zolmitriptan, Zomig, Zomig-ZMT
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: zolmitriptan
BRAND NAME: Zomig, Zomig-ZMT
DRUG CLASS AND MECHANISM: Zolmitriptan is a drug for treating migraine headaches. Migraine headaches are believed to result from dilation of the blood vessels in the brain. Zolmitriptan causes constriction of the blood vessels and thereby relieves the pain of a migraine headache. While zolmitriptan is very effective in relieving migraine headaches, it does not prevent or reduce the number of headaches if taken prophylactically. Its mechanism of action and effectiveness are similar to those of sumatriptan (Imitrex). Zolmitriptan was approved by the FDA in November of 1997.
GENERIC AVAILABLE: No
PREPARATIONS: Tablet: 2.5 and 5 mg. Tablet (orally disintegrating): 2.5 and 5 mg.
STORAGE: Zolmitriptan should be stored at room temperature, away from heat and light. It should be kept out of the reach of children.
DOSING: Dosing: The initial dose is 2.5 mg or less. The dose can be repeated after 2 hours if symptoms persist. The maximum dose is 10 mg per day. Doses less than 2.5 mg can be achieved by splitting the 2.5 mg tablet. Zolmitriptan may be taken with or without food.
DRUG INTERACTIONS: Monoamine oxidase inhibitors, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane)) may exaggerate the effects of zolmitriptan.
Zolmitriptan directly stimulates serotonin receptors on nerves. Serotonin reuptake inhibitors (SSRIs) that are used for treating depression, for example, fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft), enhance the effects of serotonin by preventing its uptake by nerves. Therefore, the combination of zolmitriptan and an SSRI may lead to exaggerated effects of serotonin, and has been reported to cause weakness, increased reflexes, and loss of coordination.
Ergots, like dihydroergotamine (DHE) and ergotamine tartrate (Cafergot) that often are used to treat migraine headaches, can cause blood vessels to go into spasm. It is possible that the combination of ergots and zolmitriptan will result in exaggerated spasm of the vessels. Therefore, it is not recommended that zolmitriptan and ergots be used within 24 hours of each other.
Cimetidine (Tagamet) may double the concentration of zolmitriptan in the blood by interfering with its elimination. Potentially, this may lead to zolmitriptan toxicity.
PREGNANCY: Safe use in pregnancy has not been established.
NURSING MOTHERS: Safe use in nursing mothers has not been established.
SIDE EFFECTS: Side effects are generally transient. Some common side effects include pain or tightness in the chest or throat, tingling sensations, flushing, weakness, dizziness, abdominal discomfort, and sweating. Rarely, allergic reactions (even shock) have been reported though usually in individuals who are highly allergic to many substances.
Reference: FDA Prescribing Information
Last Editorial Review: 12/30/2010
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