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Zomig

Generic name: zolmitriptan (oral) [ ZOLE-mi-TRIP-tan ]
Brand names: Zomig, Zomig-ZMT
Drug class: Antimigraine agents

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 25, 2023.

What is Zomig?

Zomig 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.

Zomig is used to treat migraine headaches in adults.

Zomig will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Zomig 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.

Warnings

You should not use Zomig if you have uncontrolled high blood pressure, heart problems, certain heart rhythm disorders, a history of heart attack or stroke, or circulation problems that cause a lack of blood supply within the body.

Do not use Zomig if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Do not take Zomig within 24 hours before or after using another migraine headache medicine, including zolmitriptan nasal spray, 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).

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).

Zomig will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

After taking a Zomig tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 10 mg of zolmitriptan in 24 hours.

Before taking this medicine

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

Do not use Zomig if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure Zomig is safe for you, tell your doctor if you have:

Zomig disintegrating tablets may contain phenylalanine. Talk to your doctor before using this form of zolmitriptan if you have phenylketonuria (PKU).

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether zolmitriptan passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Zomig is not approved for use by anyone younger than 18 years old.

How should I take Zomig?

Take Zomig exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Use Zomig as soon as you notice migraine symptoms.

Take the regular tablet whole with a full glass of water.

To take the orally disintegrating tablet (Zomig-ZMT):

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet 2 hours after the first. Do not take more than 10 mg of zolmitriptan in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

Call your doctor if your headache does not go away at all after taking the first Zomig tablet.

Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse.

Contact your doctor if you have more than four headaches in one month (30 days). Tell your doctor if this medicine seems to stop working as well in treating your migraine attacks.

Zomig can raise blood pressure to dangerous levels. Your blood pressure may need to be checked often while you are using this medicine. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).

Store at room temperature away from moisture, heat, and light.

Dosing information

Usual Adult Dose for Migraine:

Oral:
-Initial dose: 1.25 or 2.5 mg orally once (may break the scored 2.5 mg tablet in half to obtain 1.25 mg dose); may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Orally Disintegrating Tablets:
-Initial dose: 2.5 mg orally once; may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Nasal Spray:
-Initial dose: 2.5 mg intranasally once; may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Comments:
-This drug should only be used after a clear diagnosis of migraine has been established; if a patient has no response for the first migraine attack, reconsider the diagnosis of migraine before treating any subsequent attacks.
-Do not break the oral disintegrating tablet, they are not scored.
-In trials, the majority of patients had headache response following a 2.5 mg or 5 mg dose compared with a 1 mg dose; little added benefit was observed with the 5 mg dose compared to the 2.5 mg dose, but adverse events were more frequent.
-The safety of treating an average of more than 4 headaches in a 30-day period has not been established.

Use: For the acute treatment of migraine with or without aura.

Usual Pediatric Dose for Migraine:

Age 12 years and older:

Nasal Spray:
-Initial dose: 2.5 mg intranasally once; may repeat in 2 hours if migraine has not resolved or returns after a transient improvement
-Maintenance Dose: Adjust dose based on individual response
Maximum single dose: 5 mg
Maximum daily dose: 10 mg in a 24-hour period

Comments:
-This drug should only be used after a clear diagnosis of migraine has been established; if a patient has no response to this drug for the first migraine attack, reconsider the diagnosis of migraine before treating any subsequent attacks.
-The safety of treating an average of more than 4 headaches in a 30-day period has not been established.

Use: For the acute treatment of migraine with or without aura.

What happens if I miss a dose?

Since Zomig is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using Zomig .

What happens if I overdose?

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

What to avoid

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

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

Zomig side effects

Get emergency medical help if you have signs of an allergic reaction to Zomig: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Zomig and call your doctor at once if you have:

Common Zomig side effects may include:

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.

What other drugs will affect Zomig?

Using Zomig while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:

This list is not complete. Other drugs may interact with zolmitriptan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Popular FAQ

If you’ve taken one Zomig or Zomig-ZMT tablet, or one Zomig nasal spray for your migraine and still need more relief after 2 hours, you can take a second dose. Do not exceed 5 mg per single dose and a total dose of 10 mg in any 24-hour period. Continue reading

Zomig starts to work quickly, and most people who respond with a single dose will have responded within 1 hour. Some people may take up to 2 hours to experience a decrease in their headache pain. Continue reading

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zomig only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.