Zolmitriptan

Generic Details

Generic Name

Zolmitriptan

Other Names

  • Zomig

Drug Class

  • Antimigraine Agent

Chemical Formula

C16H21N3O2S

Molecular Weight

303.43 g/mol

Mechanism of Action

  • Selective agonist for serotonin (5-HT1B/1D) receptors

Indications

  • Acute treatment of migraine attacks with or without aura in adults

Common Dosage Forms

  • Tablet
  • Orally disintegrating tablet

Typical Dosage

  • 2.5-5 mg once during a migraine attack; may repeat after 2 hours if needed, not to exceed 10 mg in 24 hours

Pediatric Dosage

  • Safety and efficacy not established in children under 18 years

Geriatric Dosage

  • Dose adjustment may be necessary based on renal function

Side Effects

  • Dizziness
  • Drowsiness
  • Paresthesia
  • Chest discomfort
  • Dry mouth
  • Nausea

Contraindications

  • Ischemic heart disease
  • Uncontrolled hypertension
  • History of stroke or transient ischemic attack
  • Peripheral vascular disease
  • Severe hepatic impairment

Pregnancy Category

  • C - Risk cannot be ruled out

Lactation Safety

  • L2 - Safer: Drug has moderate levels of safety in lactation

Drug Interactions

  • SSRIs
  • MAOIs
  • Ergotamine derivatives
  • Other 5-HT1 agonists

Overdose Symptoms

  • Dizziness
  • Nausea
  • Somnolence
  • Vomiting

Antidote for Overdose

  • General supportive measures

Storage Conditions

  • Store at controlled room temperature (20-25°C)

Pharmacokinetics

  • Absorption: Well absorbed after oral administration
  • Distribution: Crosses the blood-brain barrier
  • Metabolism: Extensively metabolized primarily by CYP1A2
  • Excretion: Eliminated in urine (40%) and feces (60%)

Precautions

  • Caution in patients with a history of epilepsy or seizures
  • Monitor for signs of serotonin syndrome

Warnings

  • Risk of coronary vasospasm
  • May cause increases in blood pressure

Others

  • Avoid use in patients with hemiplegic or basilar migraine