zolmitriptan at a glance
Medicine class
Selective serotonin 5-HT1B/1D receptor agonist, commonly called a triptan.
Usual role
Acute treatment of migraine headache with or without aura; not migraine prevention.
What is zolmitriptan used for?
Selected products are licensed for acute migraine treatment, but licensing differs by formulation and age.
Acute migraine headache with or without aura.
The selected nasal spray is licensed for adults and adolescents aged 12 years and over.
Selected oral formulations are not recommended for people under 18 because efficacy has not been established.
Zolmitriptan is not licensed to prevent migraine attacks.
How does zolmitriptan work?
Zolmitriptan activates serotonin 5-HT1B and 5-HT1D receptors associated with cranial blood vessels and trigeminal nerve pathways. This reduces migraine-related vessel widening and pain-signal transmission, helping relieve headache and associated symptoms such as nausea and sensitivity to light or sound.
zolmitriptan preparations and strengths
Nasal preparation
Route: Nasal
Strengths: 5 mg
Dispersible tablet
Route: Oral
Strengths: 2.5 mg, 5 mg
Tablet
Route: Oral
Strengths: 2.5 mg, 5 mg
How to take zolmitriptan
Follow the instructions for the particular product supplied. Zolmitriptan is used during the headache phase of a migraine rather than as daily prevention.
Swallow film-coated tablets by mouth.
Place an orodispersible tablet on the tongue, allow it to dissolve and swallow it with saliva; water is not required.
Administer the nasal spray into one nostril. Each device is intended for one use.
Orodispersible tablets are convenient when water is unavailable, but they are still swallowed and absorption may be delayed.
Check the leaflet for product-specific handling instructions and do not use a damaged nasal device or blister.
zolmitriptan side effects
Common or expected effects
- Dizziness, sleepiness, warmth, tingling or altered sensation
- Nausea, vomiting, abdominal discomfort or dry mouth
- Muscle weakness, muscle pain or tiredness
- Palpitations
- Temporary heaviness, tightness, pain or pressure in the throat, neck, limbs or chest
- Taste disturbance, nosebleed or nasal discomfort with the nasal spray
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling or difficulty breathing
- Persistent or severe chest pain, coronary spasm, angina or heart attack symptoms
- Stroke-like symptoms such as new weakness, facial droop or speech difficulty
- Severe abdominal pain or bloody diarrhoea suggesting reduced intestinal blood flow
- Serotonin syndrome, with agitation or confusion, fever, sweating, tremor, muscle twitching or stiffness
zolmitriptan in pregnancy
Information for zolmitriptan is more limited than for sumatriptan, but current UK pregnancy information identifies no specific concern that other triptans cause harm. Zolmitriptan may be considered when a doctor judges it necessary; anyone pregnant, planning pregnancy or unexpectedly pregnant while using it should discuss treatment with their prescriber.
zolmitriptan while breastfeeding
A small study found low estimated infant exposure to zolmitriptan through breast milk, although evidence remains limited. Discuss its use with a prescriber or pharmacist, particularly for a premature, newborn or unwell infant, so the benefits of treatment and breastfeeding can be assessed together.
zolmitriptan interactions
Check all prescribed, pharmacy and herbal products before using zolmitriptan.
Ergotamine, ergot derivatives and other triptans
Do not use together because additive blood-vessel narrowing may increase cardiovascular risk.
SSRIs, SNRIs and serotonergic opioids such as buprenorphine
Common questions about zolmitriptan
Answers are fully visible for fast scanning and source review.
Does zolmitriptan prevent migraines?
No. It treats symptoms after a migraine attack has begun and is not licensed as preventive treatment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.