Zolmitriptan Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Feb 25, 2025.

Applies to zolmitriptan: oral tablet, oral tablet disintegrating.

Other dosage forms:

• nasal spray

Precautions

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Do not take this medicine if you have used other triptan or ergot-type migraine medicines within the past 24 hours. Some examples of triptan medicines are almotriptan (Axert™), eletriptan (Relpax®), frovatriptan (Frova®), naratriptan (Amerge®), or sumatriptan (Imitrex®, Treximet®). Some examples of ergot-type medicines are dihydroergotamine (D.H.E. 45®, Migranal®), ergotamine (Bellergal®, Cafergot®, Ergomar®, Wigraine®), and methysergide (Sansert®). Do not take this medicine within 2 weeks after taking an MAO inhibitor, such as phenelzine, tranylcypromine, Nardil®, or Parnate®.

Check with your doctor if you used this medicine and your migraine did not go away, or if your migraine got worse or started occurring more often.

This medicine may increase your risk of having abnormal heart rhythm, heart attack, angina, or stroke. This is more likely to occur if you or a family member already has heart disease, if you have diabetes, high blood pressure, or if you smoke. Call your doctor right away if you have any symptoms of a heart problem, such as chest pain or discomfort, an uneven heartbeat, nausea or vomiting, pain or discomfort in the shoulders, arms, jaw, back, or neck, shortness of breath, or sweating. Call your doctor right away if you have any symptoms of a stroke, such as confusion, difficulty with speaking, double vision, headaches, an inability to move the arms, legs, or facial muscles, an inability to speak, or slow speech.

Check with your doctor right away if you have chest discomfort, jaw or neck tightness after taking this medicine. Also, tell your doctor if you have sudden or severe abdominal or stomach pain or bloody diarrhea after using this medicine.

Check with your doctor right away if you have blurred vision, difficulty with reading, or any other change in vision while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Using zolmitriptan alone or in combination with other migraine medicines for 10 or more days per month may lead to worsening of headache. You may keep a headache diary to record the headache frequency and drug use.

Make sure your doctor knows about all the other medicines you are using. Zolmitriptan may cause a serious condition called serotonin syndrome when taken with some medicines. This includes medicines to treat depression, such as citalopram (Celexa®), duloxetine (Cymbalta®), escitalopram (Lexapro®), fluoxetine (Prozac®, Sarafem®, Symbyax®), fluvoxamine (Luvox®), olanzapine (Zyprexa®), paroxetine (Paxil®), sertraline (Zoloft®), or venlafaxine (Effexor®). Check with your doctor right away if you have agitation, confusion, diarrhea, excitement while talking that is not normal, fever, overactive reflexes, poor coordination, restlessness, shivering, sweating, trembling or shaking that you cannot control, or twitching. These could be symptoms of serotonin syndrome.

Some people feel drowsy or dizzy during or after a migraine, or after taking zolmitriptan to relieve a migraine. As long as you are feeling drowsy or dizzy, do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.

Drinking alcoholic beverages can make headaches worse or cause new headaches to occur. People who suffer from severe headaches should probably avoid alcoholic beverages, especially during a headache.

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:

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:

For healthcare professionals

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

General adverse events

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]

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]

Cardiovascular

• 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]

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]

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.

See also:

Frequently asked questions

• How long does Zomig take to work?

Further information

Zolmitriptan side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer