Zolmitriptan

Key facts

• Zolmitriptan is a triptan taken at the onset of a migraine attack or cluster headache, available as tablets, an orally disintegrating tablet, or a nasal spray.
• It works fastest when taken as soon as migraine symptoms begin, rather than waiting until pain is severe.
• Zolmitriptan narrows blood vessels, so it must be avoided in people with coronary artery disease, a past heart attack, or uncontrolled high blood pressure, because it can trigger chest pain, heart attack, or stroke in those at risk.
• Seek urgent care for chest pain, sudden weakness on one side of the body, or sudden vision loss.

What zolmitriptan treats

Zolmitriptan treats acute migraine attacks, with or without aura, and cluster headache. It is not a preventive medicine and does not treat other headache types, such as tension headache. It is not suitable for migraine with hemiplegic or brainstem aura symptoms.

How zolmitriptan works

Zolmitriptan activates serotonin receptors on blood vessels around the brain, narrowing vessels that have widened during a migraine attack. It also blocks the release of inflammatory pain-signaling substances from nerve endings, which together relieve the throbbing pain and other migraine symptoms.

Before you take it

• Avoid zolmitriptan if you have coronary artery disease, uncontrolled high blood pressure, peripheral vascular disease, or a history of stroke or transient ischemic attack.
• Do not take zolmitriptan within 24 hours of another triptan or an ergotamine-type medicine.
• Combining zolmitriptan with an SSRI, SNRI, or MAOI raises the risk of serotonin syndrome; tell your prescriber about any antidepressants you take.
• Avoid zolmitriptan if you have known hypersensitivity to triptans.

Side effects

Common effects include tingling, warmth or flushing, tightness in the neck, throat, or chest, dizziness, dry mouth, and drowsiness. The chest or throat tightness usually is not a sign of heart trouble, but tell your prescriber if it happens.

Stop and seek urgent medical care for any of these:

• Chest pain or pressure that persists.
• An irregular or unusually fast heartbeat.
• Sudden weakness or numbness on one side of the body, or sudden vision changes.
• Agitation, rapid heartbeat, high fever, or muscle rigidity, which can signal serotonin syndrome.

Safety essentials

• Coronary artery disease and uncontrolled high blood pressure are the defining contraindication for zolmitriptan; cardiovascular risk factors should be assessed before first use, even without a formal diagnosis of heart disease.
• Do not exceed the maximum daily dose, and limit use to a few days a week, since frequent use can cause medication-overuse headache.
• Avoid combining zolmitriptan with other triptans, ergotamines, or serotonergic antidepressants without medical advice.
• Seek immediate care for chest pain during or after use, even if it seems mild.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.