zolmitriptan
Zolmitriptan (Zomig) is used for the short-term treatment of migraines. You typically take just one dose when you have a migraine. Zolmitriptan (Zomig) can cause side effects like dizziness and chest, neck, or jaw pain. This medication is a tablet that you swallow. It also comes as an orally disintegrating tablet (ODT) and a nasal spray, which can be good options for people who have trouble swallowing pills during a migraine. Zolmitriptan (Zomig) is available by prescription only as a brand-name and generic medication; it's not found over the counter.
What is Zolmitriptan (Zomig)?
What is Zolmitriptan (Zomig) used for?
- Treatment of migraine
How Zolmitriptan (Zomig) works
Zolmitriptan (Zomig) is a triptan. It works by attaching to certain serotonin receptors (proteins) in your brain and nervous system. These proteins react to serotonin, which is a natural chemical in your body that might play a role in migraines.
When zolmitriptan (Zomig) attaches to these receptors, it's thought to help lower blood vessel swelling in the brain. It's also thought to help stop the release of pain signals through your nerves. This helps relieve migraine pain.
Drug facts
Side effects of Zolmitriptan (Zomig)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Tablets and orally disintegrating tablets
- Nausea (up to 9%)
- Dizziness (up to 8%)
- Pins and needles feeling in the arms or legs (up to 7%)
- Neck, throat, or jaw pain, tightness, or pressure (up to 7%)
- Sleepiness (up to 6%)
- Feeling warm or cold (up to 6%)
- Body weakness (up to 5%)
- Dry mouth (up to 5%)
- Chest pain, tightness, pressure, or heaviness (up to 3%)
- Unusual taste (up to 17%)
- Dizziness (6%)
- Pins and needles feeling in your arms or legs (5%)
- Throat pain (4%)
- Feeling warm (4%)
- Dry mouth (3%)
- Body weakness (3%)
Less Common Side Effects
Tablets and orally disintegrating tablets
- Stomach upset
- Feelings of heaviness in other parts of the body
- Sweating
Nasal spray
- Body weakness
- Sleepiness
- Nausea
- Nasal discomfort
- Higher sensitivity to touch, smell, taste, etc.
Zolmitriptan (Zomig) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: chest or arm pain, shortness of breath, cold sweat
- Stroke: sudden weakness on one side of your body, headache, changes in your speech or vision, confusion
- Serotonin syndrome: high fever, racing heart, hallucinations, sudden changes in thought or mood, movement problems
- Allergic reaction: rash; hives; difficulty breathing or swallowing; swollen face, lips, mouth, tongue, or throat
The following Zolmitriptan (Zomig) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Chest pain (severe)
heaviness, tightness, or pressure in the chest or neck
sensation of burning, warmth, heat, numbness, tightness, or tingling
Less common or rare
Abdominal or stomach pain (severe)
changes in facial skin color
cough or hoarseness
fast or irregular heartbeat
fever or chills
loss of appetite
lower back or side pain
painful or difficult urination
puffiness or swelling of the eyelids or around the eyes, face, or lips
tightness in the chest
trouble breathing
weakness
Rare
Blurred vision
confusion
difficulty swallowing
dizziness
fainting
frequent strong or increased urge to urinate
headache
increased volume of pale, dilute urine
nervousness
pounding in the ears
severe numbness, especially on one side of the face or body
slow heartbeat
unusual tiredness or weakness
Incidence not known
Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Dizziness or lightheadedness
feeling of constant movement of self or surroundings
sensation of spinning
Rare
crying
depersonalization
dysphoria
euphoria
hyperventilation
irritability
loss of memory
paranoia
problems with memory
quick to react or overreact emotionally
rapidly changing moods
redness of the skin
seeing, hearing, or feeling things that are not there
shaking
trouble sleeping
welts
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Zolmitriptan (Zomig)
Pros
- One of the first-choice options for adults to treat moderate or severe migraine
- Works within 2 hours after taking the dose
- Has ODT and nasal spray forms, so it's a good option for people who have trouble swallowing pills during a migraine
Cons
- Not used for other types of headaches
- Doesn't prevent migraines from happening
- Can worsen your headaches if you take the medication for more than 9 days in a month
Pharmacist tips for Zolmitriptan (Zomig)
- Take zolmitriptan (Zomig) at the first sign of a migraine. Zolmitriptan (Zomig) doesn't prevent migraine attacks from happening.
