Zolmitriptan - for migraine Zomig
Take zolmitriptan as soon as the migraine headache develops.
It can make you feel tired or sleepy. If this happens, do not drive and do not use tools or machines.
Your chest may feel tight or 'heavy' after taking zolmitriptan. These sensations do not usually last for long, but if they continue or become intense, do not take any more zolmitriptan and let your doctor know as soon as possible. Other side-effects may occur, but they are generally mild and do not last for long.
|Type of medicine||5HT1-receptor agonist (also known as a 'triptan')|
|Used for||Treatment of acute migraine attacks|
|Available as||Tablets, orodispersible (melt-in-the-mouth) tablets and nasal spray|
In people with migraine, it is thought that some chemicals in the brain increase in activity and as a result parts of the brain then send out confused signals which result in the symptoms of headache and sickness. Why people with migraine should develop these chemical changes is not clear. Many migraine attacks occur for no apparent reason, but for some people there may be things which trigger an attack, like certain foods or drinks.
Zolmitriptan belongs to a class of medicines known as 5HT1-receptor agonists. They are also known simply as triptans. Triptans work by stimulating the receptors of a natural substance in the brain, called serotonin (or 5HT). This eases the symptoms of migraine headache.
Before taking zolmitriptan
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking zolmitriptan it is important that your doctor knows:
- If you are aged over 65 years or under 18 years.
- If you are pregnant or breastfeeding.
- If you have a heart condition such as angina or an irregular heartbeat, or if you have had a heart attack.
- If you have high blood pressure.
- If you have any problems with the way your liver works.
- If you have ever had a stroke or a transient ischaemic attack (this is also referred to as a TIA, or 'mini-stroke').
- If you have ever had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take zolmitriptan
- Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about zolmitriptan and will provide you with a full list of the side-effects which you may experience from taking it.
- Your dose will be on the label of the pack. Take zolmitriptan exactly as your doctor tells you to.
- If you are taking tablets: the usual dose is one 2.5 mg tablet as soon as the headache phase develops. Take the tablet with a drink of water. Your doctor may subsequently increase your dose to two tablets if this is considered necessary. If your migraine at first improves but then comes back, you may take a further dose, providing it is at least two hours after the initial dose. If the first tablet has no effect, do not take a second dose for the same attack, as it is unlikely to work.
- If you have been prescribed orodispersible tablets (Zomig® Rapimelt brand), these tablets have been designed to dissolve on your tongue rather than be swallowed. They can be helpful if you get sickness with a migraine. Peel open the foil packaging and gently remove a tablet. Place it on your tongue and allow it to dissolve in your mouth before you swallow. If your migraine at first improves but then comes back, you may take a further dose, providing it is at least two hours after the initial dose. If the first tablet has no effect, do not take a second dose for the same attack.
- If you using the nasal spray: use one spray into one nostril as soon as the migraine headache starts. If your migraine at first improves but then comes back, you can use the spray again providing it is at least two hours after your first dose. If the first spray has no effect, do not use a second dose for the same attack. Do not use more than two sprays in 24 hours. To use the nasal spray, remove the protective cover and block one nostril by pressing on it with your finger. Insert the nozzle of the spray into the other nostril and breathe in through your nose as you squeeze the plunger to release the dose. The spray contains only one dose.
Getting the most from your treatment
- Zolmitriptan is used to treat headache pain during a migraine attack, not to stop the pain from coming on. You should wait until the migraine symptoms start to develop, rather than taking it when you feel that a migraine may be developing.
- Do not take other migraine treatments (such as other triptans or ergotamine) at the same time as zolmitriptan.
- Some people may benefit from taking a non-steroidal anti-inflammatory painkiller (such as naproxen) in addition to zolmitriptan. Your doctor will advise you about this if it is recommended for you.
- If you find that zolmitriptan does not relieve your migraine, make an appointment to discuss this with your doctor, as an alternative medicine may be more effective for you.
- It may help to keep a migraine diary. Note down when and where each migraine attack started, what you were doing, and what you had eaten that day. A pattern may emerge and it may be possible for you to avoid some of the things that trigger your migraine attacks.
- Zolmitriptan is used to treat migraine attacks once the pain has started, but there are other medicines available that may help to reduce the number of migraine attacks. If you have migraines frequently, discuss this with your doctor.
- Some people who get frequent migraine attacks are in fact getting medication-induced headache. Medication-induced headache (also called medication-overuse headache) is caused by taking painkillers or triptans too often. If you use zolmitriptan or painkillers on more than two days a week on a regular basis, you may be at risk of this. You should talk to your doctor if you suspect it.
Can zolmitriptan cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with zolmitriptan. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common zolmitriptan side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting), stomach pain||Stick to simple foods|
|Feeling dizzy, sleepy, or tired||If this happens, do not drive and do not use tools or machines|
|Feelings ot tightness or heaviness, particularly in the throat or chest||If the pain is intense, do not take any further doses and speak with your doctor about it as soon as possible|
|Tingling feelings, the sensation of having a 'thumping' heart (palpitations), dry mouth, feeling hot or flushed, muscle ache or weakness||If any of these become troublesome, speak with your doctor|
|Unpleasant taste (if using the nasal spray), problems swallowing||These should soon pass|
If you experience any other symptoms that you think may be due to the medicine, speak with your doctor or pharmacist for advice.
How to store zolmitriptan
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine, ask your pharmacist.
Further reading and references
Manufacturer's PIL, Zomig® Tablets 2.5 mg; Grunenthal Ltd, The electronic Medicines Compendium. Dated March 2020.
Manufacturer's PIL, Zomig® Rapimelt 2.5 mg; Grunenthal Ltd, The electronic Medicines Compendium. Dated March 2020.
Manufacturer's PIL, Zomig® 5 mg Nasal Spray; Grunenthal Ltd, The electronic Medicines Compendium. Dated March 2020.
British National Formulary, 79th Edition (Mar 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.