Zolmitriptan (311C90)

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

  1. abdominal pain
  2. agitation
  3. akathisia
  4. amblyopia
  5. amnesia
  6. anaphylactic shock
  7. anaphylactoid reactions
  8. angina
  9. angioedema
  10. anorexia
  11. anxiety
  12. apnea
  13. appetite stimulation
  14. arthralgia
  15. asthenia
  16. ataxia
  17. atopic dermatitis
  18. atrial fibrillation
  19. back pain
  20. bone pain
  21. bowel ischemia
  22. bowel necrosis
  23. bradycardia
  24. bronchospasm
  25. chest pain (unspecified)
  26. chest pressure syndrome
  27. chills
  28. colitis
  29. confusion
  30. conjunctivitis
  31. constipation
  32. coronary vasospasm
  33. cough
  34. cyanosis
  35. cystitis
  36. dehydration
  37. depression
  38. diarrhea
  39. diplopia
  40. dizziness
  41. drowsiness
  42. dysarthria
  43. dysgeusia
  44. dysmenorrhea
  45. dyspepsia
  46. dysphagia
  47. dyspnea
  48. dystonic reaction
  49. ecchymosis
  50. edema
  51. emotional lability
  52. eosinophilia
  53. epistaxis
  54. eructation
  55. erythema
  56. erythema multiforme
  57. esophagitis
  58. euphoria
  59. fever
  60. flushing
  61. gastritis
  62. GI bleeding
  63. GI obstruction
  64. gingivitis
  65. glossitis
  66. hallucinations
  67. headache
  68. hematemesis
  69. hematuria
  70. hiccups
  71. hyperacusis
  72. hyperesthesia
  73. hyperglycemia
  74. hyperhidrosis
  75. hyperkinesis
  76. hypersalivation
  77. hypertension
  78. hyperthermia
  79. hyperthyroidism
  80. hypertonia
  81. hyperventilation
  82. hypotonia
  83. increased urinary frequency
  84. infection
  85. influenza
  86. insomnia
  87. intracranial bleeding
  88. irritability
  89. jaundice
  90. lacrimation
  91. laryngeal edema
  92. laryngitis
  93. leukopenia
  94. lymphadenopathy
  95. malaise
  96. mania
  97. melena
  98. menorrhagia
  99. muscle cramps
  100. myalgia
  101. myasthenia
  102. myocardial infarction
  103. nausea
  104. ocular pain
  105. orthostatic hypotension
  106. osteoporosis
  107. otalgia
  108. palpitations
  109. pancreatitis
  110. paresthesias
  111. parosmia
  112. peptic ulcer
  113. peripheral edema
  114. peripheral neuropathy
  115. peripheral vasoconstriction
  116. pharyngitis
  117. photophobia
  118. photosensitivity
  119. polyuria
  120. pruritus
  121. psychosis
  122. QT prolongation
  123. rash
  124. rhinitis
  125. seizures
  126. serotonin syndrome
  127. sialadenitis
  128. sinus tachycardia
  129. sinusitis
  130. splenic rupture
  131. stomatitis
  132. stroke
  133. syncope
  134. tardive dyskinesia
  135. tetany
  136. thrombocytopenia
  137. tinnitus
  138. tremor
  139. urinary urgency
  140. urticaria
  141. vaginitis
  142. ventricular fibrillation
  143. ventricular tachycardia
  144. vertigo
  145. visual impairment
  146. weight gain
  147. xerophthalmia
  148. xerostomia
  149. 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
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