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zolmitriptan (Zomig)

Tradename: Zomig. Indications: migraine headache Contraindications: 1) ischemic heart disease 2) Prinzmetal's angina 3) concurrent use of MAO inhibitors [4] Dosage: 1) start 2.5 mg every 2 hours PRN 2) 1 spray (5 mg) 3) maximum 10 mg QD Tabs: 2.5 mg (yellow) & 5 mg (pink) (store at room temp; protect from light & moisture) Zomig ZMT: oral disintegrating tablets Nasal spray: 5 mg No dose adjustment for renal failure needed Pharmacokinetics: 1) well absorbed after oral administration 2) onset of action: [5] a) 15 minutes (nasal spray) b) 30 minutes (tablet) 3) peak concentration in serum (8 ng/mL) reached 2 hours after oral administration 4) metabolized in the liver to N-desmethyl derivative a) N-desmethyl derivative is 2-6 times as active as the parent compound b) 1/2 life of the N-desmethyl derivative is 3 hours Adverse effects: (similar to other triptans) 1) dizziness 2) asthenia 3) paresthesia 4) drowsiness 5) limb heaviness 6) nausea 7) throat or neck tightness/pressure 8) coronary vasoconstriction has been reported 9) frequent use may exacerbate migraines [3] 10) bad taste Mechanism of action: -> 5-HT 1B & 1D receptor agonist

Interactions

drug interactions drug adverse effects of triptan(s)

General

amine heterocyclic compound, 2 rings serotonin agonist (5-HT receptor agonist, triptan)

Properties

MISC-INFO: elimination route LIVER 1/2life 3 HOURS protein-binding 25%

Database Correlations

PUBCHEM correlations

References

  1. Physician's Desk Reference
  2. Micromedex
  3. Prescriber's Letter 9(1):2 2002
  4. Prescriber's Letter 10(3):14-15 2003
  5. Prescriber's Letter 10(11):61 2003
  6. Department of Veterans Affairs, VA National Formulary