Zolmitriptan

(zohl mi trip' tan)

Brand Name(s): Zomig®, Zomig-ZMT®; also available generically

WHY is this medicine prescribed?

Zolmitriptan is used to treat the symptoms of migraine headaches (severe throbbing headaches that sometimes come with nausea and a strong reaction to sound and light). Zolmitriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels around the brain, stopping pain signals from being sent to the brain, which stops the release of certain natural substances that cause pain, nausea, and other symptoms of migraines. Zolmitriptan does not stop migraine attacks from coming or reduce the number of headaches you have.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Zolmitriptan comes as a tablet and an orally disintegrating tablet (tablet that dissolves quickly in the mouth) to take by mouth. Take at the first sign of a migraine headache. If your symptoms improve after you take zolmitriptan but return after 2 hours or longer, you may take a second tablet. However, if your symptoms do not improve after you take zolmitriptan, do not take a second tablet without calling your doctor. Your doctor will tell you the maximum number of tablets or orally disintegrating tablets you may take in a 24-hour period. Take zolmitriptan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If your doctor has prescribed a dose lower than 2.5 mg, you may use your fingers to break the 2.5-mg tablet on the line that divides it in half. However, you should not break or split the orally disintegrating tablet.

To take the orally disintegrating tablet, use dry hands to peel back the foil packaging. Immediately take out the tablet and place it on your tongue. The tablet will quickly dissolve and can be swallowed with saliva. No water is needed to swallow disintegrating tablets. Do not open the foil packaging or remove the orally disintegrating tablet until just before you are ready to take it.

Call your doctor if your headaches do not get better or occur more frequently after taking zolmitriptan.

If you take zolmitriptan more often or for longer than the recommended period of time, your headaches may get worse or may occur more often. You should not take zolmitriptan or any other headache medication for more than 10 days per month. Call your doctor if you need to take zolmitriptan to treat more than 3 headaches in a 1-month period.

What SPECIAL PRECAUTIONS should I follow?

Before taking zolmitriptan,

  • tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.

  • do not take zolmitriptan if you have taken any of the following medications in the past 24 hours: other selective serotonin receptor agonists such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, or sumatriptan; or ergot-type medications such as bromocriptine, cabergoline, dihydroergotamine, ergoloid mesylates, ergonovine, ergotamine, methylergonovine, methysergide, and pergolide.

  • tell your doctor or pharmacist if you are taking the following medications or have stoppedtaking them within the past 2 weeks: isocarboxazid, phenelzine, selegiline, and tranylcypromine.

  • some medications should not be taken with zolmitriptan. Other medications may cause dosing changes or extra monitoring when taken with zolmitriptan. Make sure you have discussed any medications you are currently taking or plan to take before starting zolmitriptan with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking zolmitriptan, please get the advice of your doctor or pharmacist.

  • tell your doctor if you have or have ever had heart disease; a heart attack; angina (chest pain); irregular heartbeats; stroke or 'mini-stroke'; or circulation problems such as varicose veins, blood clots in the legs, Raynaud's disease (problems with blood flow to the fingers, toes, ears, and nose), or ischemic bowel disease (bloody diarrhea and stomach pain caused by decreased blood flow to the intestines). Your doctor may tell you not to take zolmitriptan.

  • tell your doctor if you smoke or are overweight; if you have or have ever had high blood pressure, high cholesterol, diabetes, or liver or kidney disease; if you have gone through menopause ; or if any family members have or have ever had heart disease or stroke.

  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you plan to be sexually active while you are taking this medication, talk to your doctor about effective methods of birth control.If you become pregnant while taking zolmitriptan, call your doctor.

  • you should know that this medication may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how zolmitriptan affects you.

  • talk to your doctor about your headache symptoms to make sure they are caused by migraine. Zolmitriptan should not be used to treat certain types of headaches.

  • if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent damage to your brain), you should know that the orally disintegrating tablets contain phenylalanine.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Zolmitriptan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • feeling warm or cold
  • drowsiness, dizziness or faintness
  • dry mouth
  • nausea
  • heartburn
  • sweating

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

  • pain, tightness, pressure, or heaviness in the chest, throat, neck, or jaw
  • slow or difficult speech
  • weakness or numbness of an arm or leg
  • fast, pounding, or irregular heartbeat
  • bloody diarrhea
  • sudden or severe stomach pain
  • paleness or blue color of the fingers and toes
  • shortness of breath
  • swelling of the eyes, face, lips, tongue, or throat
  • difficulty breathing or swallowing
  • hoarseness
  • rash, hives
  • pain, burning, or tingling in the hands or feet

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat, and moisture (not in the bathroom). Dispose of any orally disintegrating tablets that you removed from the blister pack but did not use immediately.

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

  • feeling very sleepy

What OTHER INFORMATION should I know?

Keep all appointments with your doctor. Your blood pressure should be checked regularly.

You should keep a headache diary by writing down when you have headaches and when you take zolmitriptan.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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