhythm problems such as ventricular fibrillation, should use this medication with caution. Using Zolmitriptan for migraine headaches can heart rhythm problems worse. Give feedback to your doctor and keep office visits to stay healthy. Patients diagnosed with Wolff-Parkinson-White Syndrome should not take Zolmitriptan.

If you have moderate to severe liver disease, taking the oral disintegrating tablet for migraine headaches is not recommended. A lower is dosage is recommended and the oral disintegrating tablets cannot be broken in half. Patients diagnosed with Phenylketonuria or PKU, which is a genetic disorder that is characterized by an inability of the body to utilize the essential amino acid, phenylalanine, should not take the oral disintegrating tablet for migraine headaches. The oral disintegrating tablet contains phenylalanine, and this can make PKU worse.

Storage:

Zolmitriptan should be stored at room temperature and kept in a closed container. Do not allow Zolmitriptan to come in contact with heat, moisture or direct light. Do not freeze Zolmitriptan. Keep Zolmitriptan and all medications away from children. When you are through with Zolmitriptan, discard the unused or expired portion. Ask your doctor or pharmacist about discarding medication that you no longer need.

Summary:

Zolmitriptan is a medication used for migraine headaches only. It belongs to a group of medications known as triptans. It is not to be used for any other type of pain, including headaches other than migraine headaches. Zolmitriptan does not prevent migraine headaches and it is not prescribed for cluster headaches. Zolmitriptan is not for use by children and may compromise geriatric patients if they have high blood pressure or heart disease.

Zolmitriptan is available by prescription only. It is available in tablet or disintegrating tablet form. Zolmitriptan can be broken in half if your doctor prescribes 1.25 milligram as an initial dose. Generally, a patient is prescribed a 1.25 or 2.5 milligram initial dose. If you find relief and your migraine headache returns after a two-hour period, a second dose may be taken. Do not take a second dose if your migraine headache does not dissipate within two hours. Consult your doctor for further instruction. Patients should not take more than 5 milligrams in a single dose or 10 milligrams in a 24-hour period.

There haven’t been adequate studies performed in pregnant women to establish the safety of taking Zolmitriptan in pregnancy or breastfeeding. This drug should only be used during pregnancy or while breastfeeding if the benefits outweigh the possible harm to the infant. This is a decision to discuss at length with your doctor to find a safe and healthy option to meet your needs.

Zolmitriptan may cause unwanted side effects in some patients. While some side effects can be bothersome, they will generally dissipate and will not need immediate medical attention. Side effects, such as difficulty breathing, and allergic reaction require that you discontinue the medication and get immediate medical attention.

It is important to tell your healthcare provider all the medications and supplements you are taking so that he or she may adjust the dosage or avoid prescribing certain medications that may interact with Zolmitriptan. There are some medications that must be avoided when you are taking Zolmitriptan. Other medications may not be recommended while taking Zolmitriptan, but your doctor may determine that it is the best treatment for you after weighing the benefits and the risks. Medication and dosage is a personal decision based on may factors regarding the patient’s health. The use of alcohol and tobacco while taking Zolmitriptan may cause unwanted side effects. Discuss alternative options with your healthcare provider.

Avoid taking this medication with other triptans within a 24-hour period. Store Zolmitriptan at room temperature in a closed container. Keep Zolmitriptan away from heat, moisture and direct light. Avoid freezing Zolmitriptan. Discard medication once it expires. Keep Zolmitriptan out of reach of children.

Zolmitriptan is a member of the class of drugs known as triptans. It is considered and antimigraine and is used for the treatment of migraine headaches. Zolmitriptan is not useful in preventing migraine headaches or limiting the number of headaches you get. Most people find that their migraine headache is alleviated after consuming a single dose of Zolmitriptan or they find enough relief from the dose to continue with their daily activities.

 

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Last Reviewed:
December 22, 2017
Last Updated:
December 22, 2017
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