In the U.S.—

• Antimigraine agent

Zolmitriptan (zohl-mi-TRIP-tan) is used to treat severe migraine headaches. Many people find that their headaches go away completely after they take zolmitriptan. Other people find that their headaches are much less painful, and that they are able to go back to their normal activities even though their headaches are not completely gone. Zolmitriptan often relieves symptoms that occur together with a migraine headache, such as nausea, vomiting, sensitivity to light, and sensitivity to sound.

Zolmitriptan is not an ordinary pain reliever. It should not be used to relieve any kind of pain other than migraine headaches.

Zolmitriptan may cause serious side effects in some people, especially people who have heart or blood vessel disease. Be sure that you discuss with your doctor the risks of using this medicine as well as the good that it can do.

Zolmitriptan is available only with your doctor's prescription, in the following dosage form:

Oral
• Tablets (U.S.)
• Oral disintegrating tablets (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For zolmitriptan, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to zolmitriptan. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Zolmitriptan has not been studied in pregnant women. However, in some animal studies, zolmitriptan caused harmful effects to the fetus. These unwanted effects usually occurred when zolmitriptan was given in amounts that were large enough to cause harmful effects in the mother.

Breast-feeding—Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—There is no specific information comparing use of zolmitriptan in children with use in other age groups.

Older adults—There is no specific information comparing use of zolmitriptan in patients older than 65 years of age with use in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine, especially other prescription medicine for migraine headaches, or if you smoke tobacco.

When you are taking zolmitriptan, it is especially important that your health care professional know if you are taking the following:

• Monoamine oxidase-A (MAO-A) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])—Taking zolmitriptan while you are taking or within 2 weeks of taking MAO inhibitors may cause sudden high body temperature, extremely high blood pressure, and severe convulsions; at least 14 days should be allowed between stopping treatment with one medicine and starting treatment with the other.

• Angina (chest pain) or
• Fast or irregular heartbeat or
• Heart or blood vessel disease or
• High blood pressure or
• Kidney disease or
• Liver disease or
• Stroke (history of)—The chance of side effects may be increased. Heart or blood vessel disease and high blood pressure sometimes do not cause any symptoms, so some people do not know that they have these problems. Before deciding whether you should use zolmitriptan, your doctor may need to do some tests to make sure that you do not have any of these conditions.

• Phenylketonuria (PKU)—The oral disintegrating tablets may contain aspartame, which can make your condition worse

Do not use zolmitriptan for a headache that is different from your usual migraines . Instead, check with your doctor.

To relieve your migraine as soon as possible, use zolmitriptan as soon as the headache pain begins. Even if you get warning signals of a coming migraine (an aura), you should wait until the headache pain starts before using zolmitriptan.

Lying down in a quiet, dark room for a while after you use this medicine may help relieve your migraine.

Ask your doctor ahead of time about other medicine you might take if zolmitriptan does not work. After you take the other medicine, check with your doctor as soon as possible. Headaches that are not relieved by zolmitriptan are sometimes caused by conditions that need other treatment.

If you feel much better after a dose of zolmitriptan, but your headache comes back or gets worse after a while, you may use more zolmitriptan. However, use this medicine only as directed by your doctor. Do not use more of it, and do not use it more often, than directed. Using too much zolmitriptan may increase the chance of side effects.

Your doctor may direct you to take another medicine to help prevent headaches. It is important that you follow your doctor's directions, even if your headaches continue to occur. Headache-preventing medicines may take several weeks to start working. Even after they do start working, your headaches may not go away completely. However, your headaches should occur less often, and they should be less severe and easier to relieve. This can reduce the amount of zolmitriptan or other pain medicines that you need. If you do not notice any improvement after several weeks of headache-preventing treatment, check with your doctor.

For patients using the oral disintegrating tablet form of this medicine:

• Make sure your hands are dry.
• Remove tablet from package, and immediately place the tablet on top of your tongue.
• The tablet will dissolve in seconds, and you may swallow it with your saliva. You do not need to drink water or other liquid to swallow the tablet.

Dosing—

The dose of zolmitriptan will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of zolmitriptan. If your dose is different, do not change it unless your doctor tells you to do so.

• For oral dosage form (tablets):
  • For migraine headaches:
    • Adults—2.5 mg or lower (tablet may be broken in half) as a single dose. If the migraine comes back after being relieved, another dose may be taken two hours after the last dose. Do not take more than 10 mg in any twenty-four-hour period (one day).
    • Children—Use and dose must be determined by your doctor.
• For oral dosage form (oral disintegrating tablets):
  • For migraine headaches:
    • Adults—2.5 mg placed on top of your tongue. If the migraine comes back after being relieved, another dose may be taken two hours after the last dose. Do not take more than 10 mg in any twenty-four-hour period (one day).
    • Children—Use and dose must be determined by your doctor.

Storage—

To store this medicine:

• Keep out of the reach of children since overdose is especially dangerous in children.
• Store away from heat and direct light.
• Do not store tablets in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Drinking alcoholic beverages can make headaches worse or cause new headaches to occur. People who suffer from severe headaches should probably avoid alcoholic beverages, especially during a headache.

Some people feel drowsy or dizzy during or after a migraine, or after taking zolmitriptan to relieve a migraine. As long as you are feeling drowsy or dizzy, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Stop using this medicine and check with your doctor immediately if any of the following side effects occur:

• More common
  • Chest pain (severe);  heaviness, tightness, or pressure in chest and/or neck;  sensation of burning, warmth, heat, numbness, tightness, or tingling 
  
  

• Less common or rare
  • Abdominal pain (severe);  changes in facial skin color;  cough or hoarseness;  diarrhea;  fast or irregular heartbeat ;  fever or chills;  loss of appetite;  lower back or side pain;  nausea;  painful or difficult urination ;  puffiness or swelling of the eyelids or around the eyes, face, or lips;  shortness of breath, troubled breathing, tightness in chest, and/or wheezing;  skin rash, hives, and/or itching;  weakness 
  
  

Other side effects may occur that usually do not need medical attention. Some of the following effects, such as nausea, vomiting, drowsiness, dizziness, and general feeling of illness or tiredness, often occur during or after a migraine, even when zolmitriptan has not been used. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Dizziness;  nausea;  sleepiness;  unusual tiredness or muscle weakness  
  
  

• Less common
  • Agitation;  anxiety;  depression;  discomfort in jaw, mouth, or throat;  difficulty in swallowing;  dry mouth ;  fainting;  heartburn;  itching of the skin;  large nonelevated blue or purplish patches in the skin;  muscle aches ;  pounding heartbeat;  sudden large increase in frequency and quantity of urine;  sweating;  swelling of face, fingers, feet and/or lower legs 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.