Generic Name: zolmitriptan (nasal) (ZOL mi TRIP tan)
Brand Name: Zomig

What is zolmitriptan nasal?

Zolmitriptan is a headache medicine that narrows 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 should not be used to treat a common tension headache, a headache that causes loss of movement on one side of your body, or any headache that seems to be different from your usual migraine headaches. Use this medication only if your condition has been confirmed by a doctor as migraine headaches.

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

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

You should not use this medication if you are allergic to zolmitriptan, if you have any history of heart disease, or if you have coronary heart disease, angina, blood circulation problems, lack of blood supply to the heart, uncontrolled high blood pressure, ischemic bowel disease, a history of a heart attack or stroke, or if your headache seems to be different from your usual migraine headaches.

Do not use zolmitriptan within 24 hours before or after using another migraine headache medicine, including zolmitriptan tablets, almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), sumatriptan (Imitrex, Treximet), or ergot medicine such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or methylergonovine (Methergine).

Slideshow: Living with Your Migraines: Tips for Treatment and Prevention

Do not use zolmitriptan if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

Before using zolmitriptan, tell your doctor if you have liver or kidney disease, high blood pressure, a heart rhythm disorder, or coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having 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).

Also tell your doctor if you are also taking an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), 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 using zolmitriptan spray, you must wait two (2) hours before using a second dose. Call your doctor if your headache does not completely go away after the first dose. Do not use more than 10 mg of zolmitriptan in 24 hours.

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

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

  • coronary heart disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;

  • a history of heart disease, heart attack, or stroke, including "mini-stroke";

  • severe or uncontrolled high blood pressure;

  • ischemic bowel disease; or

  • a headache that seems different from your usual migraine headaches.

Do not use zolmitriptan if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

To make sure you can safely use zolmitriptan, tell your doctor if you have any of these other conditions:

  • kidney disease;

  • liver disease;

  • high blood pressure, a heart rhythm disorder; or

  • coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having 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).

FDA pregnancy category C. It is not known whether zolmitriptan will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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.

Do not give this medication to a child younger than 18 years old.

How should I use zolmitriptan nasal?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Overuse of migraine headache medicine can actually make your headaches worse.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

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

The usual dose of zolmitriptan is a single spray into one nostril. Follow your doctor's instructions.

Blow your nose gently to clear your nostrils before using this medication. Remove the protective cap from the nasal spray device. Hold the device upright and insert the tip into your nostril. Hold your other nostril closed with the tip of your index finger.

Tilt your head back slightly and press the plunger on the nasal spray device. Inhale slowly as you spray the zolmitriptan dose into your nostril. Remove the spray device and breathe gently through your nose for 5 to 10 seconds. Keep your head tilted back, as you may feel some liquid in your nose or in the back of your throat.

There is only one spray in each zolmitriptan spray device. Do not press the plunger on the device until you have inserted the tip into your nostril.

After using the nasal spray: If your headache goes away and comes back, use a second dose two (2) hours after the first. Do not use more than 10 mg of zolmitriptan in 24 hours. If your headache does not completely go away, call your doctor before using a second dose of zolmitriptan.

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

If you use zolmitriptan long-term, your doctor may want to check your heart function using an electrocardiograph or ECG (sometimes called an EKG), a machine that measures electrical activity of the heart. This will help your doctor determine if it is still safe for you to use this medication. Visit your doctor regularly.

Store at room temperature away from moisture and heat. Keep the protective cap on the nasal spray until you are ready to use it.

Throw away the single-use nasal spray device after one use.

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 using zolmitriptan, you must wait two (2) hours before using it a second time. Do not use more than 10 mg of zolmitriptan in 24 hours.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using zolmitriptan nasal?

Do not use zolmitriptan within 24 hours before or after using another migraine headache medicine, including:

  • zolmitriptan tablets, almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or sumatriptan (Imitrex, Treximet); or

  • ergot medicine such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or methylergonovine (Methergine).

Zolmitriptan may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Zolmitriptan nasal side effects

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 a serious side effect such as:

  • feeling of pain or tightness in your jaw, neck, or throat;

  • 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 severe headache, confusion, problems with vision, speech, or balance;

  • sudden and severe stomach pain and bloody diarrhea;

  • numbness or tingling and a pale or blue-colored appearance in your fingers or toes; or

  • (if you are also taking an antidepressant) -- agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Less serious side effects may include:

  • drowsiness;

  • pressure or heavy feeling in any part of your body;

  • nausea, dry mouth, unusual or unpleasant taste in your mouth;

  • pain or discomfort in your nose or throat after using the nasal spray; or

  • warmth, redness, or mild tingling under your skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect zolmitriptan nasal?

Tell your doctor about all other medicines you use, especially:

  • cimetidine (Tagamet); or

  • an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

This list is not complete and other drugs may interact with zolmitriptan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about zolmitriptan nasal.
  • 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.
  • Disclaimer: 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 1996-2012 Cerner Multum, Inc. Version: 2.04. Revision Date: 2014-01-08, 9:56:00 AM.

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