Nomi

Indications

Zolmitriptan is used for the acute treatment of migraine attacks, with or without aura, in adults. It may also be used for cluster headache (nasal spray, as prescribed). It relieves the headache and other migraine symptoms but does not prevent attacks.

How It Works

Zolmitriptan is a triptan. It acts on serotonin receptors (5-HT1B and 5-HT1D) in the blood vessels and nerves of the head. It narrows the swollen blood vessels around the brain and reduces the release of substances that cause pain and inflammation during a migraine.

Dosage and Administration

Tablets or orally dissolving tablets (adults): usually 2.5 mg taken as soon as possible after the migraine starts. If the migraine returns, a second dose may be taken at least 2 hours after the first. Do not take more than 10 mg in 24 hours. Nasal spray: usually 5 mg into one nostril, with a repeat after at least 2 hours if needed, as prescribed. If the first dose gives no relief, do not take a second dose for the same attack. Not recommended for children or adults over 65 unless prescribed.

Interactions

Do not take within 24 hours of other triptans or ergot medicines (such as Ergotamine). Do not take with, or within 2 weeks of stopping, MAO inhibitors (such as Moclobemide or Selegiline). Cimetidine and some antibiotics such as Ciprofloxacin may raise its level, so a lower maximum dose may be needed. Taking it with SSRIs or SNRIs (such as Fluoxetine or Venlafaxine) can rarely cause serotonin syndrome.

Contraindications

Do not use if you have heart disease (such as angina or past heart attack), past stroke or mini-stroke, peripheral vascular disease, uncontrolled high blood pressure, certain heart rhythm problems (such as Wolff-Parkinson-White syndrome), hemiplegic or basilar migraine, or allergy to Zolmitriptan.

Side Effects

Common effects include tingling, warmth or heaviness, tightness or pressure in the throat, chest or jaw, dizziness, drowsiness, dry mouth, nausea and weakness. The nasal spray may cause an unusual taste.

Get urgent medical help if you have chest pain or pressure that does not settle, shortness of breath, an irregular heartbeat, sudden severe headache, weakness on one side of the body, trouble speaking, severe stomach pain or bloody diarrhoea, agitation with fever and muscle twitching, or swelling of the face or throat.

Pregnancy and Lactation

Information on use in pregnancy is limited; use only if your doctor says the benefit outweighs the risk. It is not known if it passes into breast milk; avoiding breastfeeding for 24 hours after a dose is often advised.

Precautions and Warnings

People with risk factors for heart disease (smoking, diabetes, high cholesterol, obesity, strong family history) should have a heart check before starting. Using migraine medicines on 10 or more days a month can cause medication overuse headache. It may cause drowsiness; do not drive if affected. Make sure the headache really is migraine; get medical advice for any new or different headache.

Overdose

An overdose may cause sleepiness, raised blood pressure and heart-related effects. Seek medical help; the person should be monitored for at least 15 hours.

Therapeutic Class

Antimigraine agent, serotonin 5-HT1B/1D receptor agonist (triptan).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep orally dissolving tablets in the blister until use.