Medication Search: Zomig Rapimelt
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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.
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 tablets should be taken whole with water at the first sign of a migraine headache, but they can be taken at any time during a migraine headache. You may also split the tablets in half if your doctor has recommended that you do this to get a lower dose.
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.
It is important to use this medication exactly as prescribed by your doctor.
Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.
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?
- changed sense of taste (nasal spray only)
- discomfort inside the nose
- dry mouth
- feeling sick
- muscle aches
- nosebleeds (nasal spray only)
- stomach pain
- unusual tiredness or muscle weakness
Check with your doctor as soon as possible if any of the following side effects occur:
- fast, pounding, or irregular heartbeat
- increased blood pressure
- increased urine production or need to urinate
- trouble swallowing
Stop taking the medication and seek immediate medical attention if any of the following occur:
- convulsions (seizures)
- 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
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.
Galactose intolerance/glucose malabsorption: Zolmitriptan tablets are prepared with lactose. If you have lactose or galactose intolerance, you should not take the tablet formulation.
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 function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication. You may need a lower dose of zolmitriptan.
Medication overuse headaches: As with other pain relief medications, overuse of zolmitriptan may lead to medication overuse headaches, or "rebound headaches" where the headache returns as the medication wears off. Avoid taking more of this medication than is recommended by your doctor. If you experience more frequent headaches, contact your doctor as soon as possible.
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.
Serotonin syndrome: Severe reactions are possible when zolmitriptan is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors – medications used to treat depression. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.
If you are taking antidepressants, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
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 adolescents.
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:
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- ergot-containing medications (e.g., dihydroergotamine, ergotamine, or methysergide) if taken at the same time or within the previous 24 hours
- monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine) if taken at the same time or within 14 days of taking zolmitriptan
- St. John’s wort
- serotonin antagonists (antiemetic medications; e.g., granisetron, ondansetron)
- serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- other "triptans" (5-hydroxytryptamine agonists) (e.g., naratriptan, rizatriptan, sumatriptan) if taken at the same time or within the previous 24 hours
- 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.
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.
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