- If your migraine doesn't go away or comes back, you can consider taking a second dose of zolmitriptan (Zomig) if it’s been at least 2 hours since your first dose. Taking another dose sooner than 2 hours from your previous dose might cause more side effects. Don't take more than 10 mg in a 24-hour period.
- Write down when you have headaches and how often you take zolmitriptan (Zomig). This helps you keep track of how often you need to use zolmitriptan (Zomig) so you can avoid rebound headaches from happening. Taking migraine medications for more than 9 days out of a month can lead to rebound (medication-overuse) headaches.
- You might feel tightness, pain, or pressure in your chest, throat, neck, or jaw when you take zolmitriptan (Zomig). These effects can be similar to those related to heart problems. Talk to your healthcare provider if you experience these side effects and are concerned about them.
- Zolmitriptan (Zomig) can make you feel sleepy or dizzy. Don't drive or do anything that requires concentration until you know how the medication affects you.
- If you finish your entire month's supply of zolmitriptan (Zomig) before it's time for your next refill or if you have more than three or four migraines in a month, talk to your healthcare provider. We don't know if zolmitriptan (Zomig) works well or if it's safe to use if you have more than three or four migraines in a month. Your provider might have other recommendations to help with your migraines.
For the zolmitriptan orally disintegrating tablets (Zomig ZMT)
- When you're ready to take zolmitriptan (Zomig ZMT), remove the orally disintegrating tablet from the blister pack by peeling open the packaging. Don't push the tablet through the foil so you don't break the tablet.
- Place the zolmitriptan (Zomig ZMT) tablet on your tongue, let it dissolve, and then swallow once it has completely dissolved. You don't need to take the tablet with water since it'll dissolve on your tongue.
For the zolmitriptan nasal spray (Zomig)
- Each nasal spray bottle only contains one dose of zolmitriptan (Zomig). Don't prime the bottle or press down on the plunger before you're ready to take the dose. Otherwise, you'll lose the dose from the spray bottle.
- It's important to read the instructions for use before you use the zolmitriptan nasal spray (Zomig) to make sure you use it properly. After blowing your nose to clear it, close one nostril with your finger, and gently breathe out through your mouth. Place the sprayer tip into the other nostril as far as you comfortably can. Tilt your head back a little. Then, as you press down on the plunger to administer the dose, breathe in gently through your nose. Remove the sprayer tip from your nostril, and breathe in gently through your mouth for 5 to 10 seconds.
- It's normal to feel liquid in your nose or the back of your throat after spraying the medication into your nose. You might also have an unusual taste in your mouth after you use the nasal spray.
More on Zolmitriptan (Zomig) tips
Common questions about Zolmitriptan (Zomig)
Zolmitriptan (Zomig) typically works within 2 hours to relieve your migraine pain. In studies, the medication worked to lower pain to mild or no pain within this time frame.
You can take zolmitriptan (Zomig) as needed for migraine. The American Headache Society recommends that you use zolmitriptan (Zomig) for no more than 2 days per week on average. This helps lower your risk of rebound headaches (also known as medication-overuse medications). Rebound headaches can happen if you take zolmitriptan (Zomig) for 10 or more days per month. If you need to use zolmitriptan (Zomig) more often than this, talk to your provider about other options to relieve your migraines.
