Buy Zomig
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What is the other name for Zomig?
Zomig may be marketed under different names in various countries. Some of them are the following: Zolmist.
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(British Approved Name, US Adopted Name, rINN)
What Is Zomig (Zolmitriptan)?
Zomig, or Zolmitriptan, is a medication commonly prescribed for the treatment of migraines. It belongs to the class of drugs known as triptans, which work by narrowing blood vessels in the brain and inhibiting the release of substances that cause migraine symptoms. Zomig is available in various forms, including tablets and nasal spray, offering flexibility for patients with different preferences or needs during a migraine attack. It is designed to relieve the acute symptoms of migraines and is not meant for preventive use. As with any medication, it’s crucial to use Zomig under the guidance of a healthcare professional, taking into consideration individual health factors and potential interactions with other drugs. Regular check-ins with a healthcare provider are advisable for those using Zomig to manage migraines.
Pharmacokinetics
The absolute bioavailability of zolmitriptan after oral and intranasal doses is about 40%, and peak plasma concentrations are achieved in about 1.5 to 3 hours after oral doses, depending on the formulation, and in about 3 hours with the intranasal spray. Plasma protein binding is about 25%. Zolmitriptan undergoes hepatic metabolism, principally to the indole acetic acid and N-oxide and N-desmethyl analogs. The N-desmethyl metabolite (183C91) was more active than the parent compound in animal studies and would be expected to contribute to the therapeutic effect of zolmitriptan.
The primary metabolism of zolmitriptan is mediated mainly by the cytochrome P450 isoenzyme CYP1A2, while monoamine oxidase type A is responsible for the further metabolism of the N-desmethyl metabolite. Over 60% of a dose is excreted in the urine, mainly as the indole acetic acid, and about 30% appears in the feces, mainly as an unchanged drug. The elimination half-life is 2.5 to 3 hours and is prolonged in patients with liver disease. Distribution into milk has been found in studies in rats.
Clinical Studies
Synthesizing the results of three previous studies, researchers from the Headache Care Center in Springfield, Missouri, concluded that one 2.5 mg dose of zolmitriptan (Zomig) may provide long-term relief from migraines.
The findings, presented at the Diamond Headache Clinic’s Headache Update ’99, analyze the compiled data of three different studies. Each study compared group participants who took either zolmitriptan (Zomig) or a placebo, though no one knew which pill they were taking.
The studies show that migraines most often occur between six and seven in the morning when people are getting ready for work and school. Taking the medication between 6 and 9 a.m. provided headache relief for an average of 23 hours for those who responded to the medication. Participants who responded to the placebo had an average relief time lasting only eight hours.
Approximately 60 percent of those taking a single dose (2.5 mg) of zolmitriptan had a positive response within two hours of taking the drug. In contrast, only 22 to 39 percent of the people taking the placebo responded positively in that period.
The researchers concluded that zolmitriptan (Zomig) does provide long-acting, reliable relief for migraines, despite the time of day the headache occurs.
The manufacturer suggests that the medication is appropriate to treat acute migraines in adults, either with or without an aura. It’s not recommended if you have hypertension, ischemic heart disease, or another significant type of heart condition.
Side effects include feelings of pain, pressure, and heaviness or tightness in various parts of the body, including the chest. Adverse effects during clinical trials ranged from mild to moderate, with the most prevalent being asthenia (weakness), dizziness, and nausea.
Uses and Administration
Zolmitriptan is a selective serotonin (5-HT1) agonist with actions and uses similar to those of sumatriptan. It is used for the acute treatment of migraine attacks. Zolmitriptan should not be used for disease prevention.
The recommended dose in the UK is 2.5 mg orally. A clinical response can be expected within 1 hour. If symptoms persist or return within 24 hours, a second dose may be taken not less than 2 hours after the first dose. If a patient does not achieve satisfactory relief with a dose of 2.5 mg, subsequent attacks may be treated with doses of 5 mg. The maximum dose of zolmitriptan in 24 hours is 10 mg. Recommended doses in the USA are somewhat lower; the dose is 1.25 or 2.5 mg with a maximum dose of 10 mg in 24 hours. When used intranasally, a clinical response can be expected in 15 minutes. The usual dose is 5 mg, a single dose into one nostril. If symptoms persist or return within 24 hours, a second dose may be given after at least 2 hours, up to a maximum of 10 mg daily.
