Zolmitriptan

What is Zolmitriptan Used For?

Zolmitriptan tablets and orodispersibles contain the active ingredient zolmitriptan and belong to a classification of medicines called ‘triptans’. They are used to treat acute migraine attacks with or without aura, though they should not be taken before the headache element of the migraine begins.

It’s important to note that Zolmitriptan cannot be used as a preventative measure. The medication does not stop future migraine attacks from occurring, nor will it prevent an upcoming headache if taken during the aura phase. 

How Does Zolmitriptan Work?

Zolmitriptan is a triptan that treats acute migraine attacks. It is a selective serotonin receptor agonist that works by binding to serotonin receptors in the brain to narrow blood vessels that have widened and block the release of certain nerve proteins involved in nerve pathways.

By activating these receptors in the brain, zolmitriptan relieves the common migraine symptoms, such as pain, nausea, light sensitivity, and noise sensitivity.

How Long Does Zolmitriptan Take to Work?

Zolmitriptan starts working within 30 to 60 minutes after you take it, but it can take 2 to 4 hours to feel pain-free. It’s recommended that you take the medication at the very first signs of a migraine attack, rather than waiting until the pain gets severe. 

Is Zolmitriptan an Effective Migraine Medication?

Yes, zolmitriptan is an effective migraine medication. A study found that 66% of migraines treated by zolmitriptan needed only a single oral dose. For attacks where the headache returned and needed a second dose, a pain-free response was achieved in headaches of any intensity in 78% of attacks treated with 2.5 mg and 70% of those given 5 mg.

Meanwhile, another study found that zolmitriptan 2.5 mg and 5 mg provided similar relief rates at 2 hours compared to another effective migraine medication, sumatriptan (66%, 67%, and 68%).

How to Take Zolmitriptan 

There are 2 forms of zolmitriptan tablets available: film-coated tablets and orodispersible tablets. Whichever you take, you must take them exactly as they are prescribed to you, and they are only suitable if you are aged between 18 and 65. If you are unsure about how to take zolmitriptan, consult the patient information leaflet that comes with your medication or speak to your clinician for advice. 

How to Take Zolmitriptan Tablets

The recommended dose is one 2.5 mg Zolmitriptan film-coated tablet. Some people may be prescribed a 5 mg dose. Your clinician will tell you which dose you should take. We only supply a 2.5 mg dose. The maximum daily dose is 10 mg.

To take a zolmitriptan film-coated tablet, you should:

• Take it as soon as a migraine headache starts for the best results, but you can take it during an attack.
• Swallow one 2.5 mg tablet whole with a drink of water.
• If you still have a headache after 2 hours or it returns within 24 hours, take a second tablet.

If the zolmitriptan tablet did not relieve your migraine, tell the clinician as you may need an alternative migraine treatment. You must not take more than two zolmitriptan doses in a day, unless your clinician tells you to.

How to Take Zolmitriptan Orodispersible Tablets

Zolmitriptan orodispersible tablets are available in a 5 mg dose and may be more suitable if you experience other migraine symptoms, such as nausea or vomiting.

To take zolmitriptan orodispersible tablets, you should:

• Take the tablet as soon as a migraine starts or while it is happening.
• Place one tablet on your tongue, where it will dissolve, then swallow it with your saliva. You do not need to drink water to swallow the tablet.
• If you still have a headache after 2 hours or it returns within 24 hours, take a second tablet.

If the zolmitriptan tablet did not relieve your migraine, tell the clinician as you may need an alternative migraine treatment. You must not take more than two zolmitriptan doses in a day, unless your clinician tells you to. The maximum dose you can take per day is 10 mg or two 5 mg orodispersible tablets.

If You Forget to Take Zolmitriptan 

Zolmitriptan should not be used on a regular basis to prevent a migraine and is only suitable for treating an acute migraine attack. If you forget to take it and your migraine is currently happening, take your tablet as soon as you remember.

You must not take a double dose to make up for a delayed or missed dose. If you are unsure what to do if you have forgotten to take zolmitriptan, speak to your clinician or pharmacist.

If You Take Too Much Zolmitriptan 

If you take more zolmitriptan than you have been prescribed, tell your doctor or go to the nearest hospital immediately. Take the zolmitriptan tablet packet with you.

