Uses of Zolmit: - Acute migraine headache Acute migraine attacks Patients at risk of coronary artery disease (post-menopausal women, men >40 yr, hypertension, hypercholesterolemia, smoking, obesity, DM, family history of coronary artery disease) unless evaluated. Wolff-Parkinson-White syndrome; arrhythmias associated with accessory cardiac conduction pathways; previous cerebrovascular accident; uncontrolled or severe hypertension; ischaemic heart disease, history of MI, coronary vasospasm, transient ischaemic attack. Basilar or hemiplegic migraine.

5-HT Agonists

Zolmitriptan is an antimigraine agent. It binds with high affinity to 5-HT1B/1D receptors. The therapeutic activity of Zolmitriptan for the treatment of migraine headache can most likely be attributed to the agonist effects at the 5-HT1B/1D receptors on intracranial blood vessels and sensory nerves of the trigeminal system which results in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release. Zolmitriptan is rapidly and well absorbed after oral administration.

How to use Zolmitriptan: Take this medicine in the dose and duration as advised by your doctor. Do not handle the strips/film with wet hands. Keep it in your mouth but do not swallow it. Zolmitriptan may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Acute migraine attacks Adult: Initially, 2.5 mg. A 2nd dose may be taken at least 2 hr after the 1st dose if symptoms recur within 24 hr. Max dose: 10 mg in 24 hr. Safety of treating > three headaches in a 30-day period has not been established. Hepatic impairment: Dose reduction may be needed with BP monitoring. Moderate to severe: Max dose: 5 mg/24 hr Renal Dose: After orally dosing zolmitriptan, renal clearance was Reduced by 25% in patients with severe renal impairment (Clcr ?5 ?25mL/min) compared to the normal group (Clcr ?70 mL/min); No significant change in renal clearance was observed in the moderately renally impaired group (Clcr ?26 ?50 mL/min).

Increased risk of serotonin syndrome with SSRI, selective serotonin- and norepinephrine-reuptake inhibitors (SNRI). Increased zolmitriptan concentrations with cimetidine, quinolone antibacterials and drugs that inhibit the cytochrome P450 isoenzyme CYP1A2. Potentially Fatal: Increased risk of fatal serotonin syndrome with sibutramine. Increased risk of serotonin syndrome with MAOI and reversible inhibitors of monoamine oxidase type-A (RIMA); do not use zolmitriptan during and for 2 wk after the use of MAOI and RIMAs Do not use within 24 hr of treatment with another 5-HT1 agonist. Increased risk of additive vasoconstriction with ergot alkaloids; zolmitriptan should not be taken within 24 hr of any ergotamine or ergot-type medication.

Patients at risk of coronary artery disease (post-menopausal women, men >40 yr, hypertension, hypercholesterolemia, smoking, obesity, DM, family history of coronary artery disease) unless evaluated. Wolff-Parkinson-White syndrome; arrhythmias associated with accessory cardiac conduction pathways; previous cerebrovascular accident; uncontrolled or severe hypertension; ischaemic heart disease, history of MI, coronary vasospasm, transient ischaemic attack. Basilar or hemiplegic migraine.

Common - Dizziness - Dryness in mouth - Nausea - Heaviness - Flushing (sense of warmth in the face, ears, neck and trunk) - Tightness sensation - Feeling of cold - Drowsiness - Fatigue - Peripheral neuropathy (tingling and numbness of feet and hand) 1-10% Dizziness (6-10%),Neck/throat/jaw pain (4-10%),Parasthesia (5-9%),Nausea (4-9%),Weakness (3-9%),Somnolence (5-8%),Warm/cold sensation (5-7%),Xerostomia (3-5%),Chest pain (2-4%),Diaphoresis (3%),Pain (2-3%),Dyspepsia (1-3%),Dysphagia (2%),Myasthenia (2%),Palpation (2%),Vertigo (2%),Hypoesthesia (1-2%),Myalgia (1-2%) <1% QT prolongation,Bradycardia,Tachycardia,Thrombophlebitis,Postural hypotension,Hyperglycemia,Alk phos increased,Arthritis,Twitching,Myocardial infarction and artery vasospasm in patients with CAD risk factors Potentially Fatal: Cardiac arrhythmias, MI, subarachnoid haemorrhage.

Pregnancy: Zolmitriptan should be used in pregnancy only if the benefits to the mother justify potential risk to the foetus.Lactation: Studies have shown that Zolmitriptan passes into the milk of lactating animals. No data exist in lactating women. Therefore, caution should be exercised when administering Zolmitriptan to lactating women.

Precaution: Use only if there is a clear diagnosis of migraine; exclude other potentially serious neurological conditions. Monitor BP closely. May impair ability to drive or operate machinery. Pregnancy and lactation. Child. Moderate to severe hepatic impairment. Prior CV evaluation for patients with risk factors of coronary heart disease; admin of first dose under close supervision and ECG if satisfactory CV assessment in these patients. Periodic CV evaluation for patients with risk factors of coronary arteries on zolmitriptan. Avoid oral disintegrating formulation for patients with phenylketouria. Long term use may cause accumulation of zolmitriptan in melanin rich tissue (e.g. eye). Lactation: unknown, use caution

Keep out of the reach of children. Store at a cool and dry place. Protect from light and moisture.

Zolmitriptan is a selective agonist for serotonin (5HT1 receptors). It relieves migraine by selective constriction of intracranial blood vessels, neuropeptide release inhibition and decreased transmission in the trigeminal pain pathway.