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Zomig

Zomig, the brand name for zolmitriptan, is a medication used to treat migraine headaches with or without aura. Zomig belongs to a class of drugs known as triptans (serotonin receptor agonists), which work by narrowing the blood vessels in the brain and reducing substances that trigger migraine symptoms like pain, nausea, and sensitivity to light and sound. Zomig is intended for the acute treatment of migraines once they begin, but it is not used to prevent migraines or treat other types of headaches, such as tension headaches.

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Frequently Asked Questions

How long does it take for Zomig to work?
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Zomig usually begins to work within 30 minutes to 1 hour after taking it. Relief from migraine symptoms typically occurs within 2 hours.

Can I take Zomig to prevent migraines?
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No, Zomig is not used for the prevention of migraines. It is intended for the acute treatment of a migraine once it starts.

Can Zomig be used in children?
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Zomig is approved for use in children 12 years and older for the acute treatment of migraines. It is not recommended for younger children.

What should I do if I miss a dose of Zomig?
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Zomig is taken on an as-needed basis for migraine attacks, so missing a dose is not a concern. Do not take a dose unless you have symptoms of a migraine.

Can I take Zomig with other pain relievers?
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Yes, Zomig can be taken with other pain relievers like acetaminophen or ibuprofen, but avoid taking other triptans or ergotamines at the same time.

Comprehensive Drug Guide

How Does Zomig Work?

Zomig works by activating serotonin (5-HT1B and 5-HT1D) receptors in the brain, which causes blood vessels to constrict and blocks the release of substances that lead to inflammation and pain. By reducing these effects, Zomig helps relieve migraine symptoms such as headache, nausea, and sensitivity to light and sound.

Common Dosages

  • 2.5 mg tablets
  • 5 mg tablets
  • 2.5 mg orally disintegrating tablets (Zomig-ZMT)
  • 5 mg nasal spray

Typical Dosing

  • The usual starting dose for Zomig is 2.5 mg taken at the onset of a migraine. If symptoms persist after 2 hours, a second dose can be taken.
  • The maximum daily dose is 10 mg within 24 hours.
  • For Zomig nasal spray, the usual dose is 5 mg per nostril, with a second dose possible after 2 hours if the migraine persists.

Typical Dosing

FDA Approved Indications

  • Acute treatment of migraine with or without aura in adults and in pediatric patients aged 12 years and older.

Who Shouldn't Take Zomig?

  • Uncontrolled hypertension or severe coronary artery disease
  • A history of stroke or transient ischemic attacks (TIAs)
  • Peripheral vascular disease
  • Hemiplegic or basilar migraine
  • Known hypersensitivity to zolmitriptan or any of the ingredients in the formulation
  • Use of ergotamine-containing medications or other triptans within 24 hours

Advice From The Pharmacist

  • Take Zomig at the first sign of a migraine for the best chance of relief. It is not for prevention of migraines, but rather for treatment when symptoms occur.
  • If using the orally disintegrating tablet, place it on your tongue and allow it to dissolve without chewing or swallowing.
  • If using the nasal spray, administer it as directed into one nostril and do not blow your nose immediately after use to allow the medication to be absorbed.
  • Avoid driving or operating heavy machinery after taking Zomig if you experience drowsiness or dizziness.
  • Limit the use of Zomig to avoid medication-overuse headaches (rebound headaches) that can occur with frequent use.

Side Effects of Zomig

Common Side Effects

  • Dizziness or lightheadedness
  • Drowsiness or fatigue
  • Nausea
  • Dry mouth
  • Sensations of pressure or tightness, especially in the chest or throat

Uncommon/Severe Side Effects

  • Chest pain or tightness (could indicate a heart problem)
  • Severe allergic reactions (such as rash, itching, or swelling)
  • Serotonin syndrome, especially when combined with other serotonergic drugs

Risks and Warnings of Zomig

  • Heart and blood vessel risks: Zomig can cause serious cardiovascular side effects such as heart attack or stroke, especially in patients with underlying heart disease or risk factors like high blood pressure, high cholesterol, or smoking.
  • Serotonin syndrome: Zomig can cause serotonin syndrome when taken with other drugs that increase serotonin levels, such as SSRIs, SNRIs, or tricyclic antidepressants. Symptoms include agitation, confusion, rapid heart rate, and high blood pressure.
  • Medication overuse: Frequent use of Zomig can lead to rebound headaches. If you need to take Zomig more than twice a week, consult your doctor to discuss preventive options for migraines.
  • Peripheral vascular disease: Zomig should not be used by individuals with peripheral artery disease, as it may cause blood vessel constriction that can worsen symptoms.

Interactions with Zomig

Common Drug Interactions

  • SSRIs or SNRIs: Medications such as fluoxetine, sertraline, and duloxetine may increase the risk of serotonin syndrome when combined with Zomig.
  • Ergotamine: Combining Zomig with ergotamine-containing medications (used to treat migraines) increases the risk of prolonged vasospasm (dangerously narrowed blood vessels).
  • Other triptans: Do not take other triptans (such as sumatriptan) within 24 hours of using Zomig to avoid serious side effects.

Alternatives to Zomig

  • Sumatriptan (Imitrex): Another triptan used for the acute treatment of migraines. It is available in tablets, injections, and nasal sprays.
  • Rizatriptan (Maxalt): A fast-acting triptan available in tablets and orally disintegrating forms.
  • Naratriptan (Amerge): A triptan with a slower onset but longer duration of action.
  • Ubrelvy (ubrogepant): A CGRP receptor antagonist used for the acute treatment of migraines.
  • Nurtec ODT (rimegepant): Another CGRP receptor antagonist used for acute migraine treatment.