Zomig

Generic name: zolmitriptan (oral) [ ZOLE-mi-TRIP-tan ]
Brand names: Zomig, Zomig-ZMT
Drug class: Antimigraine agents

Medically reviewed by Drugs.com. Last updated on Oct 24, 2022.

What is Zomig?

Zomig is a headache medicine that narrows blood vessels around the brain. Zolmitriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Zomig is used to treat migraine headaches in adults.

Zomig will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Zomig should not be used to treat a common tension headache, a headache that causes loss of movement on one side of your body, or any headache that seems to be different from your usual migraine headaches. Use this medication only if your condition has been confirmed by a doctor as migraine headaches.

Warnings

You should not use Zomig if you have uncontrolled high blood pressure, heart problems, certain heart rhythm disorders, a history of heart attack or stroke, or circulation problems that cause a lack of blood supply within the body.

Do not use Zomig if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Do not take Zomig within 24 hours before or after using another migraine headache medicine, including zolmitriptan nasal spray, almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), sumatriptan (Imitrex, Treximet), or ergot medicine such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or methylergonovine (Methergine).

Also tell your doctor if you are also taking an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Zomig will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

After taking a Zomig tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 10 mg of zolmitriptan in 24 hours.

Before taking this medicine

You should not use Zomig if you are allergic to zolmitriptan, or if you have:

• coronary heart disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;

• a history of heart disease, heart attack, or stroke, including "mini-stroke";

• Wolff-Parkinson-White syndrome;

• severe or uncontrolled high blood pressure;

• a blood vessel disorder or circulation problems that cause a lack of blood supply within the body; or

• a headache that seems different from your usual migraines.

Do not use Zomig if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure Zomig is safe for you, tell your doctor if you have:

• heart disease, high blood pressure, or a heart rhythm disorder;

• epilepsy or seizures;

• liver or kidney disease;

• a condition for which you take cimetidine (Tagamet); or

• coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

Zomig disintegrating tablets may contain phenylalanine. Talk to your doctor before using this form of zolmitriptan if you have phenylketonuria (PKU).

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether zolmitriptan passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Zomig is not approved for use by anyone younger than 18 years old.

How should I take Zomig?

Take Zomig exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Use Zomig as soon as you notice migraine symptoms.

Take the regular tablet whole with a full glass of water.

To take the orally disintegrating tablet (Zomig-ZMT):

• Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet.

• Use dry hands to remove the tablet and place it in your mouth.

• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet 2 hours after the first. Do not take more than 10 mg of zolmitriptan in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

Call your doctor if your headache does not go away at all after taking the first Zomig tablet.

Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse.

Contact your doctor if you have more than four headaches in one month (30 days). Tell your doctor if this medicine seems to stop working as well in treating your migraine attacks.

Zomig can raise blood pressure to dangerous levels. Your blood pressure may need to be checked often while you are using this medicine. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).

Store at room temperature away from moisture, heat, and light.

Dosing information

Usual Adult Dose for Migraine:

Oral:
-Initial dose: 1.25 or 2.5 mg orally once (may break the scored 2.5 mg tablet in half to obtain 1.25 mg dose); may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Orally Disintegrating Tablets:
-Initial dose: 2.5 mg orally once; may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Nasal Spray:
-Initial dose: 2.5 mg intranasally once; may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Comments:
-This drug should only be used after a clear diagnosis of migraine has been established; if a patient has no response for the first migraine attack, reconsider the diagnosis of migraine before treating any subsequent attacks.
-Do not break the oral disintegrating tablet, they are not scored.
-In trials, the majority of patients had headache response following a 2.5 mg or 5 mg dose compared with a 1 mg dose; little added benefit was observed with the 5 mg dose compared to the 2.5 mg dose, but adverse events were more frequent.
-The safety of treating an average of more than 4 headaches in a 30-day period has not been established.

Use: For the acute treatment of migraine with or without aura.

Usual Pediatric Dose for Migraine:

Age 12 years and older:

Nasal Spray:
-Initial dose: 2.5 mg intranasally once; may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Comments:
-This drug should only be used after a clear diagnosis of migraine has been established; if a patient has no response to this drug for the first migraine attack, reconsider the diagnosis of migraine before treating any subsequent attacks.
-The safety of treating an average of more than 4 headaches in a 30-day period has not been established.

Use: For the acute treatment of migraine with or without aura.

What happens if I miss a dose?

Since Zomig is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using Zomig .

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Do not take Zomig within 24 hours before or after using another migraine headache medicine, including:

• zolmitriptan nasal spray, almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, or sumatriptan; or

• ergot medicine - dihydroergotamine, ergotamine, ergonovine, methylergonovine.

Zomig may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Zomig side effects

Get emergency medical help if you have signs of an allergic reaction to Zomig: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Zomig and call your doctor at once if you have:

• feeling of tightness in your jaw, neck, throat, or chest;

• fast or pounding heartbeats, dizziness;

• sudden and severe stomach pain and bloody diarrhea;

• heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; or

• high levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Common Zomig side effects may include:

• pain or tightness in your throat or chest;

• dry mouth, upset stomach;

• pressure or heavy feeling anywhere in your body;

• drowsiness, feeling tired; or

• flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Zomig?

Using Zomig while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:

• medicine to treat depression;

• medicine to treat a psychiatric disorder;

• a narcotic (opioid) medication; or

• medicine to prevent nausea and vomiting.

This list is not complete. Other drugs may interact with zolmitriptan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zomig only for the indication prescribed.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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