Possibly. There aren't any known interactions between zolmitriptan (Zomig) and ibuprofen (Advil, Motrin). Zolmitriptan (Zomig) is a triptan, whereas ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). These two medications work differently to help relieve migraine pain and are both considered first-choice options. Some studies suggest that taking triptans like zolmitriptan (Zomig) with an NSAID like ibuprofen can help with migraine pain better than taking the two types of medications alone. But, other studies suggest that this combination might not be as helpful for people who have migraines with nausea. If you're considering taking ibuprofen (Advil) together with zolmitriptan (Zomig), speak to your provider first to make sure it's right for you.
You can only cut the 2.5 mg tablet of zolmitriptan (Zomig) in half. The 2.5 mg tablet has a score line (indented line) in the middle. This line marks where the tablet can be cut or broken in half to give an accurate, lower dose of 1.25 mg. Make sure to use a pill splitter to cut the 2.5 mg tablet in half safely and accurately, if needed. The 5 mg tablet of zolmitriptan (Zomig) and all orally disintegrating tablets (Zomig ZMT) shouldn't be cut or broken in half. These tablets aren't scored in the middle. Cutting or breaking these unscored tablets can cause you to take an incorrect dose that's higher or lower than prescribed. This can affect how well the medication works for you or your risk for side effects from the medication. Ask your pharmacist if you're not sure whether you can cut your zolmitriptan (Zomig) tablets in half and how to do so safely.
It depends on how severe your liver problem is and what form of zolmitriptan (Zomig) you're using. Your liver helps break down the medication in your body. If your liver isn't working well, the medication can stay in your body longer. This can raise your risk of side effects, like high blood pressure. If you have mild liver problems, it's generally okay to take any form of zolmitriptan (Zomig) at the usual dose. If you have moderate or severe liver problems, you'll need to take a lower dose if you're taking the zolmitriptan (Zomig) tablets. But it's not recommended that you use the orally disintegrating tablet or nasal spray. This is because it's either not possible or safe to make the 2.5 strength of these forms any smaller. If you have liver problems, ask your provider whether you can take zolmitriptan (Zomig), what dose to take, and whether there are alternatives for you.
Zomig and Zomig ZMT tablets both contain the same active ingredient (zolmitriptan). But, the tablets are taken differently. The zolmitriptan tablets (Zomig) are swallowed whole with water. The orally disintegrating tablets (Zomig ZMT) are placed on your tongue and dissolves there. You don't need to drink any liquid with the orally disintegrating tablets; once it dissolves on the tongue, you can swallow the medication along with your saliva.
Sumatriptan (Imitrex) and zolmitriptan (Zomig) are both triptan medications that treat migraines and can work within 2 hours. The main difference between the two medications are the different forms they each come in. Sumatriptan is available as an oral tablet, nasal spray or powder, and under-the-skin injection. On the other hand, zolmitriptan is available as an oral tablet, orally disintegrating tablet, and nasal spray. While the forms might be different, both medications have options for people who have trouble swallowing pills during a migraine. Compare the two medications, and discuss with your provider about which one best fits your needs.
Zolmitriptan (Zomig) can interact with several medications. Some of these interactions can raise your risk of side effects. For example, taking certain antidepressants, nausea medications, and opioid pain medications with zolmitriptan (Zomig) can raise the serotonin levels in your body. This can raise your risk of a rare, but serious condition called serotonin syndrome. Symptoms of serotonin syndrome include sweating, fast heart rate, high fever, and confusion. If you take these medications with zolmitriptan (Zomig) and experience these symptoms, let your provider know. Tell your providers about all the medications and supplements you take or plan to take. They can check for interactions and make sure your medications are safe for you to take.
