What is the most important information I should know about zolmitriptan?

Zolmitriptan can cause serious side effects on the heart, including heart attack or stroke. Although these side effects are rare, do not use this medication if you have a history of heart disease, angina (chest pain), blood circulation problems, ischemic bowel disease, severe or uncontrolled high blood pressure, or history of a heart attack or stroke.

Before using zolmitriptan, tell your doctor if you have coronary artery disease, or risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

Do not use zolmitriptan if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or phenelzine (Nardil) in the past 14 days.

Do not take zolmitriptan within 24 hours after taking almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or ergot medicine such as methysergide (Sansert), ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), methylergonovine (Methergine).

Before taking zolmitriptan, tell your doctor if you are also taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Zolmitriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

After taking a zolmitriptan tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 10 mg of zolmitriptan in 24 hours.

What is zolmitriptan?

Zolmitriptan is a headache medicine. It is believed to work by narrowing the blood vessels around the brain. Zolmitriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Zolmitriptan is used to treat migraine headaches.

Zolmitriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Zolmitriptan may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using zolmitriptan?

Do not use this medication if you are allergic to zolmitriptan, or if you have:

• a history of heart disease, angina (chest pain), blood circulation problems, or history of a heart attack or stroke;
• ischemic bowel disease;
• severe or uncontrolled high blood pressure; or
• a headache that is not like other headaches you have had.

Do not use zolmitriptan if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or phenelzine (Nardil) in the past 14 days.

Do not use zolmitriptan within 24 hours after taking any of the following medicines:

• almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), or rizatriptan (Maxalt); or
• ergot medicine such as methysergide (Sansert), ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), methylergonovine (Methergine).

Before using zolmitriptan, tell your doctor if you have:

• high blood pressure;
• liver disease;
• kidney disease;
• phenylketonuria (tablets may contain phenylalanine);
• coronary artery disease (or risk factors that include diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take zolmitriptan.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether zolmitriptan passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

This medicine should not be given to anyone younger than 18 years old.

How should I use zolmitriptan?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Take zolmitriptan as soon as you notice headache symptoms, or after an attack has already begun.

Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to see if you have any serious side effects.

Take one zolmitriptan tablet whole with a full glass of water.

To take zolmitriptan orally disintegrating tablets (Zomig-ZMT):

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.
• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
• Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet two (2) hours after the first. Do not take more than 10 mg of zolmitriptan in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

Contact your doctor if you have more than four headaches in one month (30 days).

Store zolmitriptan at room temperature away from moisture and heat.

What happens if I miss a dose?

Since zolmitriptan is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using zolmitriptan.

After taking a zolmitriptan tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 10 mg of zolmitriptan in 24 hours.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure (convulsions), neck stiffness, tiredness, lack of coordination, feeling light-headed, or fainting.

What should I avoid while using zolmitriptan?

Zolmitriptan can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of zolmitriptan?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using zolmitriptan and call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• fast heart rate, agitation, muscle stiffness, hallucinations, lack of coordination, with nausea, vomiting, or diarrhea;
• sudden and severe stomach pain and bloody diarrhea; or
• numbness or tingling and a pale or blue-colored appearance in your fingers or toes.

Less serious side effects may include:

• dry mouth, upset stomach;
• muscle pain or weakness;
• feeling of pain or pressure in your neck and throat;
• weakness, dizziness, sleepiness; or
• sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect zolmitriptan?

Before using zolmitriptan, tell your doctor if you are using any of the following drugs:

• an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor); or
• another migraine medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), or rizatriptan (Maxalt).

This list is not complete and there may be other drugs that can interact with zolmitriptan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about oral zolmitriptan.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 4.05. Revision date: 04/14/2008.