Zolmitriptan Side Effects and Cautions

Like all medications, zolmitriptan can cause side effects. Read the Patient Information Leaflet supplied with the medication to understand the potential adverse effects and cautions associated with taking zolmitriptan. This will help you understand what to watch for and when you may need to seek medical attention.

Side Effects of Zolmitriptan Tablets and Orodispersibles 

Zolmitriptan can cause side effects, although not everyone will experience them. Most side effects are mild and temporary, and may be caused by the migraine itself. If you get any side effects that you find hard to manage, get worse, or are concerning, speak to your doctor for advice

Please note that this is not a complete list of potential side effects from Zolmitriptan tablets. More details are in the Patient Information Leaflet that comes with the medication. You can also find a more detailed breakdown of possible Zolmitriptan orodispersible side effects in its Patient Information Leaflet.

It’s recommended that you read these leaflets thoroughly so you understand what to expect. If you experience any adverse reactions from either Zolmitriptan tablets or orodispersibles, you can inform your clinician or use the MHRA’s Yellow Card Scheme. 

When to Stop Taking the Medication

In rare and very rare cases, zolmitriptan can cause serious side effects. If you get any of the following, stop taking zolmitriptan and contact your doctor immediately:

• Allergic reactions: itchy rash (urticaria), swelling of the face, lips, tongue, and throat
• Angina, heart attack, or spasm of the blood vessels of the heart: signs include chest pain and shortness of breath
• Spasm of the blood vessels of the gut: stomach pain or bloody diarrhoea
• Bleeding in the brain or stroke: weakness down one side of the body, drooping face, and slurred speech

Zolmitriptan Warnings and Interactions

Not all medications are suitable for everybody. Some medical conditions and certain medications may make zolmitriptan unsuitable or even unsafe for you to take. Before taking zolmitriptan, tell your clinician about any medicines you are taking or conditions you have.

Do not take zolmitriptan if you:

• Are under 18 or over 65
• Are allergic to zolmitriptan or any other ingredients listed in the medicine
• Have high blood pressure
• Have or have had heart problems, including a heart attack, angina, Prinzmetal’s angina (chest pain that occurs at rest), or have experienced similar heart-related symptoms, like shortness of breath or pressure in the chest
• Have or have previously had a stroke or short-lasting symptoms similar to a stroke
• Are taking other medicines for your migraine, such as ergotamine or ergot-type medicines like dihydroergotamine and methysergide or other triptans

You must not take zolmitriptan orodispersible tablets if you have severe kidney problems.

Precautions Before Taking Zolmitriptan

Before taking zolmitriptan, tell the clinician if you:

• Are at risk of ischaemic heart disease, particularly if you smoke, have high blood pressure, high cholesterol levels, diabetes, or anyone in your family has had ischaemic heart disease.
• Have been told you have Wolff-Parkinson-White syndrome (a type of abnormal heartbeat).
• Have or have previously had liver problems.
• Have headaches that are not like your usual migraine headache.
• Are taking other medicines to treat depression, such as monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs).
• Are taking the herbal remedy St John’s wort.
• Are taking cimetidine for stomach ulcers.
• Are taking a quinolone antibiotic such as ciprofloxacin.

If you go into hospital, you should tell the medical staff that you are taking zolmitriptan.

Taking zolmitriptan excessively can cause daily headaches or make migraine headaches worse. If this happens, your clinician may advise you to stop your treatment.

If you take another triptan, which is different from zolmitriptan, you should wait 24 hours before taking zolmitriptan. You should also leave 24 hours before taking another triptan after taking zolmitriptan,

If you take any medications that contain ergotamine or ergot-type medications, leave 24 hours before taking zolmitriptan or leave 6 hours after taking zolmitriptan before taking ergotamine or ergot-type medications.

Pregnancy and Breastfeeding

If you are pregnant, think you might be pregnant, or trying to get pregnant, speak to your doctor, clinician, or pharmacist before taking zolmitriptan.

If you are breastfeeding, you should avoid breastfeeding for 24 hours after taking zolmitriptan, as the active ingredient can pass into your breast milk.

Frequently Asked Questions About Zolmitriptan