Zolmitriptan (Generic Zomig) - Uses, Side Effects, and More

Everything you need to know about Zolmitriptan

How does Zolmitriptan work?

In many people living with migraine, there is a problem with certain nerves supplying the blood vessels inside the brain. Either pain is transmitted along these nerves, or the nerves release pain causing chemicals, causing migraine headache symptoms.

Zolmitriptan acts like Serotonin, which is a chemical messenger used to send signals between nerves in many different parts of the body. Serotonin has many different effects on the body, however you are probably most familiar with its role as the “happy hormone.” How serotonin is involved in migraine is complex; research has shown that serotonin acts directly on blood vessels in the brain, upon nerves that control how pain is sensed and via a broad network of nerves projecting from the base of the brain (the brainstem) into almost all areas of the brain. (You may see Zolmitriptan referred to as a Serotonin (5-HT1) agonist.)

Zolmitriptan has 3 different modes of action:

Activation of specific nerves that use Serotonin.
Prevents the release of pain-causing chemicals.
Adjusts the circulation of blood in the brain.

The combination of these mechanisms can reduce the level of pain that a patient experiences. This in turn helps to relieve migraine symptoms once a migraine starts to appear.

How should I take Zolmitriptan?

Zolmitriptan works immediately to relieve symptoms of migraine, such as headache. We advise taking the tablet as soon as symptoms of migraine first appear. You can take a dose at day or at night. (It does not have caffeine-like or dizziness inducing properties.)

Zolmitriptan is available as 2.5 mg and 5 mg tablets. A normal starting dose is 5 mg once daily as required.

If taking a Zolmitriptan tablet gives temporary relief of symptoms, but migraine symptoms return after two or longer, it may be beneficial to take a second tablet. However if Zolmitriptan had no benefit initially in relieving symptoms, taking a second tablet is unlikely to be of any further benefit. This does not mean that the medication will never work for you, and there may be symptom relief in future.

It does not prevent migraine attacks in the future, or make future migraine symptoms less severe. If you find that you are taking this medication for more than 10 days a month you might benefit from preventative treatment. Prolonged use of immediate relief medication used to treat headaches can lead to Medication Overuse Headache.

Please read the prescription instructions provided and follow them closely. Do not take more than two tablets (of 5 mg each) in a 24 hour period.

What do I need to tell my doctor before taking Zolmitriptan?

You must tell the clinical team if you have a history or suspected diagnosis of any of the following contraindications. (A contraindication means any condition where you must NOT take Zolmitriptan):

Hypersensitivity (allergy) to Zolmitriptan or any ingredients in its formulation.
Coronary artery disease/ coronary heart disease including a family history of angina or heart attack.
Suspected or diagnosed coronary artery disease/ coronary heart disease; we may need further information or investigation risk factors such as:
High blood pressure.
High cholesterol levels.
Smoker.
Obesity.
Diabetes.
Menopause.
Male over 40 years of age.
Uncontrolled or severe high blood pressure.
History of stroke or Transient Ischemic Attack.
Ongoing treatment, or treatment in the last 24 hours with medication containing ergot or ergotamine (eg methysergide, dihydroergotamine) or other triptan medication.
Recent treatment in the last two weeks with any Monoamine Oxidase Inhibitor medication (these include antidepressant or antianxiety medications such as Iproniazid, Isocarboxazid, Hydracarbazine, Phenelzine, Tranylcypromine, Bifemelane, Moclobemide, and Pirlindole; anti-Parkinson medications such as Rasagiline, Selegiline, and Safinamide, and the antibiotic Linezolid).

Please notify the clinical team if you have any history of moderate or severe kidney or liver disease. There were no specific concerns in healthy volunteers over the age of 65.

There is limited data on any possible effects to mother or child during pregnancy, breastfeeding, whilst trying to conceive or during fertility treatment. We advise considering alternative options for initial migraine medication in these circumstances.

Prolonged use of immediate or acute migraine medication used to treat headaches can lead to Medication Overuse Headache, especially if you use this medication for more than 10 days in a month. We suggest seeking medical advice if you are concerned by any significant increase in duration, frequency or severity of your symptoms.

What are some of the side effects that I might experience?

Zolmitriptan can have great benefits to reduce your migraine symptoms, although some individuals may experience side effects which are important to notice and be aware of. Common side-effects include:

Digestive: dry mouth, nausea, vomiting, heartburn and diarrhea.

Abnormal feeling: warm burning numbness or tingling.

Cardiovascular: awareness of heartbeat.

Brain and nerves: dizziness, sleepiness, abnormal skin sensation, confusion, and agitation.

Skin: flushing of skin.

Other: nil.

If you are unhappy with any side effects that you experience, please speak to the clinical team to discuss your treatment.

Further information on detailed side effects can be found in the official FDA drug label information for Zolmitriptan:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b5c5cb44-7581-4856-8324-13c02a6101dd

What are the side effects that mean I need to call my doctor immediately?

If at any time you experience any worrying or potentially serious side effects, stop taking Zolmitriptan and seek immediate medical advice from Mable Support or another physician. If there is any doubt contact emergency services and state your symptoms and that you have taken a migraine medication called Zolmitriptan.

Mable Phone Number: 855-953-4316

Hours: 7am-7pm PST Mon-Fri & 9am-5pm PST Sat-Sun.

Symptoms include but are not limited to:

Chest pain, fast heartbeat, skipped heartbeats.
Shortness of breath.
Severe swelling.
Severe headache.
Severe dizziness, spell(s) of passing out.
Persistent vomiting.
Persistent nosebleed.
Change in mental clarity/status.
Change in strength or feeling of arms or legs.

In addition, stop taking this medication, and seek appropriate medical advice in the following situations:

A suspected allergy to Zolmitriptan (if in any doubt seek emergency medical advice).
Severe chest pain or discomfort, or diagnosis of coronary artery disease, high cholesterol (hypercholesterolemia), or diabetes.
Uncontrolled or severe high blood pressure.
History of stroke or Transient Ischemic Attack.
You have been advised by a physician to take a medication likely to interact with Zolmitriptan.
You have been advised to stop taking this medication by a healthcare professional.

Please inform us of any changes to your medical health, including new medication or treatment.

What other similar medications are available?

Other triptans that you may have heard of include: Almotriptan (generic Axert®), Sumatriptan(generic Imitrex®), Eletriptan (generic Relpax®), Naratriptan (generic Amerge®), Rizatriptan (generic Maxalt®), Zolmitriptan (generic Zomig®), and Frovatriptan (generic Frova®).

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