zolmitriptan

Zolmitriptan is a prescription medication used for the acute treatment of migraine with or without aura. It is a selective agonist of the serotonin 5-HT1B/1D receptors, which leads to constriction of cranial blood vessels and inhibition of pro-inflammatory neuropeptide release, helping to reduce migraine pain and related symptoms.

The drug is available in several forms, including oral tablets (commonly 2.5 mg and 5 mg), an orally disintegrating tablet (ODT) of 2.5 mg or 5 mg, and an intranasal spray (5 mg per spray). Dosing is typically 2.5–5 mg per dose as needed, with a second dose allowed after at least 2 hours if symptoms persist; the maximum daily dose is generally 10 mg.

Contraindications include ischemic heart disease, history of myocardial infarction or stroke, transient ischemic attack, or certain cardiovascular conditions; severe hepatic impairment; concurrent use with ergot-containing drugs or monoamine oxidase inhibitors; and use during pregnancy should be discussed with a clinician. Caution is advised in patients with cardiovascular risk factors, elderly patients, and those using other serotonergic medications due to the risk of serotonin syndrome.

Common side effects include dizziness, fatigue, drowsiness, nausea, dry mouth, and somewhat less frequently, chest sensation or tightness. Serious risks, though rare, include cardiovascular events (heart attack or stroke) and serotonin syndrome, particularly when combined with other serotonergic drugs.

Pharmacokinetically, zolmitriptan is absorbed relatively quickly, with onset of relief typically within 1–3 hours depending on formulation; the elimination half-life is about 3 hours. It is primarily metabolized in the liver (notably via CYP1A2 and CYP3A4) and excreted renally. Brand names include Zomig and Zomig ZMT (ODT); Zomig NS denotes the nasal form.