Dose reductions are recommended in patients taking certain other drugs. The maximum dose of zolmitriptan in 24 hours should be 5 mg in those receiving cimetidine or an inhibitor of monoamine oxidase type A (although use with monoamine oxidase type A inhibitors is contra-indicated in the USA). A similar reduction is also recommended in those taking drugs, such as fluvoxamine and ciprofloxacin, that inhibit the cytochrome P450 isoenzyme CYP1A2. For dosage in hepatic or renal impairment, see below.
Administration in Hepatic Impairment
A study has indicated that while there is no need to reduce the size of the initial dose of zolmitriptan in patients with moderate or severe hepatic impairment, accumulation may occur with repeated doses in patients with severe impairment, and their total daily dosage should be reduced.
A maximum oral dose of 5 mg in 24 hours is recommended by licensed product information in the UK in patients with moderate to severe impairment. A dose of less than 2.5 mg is recommended in the USA.
Administration in Renal Impairment
Although renal clearance of zolmitriptan and its metabolites was reduced in patients with moderate to severe impairment, the effect was unlikely to be of clinical importance and adjustment of zolmitriptan dosage in patients with renal impairment was considered unnecessary.
Migraine and Cluster Headache
For a comparison of the relative benefits of different triptans in migraine, see under sumatriptan.
Adverse Effects and Precautions
As for Sumatriptan.
Zolmitriptan should also be avoided in patients with Wolff-Parkinson-White syndrome or arrhythmias associated with accessory cardiac conduction pathways. It should be given with caution in patients with moderate to severe hepatic impairment.
Ischaemia
A spinal cord lesion related to the use of zolmitriptan has been reported in a 50-year-old woman; clinical features suggested that the lesion was an ischaemic infarct.
Medication-overuse Headache
For a report of an association between zolmitriptan and medication-overuse headache, see under Adverse Effects of Sumatriptan.
Interactions
As for Sumatriptan.
It is recommended that the maximum dose of zolmitriptan in 24 hours should be reduced in patients receiving cimetidine (see Uses and Administration section). A similar reduction in zolmitriptan dosage is anticipated if it is given with drugs, such as fluvoxamine and ciprofloxacin, that inhibit the cytochrome P450 isoenzyme CYP1A2. Opinion varies on using zolmitriptan with monoamine oxidase type A inhibitors such as moclobemide. In the UK, licensed product information recommends that the maximum dose of zolmitriptan should be reduced when used with inhibitors of monoamine oxidase type A (see Uses and Administration section). In contrast, in the USA, such combinations are contraindicated.
Beta-blockers
Propranolol increased plasma-zolmitriptan concentrations in a study of 12 healthy subjects, but the changes were not considered clinically significant enough to warrant dosage adjustment during concomitant use.
Drug Nomenclature
International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish):
Synonyms: 311C90; Tsolmitriptaani; Zolmitriptán; Zolmitriptan; Zolmitriptanum
BAN: Zolmitriptan
USAN: Zolmitriptan
INN: Zolmitriptan [rINN (en)]
INN: Zolmitriptán [rINN (es)]
INN: Zolmitriptan [rINN (fr)]
INN: Zolmitriptanum [rINN (la)]
INN: Золмитриптан [rINN (ru)]
Chemical name: (S)-4-{3-[2-(Dimethylamino)ethyl]indol-5-ylmethyl}-1,3-oxazolidin-2-one
Molecular formula: C16H21N3O2 =287.4
CAS: 139264-17-8
ATC code: N02CC03
Read code: y0ADe
Single-ingredient Preparations
Argentina: Zomigon;
Australia: Zomig;
Austria: Zomig;
Belgium: Zomig;
Brazil: Zomig;
Canada: Zomig;
Czech Republic: Zomig;
Denmark: Zomig;
Finland: Zomig;
France: Zomig; Zomigoro;
Germany: AscoTop;
Greece: Zomigon;
Hong Kong: Zomig;
Hungary: Zomig;
Ireland: Zomig;
Israel: Zomig;
Italy: Zomig;
Mexico: Zomig;
Netherlands: Zomig;
Norway: Zomig;
Portugal: Zomig;
Russia: Zomig (Зомиг);
South Africa: Zomig;
Singapore: Zomig;
Spain: Flezol; Zomig;
Sweden: Zomig;
Switzerland: Zomig;
Thailand: Zomig;
United Kingdom: Zomig;
United States: Zomig;
Venezuela: Zomig
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.