Zolmitriptan

From Drugs Prescribing Information
Jump to: navigation, search

Zolmitriptan (Brand names: Zomig, Zomigon, Zomigoro, among others) belongs to a group of medicines called triptans.

Zolmitriptan is used to treat migraine headache. Migraine symptoms may be caused by the widening of blood vessels in the head.

Zolmitriptan is thought to reduce the widening of these blood vessels. This helps to take away the headache and other symptoms of a migraine attack, such as feeling or being sick (nausea or vomiting) and being sensitive to light and sound.

Zolmitriptan works only when a migraine attack has started. It is not indicated for the prophylactic therapy of migraine

Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Zolmitriptan.jpg

[edit] MECHANISM OF ACTION

Theories on the etiology of migraine headache suggest that symptoms are due to local cranial vasodilatation and/or to the release of vasoactive and pro-inflammatory peptides from sensory nerve endings in an activated trigeminal system.

Zolmitriptan bind with high affinity to two serotonin (5-HT) subtypes, the 5HT1B and 5HT1D. The agonist effects of Zolmitriptan on these receptors results in extracerebral intracranial blood vessels constriction and in the inhibition of pro-inflammatory neuropeptide release from nerve endings.

[edit] INDICATIONS

  • Acute treatment of migraine attacks with or without aura in Adults. Zolmitriptan is intended to relieve of migraine not to prevent or reduce the number of attacks

[edit] DOSAGE

  • Adults: 2.5 mg as early as possible after the onset of migraine, may repeat dose after 2 hours if needed. Maximum daily dose 10 mg

[edit] CONTRAINDICATIONS

  • Ischemic heart disease, coronary artery vasospasm, or other significant underlying cardiovascular disease (Triptans may cause coronary artery vasospasm)
  • Cerebrovascular syndromes (e.g. history of stroke or transient ischaemic attack)
  • Peripheral Vascular Disease (including ischemic bowel disease)
  • Uncontrolled hypertension
  • Concomitant administration within 24 hours of an ergotamine derivative or another triptan.

[edit] WARNINGS AND PRECAUTIONS

  • Perform cardiac evaluation in patients with multiple cardiovascular risk factors (e.g., hypertension, hypercholesterolemia, smoker, obesity, diabetes, strong family history of coronary artery disease (CAD), female with surgical or physiological menopause, male over 40 years of age).
  • In case of chest discomfort, including pain, pressure, heaviness and tightness following Zolmitriptan administration, patients should be evaluated for the presence of Coronary artery disease (CAD) or a predisposition to Prinzmetal variant angina before receiving additional doses.
  • Arrhythmias: Discontinue Zolmitriptan if occurs
  • Cerebral hemorrhage, subarachnoid hemorrhage, and stroke: Discontinue Zolmitriptan if occurs
  • Medication overuse headache: Overuse of acute migraine drugs for 10 or more days per month may lead to exacerbation of headache. Medication overuse headache may present as migraine-like daily headaches or as a marked increase in frequency of migraine attacks. Detoxification of patients, including withdrawal of the overused drugs, and treatment of withdrawal symptoms (which often include a transient worsening of headache) may be necessary.

[edit] INTERACTIONS

  • Increased Effect: Ergot-containing products may lead to vasospasm. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine) and zolmitriptan within 24 hours of each other should be avoided
  • Propranolol, oral contraceptives and MAO-A inhibitors increase level of Zolmitriptan.
  • Concurrent use with Selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, fluvoxamine, paroxetine, sertraline) could lead to serotonin syndrome

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US)
  • It is not known whether Zolmitriptan is carried in human milk. Use with caution in nursing mothers

[edit] SIDE EFFECTS

Most common side effects include neck/throat/jaw/pain/tightness/pressure, dizziness, paresthesia, asthenia, drowsiness, warm/cold sensation, nausea, palpitations, heaviness sensation, and dry mouth.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES

Antimigraine preparations
5 HT1 agonists (Triptans) Almotriptan (Almogran, Axert)   Eletriptan (Relpax)   Frovatriptan (Frova, Migard, Menatriptan)   Rizatriptan (Maxalt)   Sumatriptan (Imigran)   Zolmitriptan (Zomig)
Ergot alkaloids Dihydroergotamine   Ergotamine
NSAIDs/ Analgesics Indometacin   Acetylsalicylic acid (Aspirin)   Diclofenac (Voltaren)   Ibuprofen (Advil, Brufen, Dolgit, Nurofen)   Ketorolac (Toradol)   Naproxen (Naprosyn, Aleve)   Nimesulide   Paracetamol (Efferalgan, Panadol...)
Prophylaxis Cinnarizine (Stugeron, Stugeron forte)   Flunarizine (Sibelium)   Nifedipine (Adalat)   Pizotifen   Propranolol (Inderal)   Topiramate (Topamax)