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Risks and warnings for Zolmitriptan (Zomig)
Zolmitriptan (Zomig) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack and chest pain (angina)
- Risk factors: Personal or strong family history of heart disease | Diabetes (high blood sugar) | High blood pressure | Older age | Smoking | Obesity
Very rarely, some people have had heart attacks within a few hours after taking zolmitriptan (Zomig). Heart attacks and chest pain (angina) during zolmitriptan (Zomig) treatment can happen even in people who don't have heart disease. If you’re at high risk for heart disease and have never taken a triptan before, your provider will make sure your heart is healthy before you start zolmitriptan (Zomig). Depending on your medical history, you might be asked to take your first dose at a provider's office so they can check to make sure your heart is okay. Your provider might also follow up with you periodically while you're using zolmitriptan (Zomig) to check your heart. If you experience chest pain, shortness of breath, lightheadedness, arm pain, or a cold sweat, get medical help right away. These can be symptoms of a heart attack.
Irregular heart rhythm (arrhythmias)
- Risk factors: History of arrhythmias
Some people taking triptans like zolmitriptan (Zomig) have had life-threatening changes to their heart rhythm. In reported cases, this happened within a few hours after taking the medication. Don't use zolmitriptan (Zomig) if you have conditions that cause an irregular heart rhythm. If you feel your heart racing after you take zolmitriptan (Zomig), stop taking the medication and let your healthcare provider know right away.
Stroke or other brain injury
- Risk factors: History of strokes
Some people who've taken triptans like zolmitriptan (Zomig) have experienced life-threatening strokes or bleeding in the brain. Symptoms of a stroke include sudden weakness on one side of the body, bad headaches, drooping face, trouble breathing, or changes in your speech or vision. These symptoms can be similar to migraine symptoms, so strokes can be mistaken for a migraine. It's important that you're properly diagnosed with migraines before you start zolmitriptan (Zomig). It might help lower the risk of making this mistake. If you notice symptoms of a stroke, stop taking zolmitriptan (Zomig) and get medical help as soon as possible, especially if you haven't had a migraine before.
Blood vessel issues
Zolmitriptan (Zomig) can cause the blood vessels in your body to spasm. This might prevent certain parts of your body from getting enough blood. For example, when the digestive system doesn't get enough blood, you might have stomach issues, like stomach pain or bloody diarrhea. Another blood circulation problem that might happen is Raynaud's syndrome. A common symptom of this condition is a tingling feeling or change in color in your fingers and toes caused by cold temperatures or emotional stress. Very rarely, blood vessel spasms might cause partial or complete vision loss. If you experience any of these symptoms, don't take another dose of zolmitriptan (Zomig) before speaking with your provider.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels
Triptans like zolmitriptan (Zomig) can raise the serotonin levels in your body. Although rare, this can cause serotonin syndrome, which is a potentially life-threatening condition that's caused by high serotonin levels in the body. The risk is higher if you’re also taking other medications that raise serotonin levels, such as certain antidepressants. Symptoms of serotonin syndrome can include a racing heart, high fever, sudden changes in thought or mood, movement problems, and hallucinations. These symptoms can appear within minutes to hours of starting a new or higher dose of a triptan or other serotonin-raising medication. Stop taking zolmitriptan (Zomig) if you notice these symptoms and talk to your provider.
High blood pressure
Zolmitriptan (Zomig) can raise your blood pressure. Check your blood pressure regularly while you're taking the medication. Though rare, some cases of high blood pressure have led to serious problems. Typically, you won't feel any symptoms if your blood pressure is high. But if it's dangerously high, you might have headache, trouble breathing, chest pain, changes in vision, and confusion. If you experience any of these symptoms, get medical help right away. Don’t take zolmitriptan (Zomig) if you have uncontrolled high blood pressure.
Caution use in people with phenylketonuria (PKU) - for orally disintegrating tablet only
The orally disintegrating tablets (ODTs) of zolmitriptan (Zomig ZMT) contain phenylalanine, a component of the artificial sweetener aspartame. If you have a genetic condition called phenylketonuria (PKU), taking the ODT form of zolmitriptan can be dangerous for you. Make sure to tell your provider and pharmacist about your full medical history before taking zolmitriptan (Zomig). Ask your pharmacist if you're not sure whether the form of zolmitriptan (Zomig) that you're prescribed is safe for you. There are other forms of the medication that might be safer for you.
