How does this medication work? What will it do for me?

Zolmitriptan belongs to a class of medications known as 5-hydroxytryptamine agonists (also called triptans). It is used to treat migraine headaches with or without aura (warning signs that occur prior to the onset of a migraine headache). The pain of migraine headaches is thought to be caused by dilated blood vessels inside the head. Zolmitriptan relieves migraine headaches by constricting these blood vessels.

Zolmitriptan is not recommended for other types of headache or for headache prevention. In most people, zolmitriptan eliminates or reduces the symptoms of migraines including headache, nausea, vomiting, and sensitivity to light and sound.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each orally dispersible, white, round uncoated tablet, intagliated "Z" on one side with a bevelled-edged, contains zolmitriptan 2.5 mg. Nonmedicinal ingredients: aspartame, citric acid, colloidal silicon dioxide, crospovidone, magnesium stearate, mannitol, microcrystalline cellulose, orange flavour, and sodium bicarbonate.

How should I use this medication?

The recommended adult dose is a single dose of 2.5 mg. If the migraine headache returns, the dose may be repeated after 2 hours. You should not take a total dose of more than 10 mg in any 24-hour period. If a dose has not helped your headache at all, do not take a second dose without first consulting a doctor.

Zolmitriptan dispersible tablets should be used as follows:

  • Peel the blister pack open as shown on the foil (do not push the tablets through the foil).
  • Place the tablet on the tongue, where it will dissolve with your saliva. Because this tablet is dispersible, you do not need to take it with water.
  • Do not split the tablet in half.

It is important to take this medication exactly as recommended by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use zolmitriptan if you:

  • are allergic to zolmitriptan or any ingredients of the medication
  • are taking monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine) or have taken them within the past 2 weeks
  • do not have a clear diagnosis of migraine
  • have angina (chest pain), including Prinzmetal's angina (coronary vasospasm)
  • have blood vessel disease (e.g., ischemic bowel disease, Raynaud's syndrome, stroke, transient ischemic attacks [TIAs])
  • have certain types of migraine headaches (including hemiplegic, basilar, or ophthalmoplegic migraine)
  • have had a heart attack
  • have heart disease (e.g., heart valve disease, ischemic heart disease, abnormal heart rhythms, congenital heart disease)
  • have severe or uncontrolled high blood pressure
  • have taken another 5-hydroxytryptamine agonist (i.e., naratriptan, sumatriptan, rizatriptan) in the previous 24 hours
  • have taken ergotamine-containing or ergot-type medications (such as dihydroergotamine, ergotamine, or methysergide) in the previous 24 hours

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • changes in taste sensation
  • dizziness
  • drowsiness
  • dry mouth
  • feeling sick or vomiting
  • heartburn or indigestion
  • nausea
  • sore throat
  • unusual tiredness or muscle weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • fast, pounding, or irregular heartbeat

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • convulsions (seizures)
  • fast or irregular breathing
  • heart attack (symptoms include pain, pressure, tightness, or heaviness in the chest, jaw, neck, or shoulder; sweating; or shortness of breath)
  • sensations of tingling, heat, heaviness or pressure, dizziness, tiredness, or feeling sick
  • severe allergic reaction (symptoms include: swelling of the face or throat; hives; difficulty breathing)
  • stroke; symptoms include:
    • sudden confusion or problems with speech
    • sudden dizziness or loss of coordination
    • sudden numbness or weakness, especially on one side of the body
    • sudden severe headache, especially if it seems different from your usual headaches
    • sudden vision problems in one or both eyes
  • sudden or severe abdominal pain, stomach pain, or bloody diarrhea

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Allergic reactions: Rare, severe allergic reactions to zolmitriptan may occur. Because of the possibility of allergic reaction, you should not use zolmitriptan if you are allergic to any of the other medications of this class (5-hydroxytryptamine agonists).

Blood pressure: Zolmitriptan may cause an increase in blood pressure. If you have severe or uncontrolled high blood pressure you should not take zolmitriptan.

Drowsiness/reduced alertness: You may feel drowsy as a result of taking zolmitriptan. Do not perform tasks requiring alertness (e.g., driving or operating machinery) if you experience drowsiness or dizziness.

Heart disease: This medication may cause narrowing of the blood vessels that supply the heart. This can lead to chest pain, heart attacks, and other heart problems. For this reason, you should not use zolmitriptan if you have heart or blood vessel disease. If you have certain risk factors for heart disease (e.g., high blood pressure, high cholesterol, smoking, obesity, diabetes, family history of coronary artery disease, menopause, men over 40 years of age), tell your doctor.

Liver disease: Liver disease should be closely monitored by a doctor while taking this medication. You may need a lower dosage of zolmitriptan.

Seizures: There have been rare reports of seizures experienced by people taking this medication. If you have a history of epilepsy or other conditions that increase the risk for seizure your doctor should closely monitor you while taking this medication.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if zolmitriptan passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children or adolesents.

Seniors: The use of zolmitriptan by people over the age of 65 years is not recommended.

What other drugs could interact with this medication?

There may be an interaction between zolmitriptan and any of the following:

  • aminophen
  • birth control pills
  • cimetidine
  • ergot-containing medications (e.g., dihydroergotamine, ergotamine, or methysergide) if taken at the same time or within the previous 24 hours
  • MAO inhibitors (e.g., tranylcypromine, phenelzine, moclobemide) if taken at the same time or within 14 days of taking zolmitriptan
  • other 5-hydroxytryptamine agonists (e.g., naratriptan, rizatriptan, sumatriptan) if taken at the same time or within the previous 24 hours
  • propranolol
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin)
  • SSRI or SNRI antidepressants (e.g., paroxetine, fluoxetine, sertraline, fluvoxamine, venlafaxine)
  • sibutramine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.