What is Zolmitriptan
Zolmitriptan (311C90) is an antimigraine agent. Zolmitriptan has actions similar to those of sumatriptan, but unlike sumatriptan, zolmitriptan can penetrate the blood-brain barrier to act centrally within the trigeminovascular system.
In preclinical trials, zolmitriptan had response rates as high as 81% within two hours of dosing.
Zolmitriptan is approved for the treatment of migraine with or without aura, but not for the management of hemiplegic or basilar migraine.
Final FDA approval for the oral tablet was granted November 26, 1997.
Zolmitriptan was also approved in 1997 in the United Kingdom and in Sweden for the treatment of migraine.
Orally disintegrating tablets (Zomig-ZMT) were FDA approved in February 2001.
The FDA approved zolmitriptan (Zomig) nasal spray for adult use in October 2003; in June 2015 its indication was expanded to include pediatric patients >= 12 years.
Brand Name
- Zomig
- Zomig -ZMT
Indications
- menstrual migraine prophylaxis
- migraine
For the acute treatment of migraine with or without aura
NOTE: Zolmitriptan is not indicated for hemiplegic or basilar migraine.
Side Effects
- abdominal pain
- agitation
- akathisia
- amblyopia
- amnesia
- anaphylactic shock
- anaphylactoid reactions
- angina
- angioedema
- anorexia
- anxiety
- apnea
- appetite stimulation
- arthralgia
- asthenia
- ataxia
- atopic dermatitis
- atrial fibrillation
- back pain
- bone pain
- bowel ischemia
- bowel necrosis
- bradycardia
- bronchospasm
- chest pain (unspecified)
- chest pressure syndrome
- chills
- colitis
- confusion
- conjunctivitis
- constipation
- coronary vasospasm
- cough
- cyanosis
- cystitis
- dehydration
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysarthria
- dysgeusia
- dysmenorrhea
- dyspepsia
- dysphagia
- dyspnea
- dystonic reaction
- ecchymosis
- edema
- emotional lability
- eosinophilia
- epistaxis
- eructation
- erythema
- erythema multiforme
- esophagitis
- euphoria
- fever
- flushing
- gastritis
- GI bleeding
- GI obstruction
- gingivitis
- glossitis
- hallucinations
- headache
- hematemesis
- hematuria
- hiccups
- hyperacusis
- hyperesthesia
- hyperglycemia
- hyperhidrosis
- hyperkinesis
- hypersalivation
- hypertension
- hyperthermia
- hyperthyroidism
- hypertonia
- hyperventilation
- hypotonia
- increased urinary frequency
- infection
- influenza
- insomnia
- intracranial bleeding
- irritability
- jaundice
- lacrimation
- laryngeal edema
- laryngitis
- leukopenia
- lymphadenopathy
- malaise
- mania
- melena
- menorrhagia
- muscle cramps
- myalgia
- myasthenia
- myocardial infarction
- nausea
- ocular pain
- orthostatic hypotension
- osteoporosis
- otalgia
- palpitations
- pancreatitis
- paresthesias
- parosmia
- peptic ulcer
- peripheral edema
- peripheral neuropathy
- peripheral vasoconstriction
- pharyngitis
- photophobia
- photosensitivity
- polyuria
- pruritus
- psychosis
- QT prolongation
- rash
- rhinitis
- seizures
- serotonin syndrome
- sialadenitis
- sinus tachycardia
- sinusitis
- splenic rupture
- stomatitis
- stroke
- syncope
- tardive dyskinesia
- tetany
- thrombocytopenia
- tinnitus
- tremor
- urinary urgency
- urticaria
- vaginitis
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- visual impairment
- weight gain
- xerophthalmia
- xerostomia
- yawning
Monitoring Parameters
- ECG
Contraindications
- acute myocardial infarction
- angina
- arteriosclerosis
- basilar/hemiplegic migraine
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cerebrovascular disease
- colitis
- coronary artery disease
- diabetes mellitus
- driving or operating machinery
- geriatric
- GI disease
- hepatic disease
- hypercholesterolemia
- hypertension
- intracranial bleeding
- MAOI therapy
- myocardial infarction
- obesity
- peripheral vascular disease
- phenylketonuria
- pregnancy
- Raynaud’s phenomenon
- renal disease
- renal failure
- renal impairment
- stroke
- tobacco smoking
- vasospastic angina
- Wolff-Parkinson-White syndrome
Interactions
- Acetaminophen
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Alfentanil
- Almotriptan
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Aprepitant, Fosaprepitant
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Bromocriptine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Cimetidine
- Citalopram
- Clomipramine
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Desipramine
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextroamphetamine
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Doxepin
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Droxidopa
- Duloxetine
- Elbasvir; Grazoprevir
- Eletriptan
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Ergot alkaloids
- Escitalopram
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluvoxamine
- Frovatriptan
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Idelalisib
- Imipramine
- Isavuconazonium
- Isocarboxazid
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lopinavir; Ritonavir
- Lorcaserin
- Meperidine
- Meperidine; Promethazine
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methylene Blue
- Milnacipran
- Mirtazapine
- Mitotane
- Morphine
- Morphine; Naltrexone
- Nalbuphine
- Naproxen; Sumatriptan
- Naratriptan
- Nefazodone
- Nortriptyline
- Obeticholic Acid
- Ombitasvir; Paritaprevir; Ritonavir
- Oritavancin
- Oxycodone
- Oxymorphone
- Ozanimod
- Paroxetine
- Peginterferon Alfa-2b
- Perphenazine; Amitriptyline
- Phenelzine
- Propranolol
- Protriptyline
- Rasagiline
- Remifentanil
- Ritonavir
- Rizatriptan
- Segesterone Acetate; Ethinyl Estradiol
- Selective serotonin reuptake inhibitors
- Selegiline
- Sertraline
- Sibutramine
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sumatriptan
- Tapentadol
- Tedizolid
- Telotristat Ethyl
- Tramadol
- Tranylcypromine
- Trazodone
- Tricyclic antidepressants
- Trimipramine
- Venlafaxine
- Vilazodone
- Vortioxetine