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