Monograph Details

Pain & Pyrexia > Migraine and headache
ZOMIG-ZMT
Manufacturer
AstraZeneca Pharmaceuticals
Legal Classification
Rx
Pharmacological Class
Selective 5-HT1B/1D receptor agonist.
Generic Name
Zolmitriptan 2.5mg, 5mg; orally-disintegrating tabs; orange flavor; contains phenylalanine.
Also
ZOMIG
ZOMIG NASAL SPRAY
Indications
Acute treatment of migraine.
Children
<18yrs: not recommended.
Adults
≥18yrs: Initially 2.5mg or lower once. If headache returns, may repeat after 2 hrs; max 10mg/day. Reevaluate if no response after 1st dose. The safety of treating an average of more than 3 headaches in a 30-day period has not been established. Hepatic impairment: use low dose. ZMT: dissolve on tongue and swallow without water.
Contraindications
Ischemic heart disease (angina pectoris, history of MI, documented silent ischemia). Coronary artery vasospasm (eg, Prinzmetal's angina). Uncontrolled hypertension. Other significant cardiovascular disease. Basilar or hemiplegic migraine. Within 24 hours of ergot-type drugs or other 5-HT1 agonists. During or within 2 weeks after discontinuing MAOIs (type A).
Precautions
Confirm diagnosis. Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders: not recommended. Exclude underlying cardiovascular disease, supervise 1st dose, and consider monitoring ECG in patients with likelihood of unrecognized coronary disease (eg, postmenopausal women, men over age 40, hypertension, hypercholesterolemia, obesity, diabetes, smokers, strong family history). Monitor cardiovascular function in long-term intermittent use. Cerebrovascular events (eg, stroke, TIA), peripheral vascular or colonic ischemia following other 5-HT1 agonists. Hepatic dysfunction (monitor BP). Elderly. Pregnancy (Cat.C). Nursing mothers.
Interactions
MAOIs (type A), methysergide, other ergotamines, other 5-HT1 agonists: see Contraindications. Serotonin syndrome with SSRIs (eg, fluoxetine, fluvoxamine, paroxetine, sertraline). Absorption and half-life increased by cimetidine.
Adverse Reactions
Paresthesia, asthenia, nausea, dizziness, pain, chest/jaw/throat tightness or heaviness, somnolence, warm feeling; rare: serious cardiac events. Nasal spray: also taste disturbances, local reactions.
How Supplied
Tabs, ZMT tabs 2.5mg—6
Tabs, ZMT tabs 5mg—3
Single-dose sprayer—6
Additional Resources
Related Prescribing Note