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a selective serotonin receptor agonist used to relieve acute migraine, administered orally.


Zomig Rapimelt (CA) (UK), Zomig-ZMT

Pharmacologic class: Selective 5-hydroxytryptamine receptor agonist

Therapeutic class: Antimigraine agent

Pregnancy risk category C


Blocks serotonin release, constricting inflamed and dilated cerebral and cranial blood vessels and reducing nerve transmission in trigeminal pain pathways


Nasal spray: 5-mg single-use spray device

Tablets (immediate-release): 2.5 mg, 5 mg

Tablets (orally disintegrating): 2.5 mg

Indications and dosages

Acute migraine

Adults: 1.25 to 2.5 mg (immediate-release) P.O., repeated if migraine returns in 2 hours or less; maximum dosage is 10 mg in any 24-hour period. Or 2.5 mg (orally disintegrating tablet) P.O., repeated if migraine returns in 2 hours or less; maximum dosage is 10 mg in any 24-hour period. Alternatively, one dose of nasal spray (5 mg); if migraine returns, may repeat dose after 2 hours; don't exceed maximum daily dosage of 10 mg in any 24-hour period.

Dosage adjustment

• Hepatic impairment


• Hypersensitivity to drug

• Hemiplegic or basilar migraine

• Ischemic cardiac disease or other significant cardiac disease

• Uncontrolled hypertension

• Cerebrovascular accident or transient ischemic attack

• Peripheral vascular disease, including ischemic bowel disease

• Use of ergot-type or ergot-containing drugs or other 5-HT1 agonists within past 24 hours

• MAO inhibitor use within past 14 days


Use cautiously in:

• hepatic or renal impairment

• risk factors for coronary artery disease (such as strong family history of this disease, diabetes mellitus, obesity, cigarette smoking, high cholesterol level, men older than age 40, postmenopausal women)

• elderly patients

• pregnant or breastfeeding patients

• children.


• Place orally disintegrating tablet on patient's tongue, where it should dissolve.

• Don't break orally disintegrating tablet in half.

• Know that each nasal spray unit is intended for one use only.

Adverse reactions

CNS: paresthesia, asthenia, dizziness, insomnia, hyperesthesia, drowsiness, syncope, vertigo, agitation, depression, anxiety, emotional lability, fatigue, malaise

CV: chest pain, heaviness, or tightness; hypertension; palpitations; angina; arrhythmias

EENT: dry eyes, ear pain, tinnitus, epistaxis, altered sense of smell, laryngitis

GI: nausea, vomiting, dyspepsia, dysphagia, gastroenteritis, esophagitis, dry mouth

GU: urinary frequency, hematuria, polyuria, cystitis

Hepatic: hepatic dysfunction

Metabolic: hyperglycemia

Musculoskeletal: leg cramps, neck pain, tenosynovitis, myasthenia, myalgia, back pain

Respiratory: bronchitis, hiccups

Skin: pruritus, rash, diaphoresis, bruising, urticaria, photosensitivity

Other: unusual taste, flushing, sweating or redness in face (with nasal spray); fever; chills; excessive thirst; facial or tongue edema; pressure or tightness in throat or jaw; yawning; warm or cold sensation


Drug-drug. Cimetidine: doubling of zolmitriptan's half-life

Ergot-containing drugs: vasospasm

Fluoxetine, fluvoxamine, paroxetine, sertraline: weakness, incoordination, hyperreflexia

MAO inhibitors: increased zolmitriptan effects

Drug-diagnostic tests. Blood glucose: increased level

Drug-herbs. S-adenosylmethionine (SAM-e), St. John's wort: serotonin syndrome

Drug-behaviors. Smoking: increased risk of adverse cardiovascular effects

Patient monitoring

• Assess therapeutic response to help gauge drug efficacy.

• Watch for adverse cardiovascular and respiratory reactions, particularly dyspnea and chest pain or tightness.

• Assess blood glucose level in diabetic patient.

Patient teaching

Tell patient to immediately report shortness of breath or pain or tightness in chest or throat.

• Explain that drug is intended to treat migraine, not prevent it.

• Tell patient to remove orally disintegrating tablet from blister pack just before taking it, and then place it on his tongue and let it dissolve. Instruct him not to break it.

• Teach patient proper use of nasal spray. Tell him each unit is intended for one use only.

• Caution patient to avoid driving and other hazardous activities during severe migraine or if drug causes adverse CNS effects.

• Inform patient that smoking may increase drug's cardiovascular risks.

• Advise female of childbearing age not to take drug if she is, might be, or plans to become pregnant.

• Advise patient to avoid sun exposure and to wear sunscreen and protective clothing when going outdoors.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.


A drug that acts as a serotonin receptor agonist and is used to treat migraine headaches.


Zomig Neurology A selective 5-HT1B/1D agonist for acute migraine with/without aura, effective in ±23 of Pts within 1 hr of therapy Adverse effects Paresthesia, anesthesia, head & neck pain/tightness/pressure, dizziness Contraindications ASHD, CAD, HTN, MI


A drug that stimulates SEROTONIN receptors and is used to treat MIGRAINE. A brand name is Zomig.
References in periodicals archive ?
Triptan Options Drug Dosing Route Usual Dose Cost/Dose [*] Sumatriptan Subcutaneous 6 mg $45.03 Sumatriptan Nasal 20 mg $19.01 Naratriptan Oral Tablet 2.5 mg $15.51 Rizatriptan Oral Dissolving 10 mg $13.50 MLT Tablet Sumatriptan Oral Tablet 50 mg $14.83 Zolmitriptan Oral Tablet 5 mg $15.49 (*.)Cost/dose is based on the average wholesale price in the 1999 Red Book.
In the multicenter study 308 patients were randomized to a single 10-mg dose of rizatriptan, 304 received a single 2.5-mg dose of zolmitriptan, and 154 patients received placebo.
Chronic cluster headache subjects showed no statistically significant treatment response to zolmitriptan. Compared with placebo, a greater proportion of episodic cluster headache sufferers experienced a 2-point reduction in headache intensity after taking 10 mg of zolmitriptan (47% vs 29%).
Zosano's lead product candidate is QtryptaTM(M207), which is an investigational, proprietary formulation of zolmitriptan delivered via ADAM technology, currently in development for the acute treatment of migraine.
> Fenoprofen (Nalfon), ketoprofen (Actron, Orudis), Indomethacin (Indocin), Keterolac (Toradol), sumatriptan (Imitrex), zolmitriptan (Zornig), for tension headaches
Kaur, "Formulation and evaluation of chitosan-chondroitin sulphate based nasal inserts for zolmitriptan," BioMed Research International, vol.
In the current study, we evaluated Strat-M (synthetic membrane), full thickness, and dermatomed ex vivo skin on percutaneous delivery of zolmitriptan from a novel drug-coated microprojections that target the epidermal/dermal layer for rapid and efficient delivery.
As part of the exclusive agreement, Sawai Pharmaceutical Co Ltd will manufacture and market AstraZeneca's migraine medication Zomig (zolmitriptan) Tablets 2.5 mg and Zomig (zolmitriptan) Rapid Melt (RM) Tablets 2.5 mg in Japan.
Efficacy of zolmitriptan nasal spray in adolescents