Zolmitriptan (Zomig) dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 6 doses of 2.5mg | 1 carton | $241.45 | $241.45 |
| 6 doses of 5mg | 1 carton | $161.04 | $161.04 |
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3 tablets of 5mg | 3 dose packs | $26.89 | $8.96 |
| 6 tablets of 2.5mg | 1 dose pack | $16.11 | $16.11 |
| 3 orally disintegrating tablets of 5mg | 3 dose packs | $38.59 | $12.86 |
| 6 orally disintegrating tablets of 2.5mg | 1 dose pack | $24.01 | $24.01 |
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg | 10 tablets | $353.32 | $35.33 |
Interactions between Zolmitriptan (Zomig) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Almotriptan
- Bromocriptine
- Cisapride
- Dihydroergotamine
- Eletriptan
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Frovatriptan
- Isocarboxazid
- Levomethadyl
- Linezolid
- Mesoridazine
- Methylene Blue
- Methylergonovine
- Methysergide
- Naratriptan
- Phenelzine
- Procarbazine
- Rizatriptan
- Sumatriptan
- Terfenadine
- Thioridazine
- Tranylcypromine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acecainide
- Ajmaline
- Alfentanil
- Amiodarone
- Amitriptyline
- Amoxapine
- Amphetamine
- Aprindine
- Azimilide
- Benzhydrocodone
- Benzphetamine
- Bretylium
- Chloroquine
- Citalopram
- Codeine
- Desipramine
- Desvenlafaxine
- Dextroamphetamine
- Dibenzepin
- Dihydrocodeine
- Disopyramide
- Dofetilide
- Dolasetron
- Doxepin
- Dronedarone
- Droperidol
- Duloxetine
- Erythromycin
- Escitalopram
- Fenfluramine
- Fentanyl
- Flecainide
- Fluconazole
- Fluoxetine
- Fluvoxamine
- Foscarnet
- Gemifloxacin
- Granisetron
- Halofantrine
- Hydrocodone
- Hydromorphone
- Hydroquinidine
- Ibutilide
- Imipramine
- Isradipine
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Lidoflazine
- Lisdexamfetamine
- Lithium
- Lorcainide
- Lorcaserin
- Mefloquine
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Milnacipran
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nefazodone
- Nortriptyline
- Octreotide
- Ondansetron
- Oxycodone
- Oxymorphone
- Palonosetron
- Paroxetine
- Pentamidine
- Pirmenol
- Pixantrone
- Prajmaline
- Probucol
- Procainamide
- Prochlorperazine
- Propafenone
- Protriptyline
- Quinidine
- Reboxetine
- Remifentanil
- Sematilide
- Sertraline
- Sibutramine
- Sotalol
- Spiramycin
- St John's Wort
- Sufentanil
- Tapentadol
- Tedisamil
- Tramadol
- Trazodone
- Trifluoperazine
- Trimipramine
- Venlafaxine
- Vilazodone
- Vortioxetine
- Ziprasidone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Zolmitriptan (Zomig) cost?
Zolmitriptan (Zomig) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Zolmitriptan (Zomig) will not be safe for you to take.
- History of heart disease (including chest pain or heart attack)
- Conditions that cause spasms in the heart blood vessels
- Conditions that cause an irregular heart rhythm (arrhythmias)
- History of stroke or "mini-stroke"
- History of migraines with double vision, dizziness, and movement problems or migraines with weakness on one side of the body
- Conditions affecting the blood vessels or blood supply to your body (like peripheral artery disease or ischemic bowel disease)
- Uncontrolled high blood pressure
- Have taken another triptan, ergotamine-containing medication, or ergot-type medication within the past 24 hours
- Take monoamine oxidase (MAO)-A inhibitors (e.g., phenelzine (Nardil), tranylcypromine (Parnate)) currently or within the past 2 weeks
What are alternatives to Zolmitriptan (Zomig)?
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