Zolmitriptan
Antimigraine Preparations · 5HT1-agonist
Indications
Acute treatment of migraine with or without aura.
Dosage
Adults: Initially 2.5 mg as soon as possible after the onset of attack. If symptoms persist or return, a repeat dose may be given at an interval of at least 2 hr. If the response is inadequate, increase to 5 mg doses for subsequent attacks. Recurrent attacks, max 10 mg in 24 hr. Children: Not recommended.
Adverse Effects
Nausea, dizziness, warm sensation, asthenia, dry mouth, somnolence, heaviness or pressure in throat, neck, limbs and chest, myalgia, muscle weakness, paraesthesia, headache, transient increased BP, palpitations, GI upset, dysphagia. Rarely, cerebrovascular events, coronary vasospasm, angina pectrois, MI, tachycardia, hypersensitivity.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Uncontrolled hypertension, ischaemic heart disease, coronary vasospasm, Prinzmetal's angina. Wolff-Parkinson-White syndrome, arrhythmias associated with other accessory pathways. Renal impairment. History of stroke or TIA. Hemiplegic, basilar or ophthalmoplegic migraine. Precautions: Patients with risk factors of ischaemic heart disease. Hepatic impairment. Elderly.
Interactions
Ergotamine, allow interval of at least 6 hours if taking together. Other serotonin agonists, moclobemide, other MAO-A inhibitors, fluvoxamine, quinolones, cimetidine, other 5HT1 agonist/triptans, SSRIs, SNRIs, St John's wort.
Advice to Patient
Take with or without meals. Do not crush, break or chew disintegrating tablet. Open blister pack of disintegrating tablets just before use with dry hands, place on tongue and let it dissolve. Regular tablet may be broken in half if needed. Do not remove cap of nasal spray until it is ready to use. Do not take this medication within 24 hours of taking another migraine medication without consulting prescriber. Second dose may be taken after 2 hours if headache returns but there was improvement in condition. If there is no improvement with first dose, do not take second dose without consulting prescriber. Do not take more than 10 mg in one day. Consult prescriber before treating more than three headaches in 30 days. Contact prescriber immediately if you experience pain/warmth/numbness in extremities, easy bruising or bleeding, blood in urine/stool/vomitus, chest pain, palpitations, throat…
Pharmacokinetics
Absorption: Well absorbed. Metabolism: Converted to an active N-desmethyl metabolite. Bioavailability: 40% (not impacted by food); mean bioavailability of nasal spray compared with oral tab: 102%. Half-life elimination: 3 hrs. Time to peak, serum: Tab: 1.5 hrs; Orally-disintegrating tab and nasal spray: 3 hrs. Excretion: Urine (approx. 60%-65% total dose; 8% of total dose as unchanged drug; 4% of total dose as N-desmethyl metabolite). Faeces (30%).
Unlicensed Use
Children: Treatment of acute migraine: ORAL: 12-18 yr, 2.5 mg, repeated after not less than 2 hr if migraine recurs. If response unsatisfactory after 3 attacks consider increasing dose to 5 mg or switching to alternative treatment, max 10 mg in 24 hr.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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