Zolmitriptan Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Jul 10, 2023.

Applies to zolmitriptan: oral tablet, oral tablet disintegrating. Other dosage forms:

nasal spray

Serious side effects of Zolmitriptan

Along with its needed effects, zolmitriptan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking zolmitriptan:

More common

Chest pain (severe)
heaviness, tightness, or pressure in the chest or neck
sensation of burning, warmth, heat, numbness, tightness, or tingling

Less common or rare

Abdominal or stomach pain (severe)
changes in facial skin color
cough or hoarseness
diarrhea
fast or irregular heartbeat
fever or chills
hives, itching, or skin rash
itching
loss of appetite
lower back or side pain
nausea
painful or difficult urination
puffiness or swelling of the eyelids or around the eyes, face, or lips
tightness in the chest
trouble breathing
weakness

Rare

Blurred vision
confusion
difficulty swallowing
dizziness
fainting
frequent strong or increased urge to urinate
headache
increased volume of pale, dilute urine
nervousness
pounding in the ears
severe numbness, especially on one side of the face or body
slow heartbeat
unusual tiredness or weakness

Incidence not known

Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Other side effects of Zolmitriptan

Some side effects of zolmitriptan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Lack or loss of strength
sleepiness or unusual drowsiness
warm or cold sensation

Less common

Dizziness or lightheadedness
dry mouth
feeling of constant movement of self or surroundings
sensation of spinning

Rare

Anxiety
crying
depersonalization
depression
dysphoria
euphoria
hyperventilation
irritability
loss of memory
paranoia
problems with memory
quick to react or overreact emotionally
rapidly changing moods
redness of the skin
seeing, hearing, or feeling things that are not there
shaking
trouble sleeping
welts

For Healthcare Professionals

Applies to zolmitriptan: nasal spray, oral tablet, oral tablet disintegrating.

Cardiovascular

Rare reports of serious cardiac adverse events have been reported including acute myocardial infarction within a few hours following administration of this drug.

Chest pain/tightness/pressure and/or heaviness appear to be dose-related occurring in 2%, 3%, and 4% of patients receiving 1 mg, 2.5 mg, and 5 mg, respectively. Neck/throat/jaw pain/tightness/pressure occurred in 4%, 7%, and 10% of patients, respectively.^[Ref]

Common (1% to 10%): Chest pain/tightness/pressure and/or heaviness, neck/throat/jaw pain/tightness/pressure, palpitations

Uncommon (0.1% to 1%): Arrhythmias, hypertension, syncope, tachycardia

Rare (less than 0.1%): Angina pectoris, myocardial infarct, coronary vasospasm, QT prolongation, thrombophlebitis^[Ref]

Nervous system

Very Common (greater than 10%): Taste disturbances (up to 21%, inhaler)

Common (1% to 10%): Paresthesia, somnolence, dizziness, hyperesthesia

Rare (less than 0.1%): Cerebral ischemia, amnesia, convulsions, ataxia, dystonia, hyperkinesia, hypotonia, hypertonia

Frequency not reported: Serotonin syndrome^[Ref]

Paresthesia appears to be a dose-related adverse event occurring in 5%, 7%, and 9% of patients receiving 1 mg, 2.5 mg, and 5 mg, respectively.^[Ref]

Other

Common (1% to 10%): Warm/cold sensation, heaviness other than chest or neck, pressure/tightness/heaviness, vertigo, asthenia, chills

Uncommon (0.1% to 1%): Tinnitus, hyperacusis, ear pain^[Ref]

Gastrointestinal

Common (1% to 10%): Nausea, dry mouth, dysphagia, dyspepsia, abdominal pain, vomiting

Uncommon (0.1% to 1%): Gastroenteritis, increased thirst

Rare (less than 0.1%): Stomatitis, constipation, hematemesis, pancreatitis, melena, ulcer

Very rare (less than 0.01%): Bloody diarrhea, gastrointestinal infarction or necrosis, gastrointestinal ischemic events, ischemic colitis, splenic infarction^[Ref]

General

The most common adverse reactions included neck, throat, jaw pain; dizziness; paresthesia; asthenia; somnolence; warm and cold sensation; nausea; heaviness sensation; and dry mouth. In adolescents treated with the nasal spray, the more commonly reported adverse reactions included dysgeusia, nasal discomfort, dizziness, oropharyngeal pain, and nausea.^[Ref]

Hematologic

Uncommon (0.1% to 1%): ecchymosis

Rare (less than 0.1%): Thrombocytopenia, eosinophilia, leucopenia^[Ref]

Metabolic

Uncommon (0.1% to 1%): Increased appetite, thirst

Rare (less than 0.1%): Anorexia, hyperglycemia^[Ref]

Musculoskeletal

Common (1% to 10%): Arthralgia, myalgia, muscle weakness

Uncommon (0.1% to 1%): Back pain, leg cramps, tenosynovitis

Rare (less than 0.1%): Arthritis, tetanus, twitching^[Ref]

Respiratory

Common (1% to 10%): Disorder/discomfort of nasal cavity, throat pain, throat tightness, oropharyngeal pain

Uncommon (0.1% to 1%): Pharyngitis, rhinitis, dyspnea, sinusitis, bronchitis, increased cough, epistaxis, laryngeal edema, hiccup, laryngitis, yawn

Rare (less than 0.1%): Apnea, voice alteration^[Ref]

Hypersensitivity

Uncommon (0.1% to 1%): Allergic reactions

Postmarketing reports: Hypersensitivity reactions including angioedema, anaphylactic reactions and anaphylactic shock^[Ref]

Ocular

Rare (less than 0.1%): Diplopia, dry eyes, lacrimation, conjunctivitis, eye pain, visual field defect^[Ref]

Genitourinary

Uncommon (0.1% to 1%): Polyuria, urinary urgency, cystitis, hematuria

Rare (less than 0.1%): Urinary frequency, miscarriage, dysmenorrhea^[Ref]

Dermatologic

Common (1% to 10%): Sweating, facial edema

Uncommon (0.1% to 1%): Urticaria, pruritus, rash, photosensitivity reaction

Rare (less than 0.1%): Angioedema^[Ref]

Local

Common (1% to 10%): Local irritation or soreness at the site of administration of nasal spray

In clinical trials using the nasal spray approximately 3% (n=460) patients reported local irritation or soreness at the site of administration. Effects were severe in about 1% of patients and approximately 57% resolved in 1 hour. Nasopharyngeal examinations of a subset of patients failed to demonstrate any clinically significant changes with repeated use of the nasal spray.