Medical Editor: John P. Cunha, DO, FACOEP
Zolmitriptan is a serotonin (5-HT)1B/1D receptor agonist (triptan) indicated for the acute treatment of migraine with or without aura in adults. Zolmitriptan is available in generic form. Common side effects of zolmitriptan include:
- neck/throat/tightness/pressure/jaw pain,
- numbness and tingling,
- warm or cold sensation,
- heaviness sensation,
- dry mouth,
- difficulty swallowing,
- spinning sensation (vertigo), and
The recommended starting dose of zolmitriptan is 1.25 mg or 2.5 mg. Zolmitriptan may interact with ergot-containing or ergot-type drugs, MAO-A inhibitors, 5-HT1B/1D agonists (including triptans), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and cimetidine. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant before using zolmitriptan; it is unknown how it will affect a fetus. It is unknown if zolmitriptan passes into breast milk. Because of the possibility of unwanted effects on a nursing infant, breastfeeding while using zolmitriptan is not recommended.
Our Zolmitriptan Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
The following adverse reactions are described elsewhere in other sections of the prescribing information:
- Myocardial Ischemia, Myocardial Infarction, and Prinzmetal's Angina [see WARNINGS AND PRECAUTIONS].
- Arrthymias [see WARNINGS AND PRECAUTIONS].
- Chest and or Throat, Neck and Jaw Pain/Tightness/Pressure [see WARNINGS AND PRECAUTIONS].
- Cerebrovascular Events [see WARNINGS AND PRECAUTIONS].
- Other Vasospasm Reactions [see WARNINGS AND PRECAUTIONS].
- Medication Overuse Headache [see WARNINGS AND PRECAUTIONS].
- Serotonin Syndrome [see WARNINGS AND PRECAUTIONS].
- Increase in Blood Pressure [see WARNINGS AND PRECAUTIONS].
Clinical Trials Experience
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.
In a long-term, open-label study where patients were allowed to treat multiple migraine attacks for up to 1 year, 8% (167 out of 2,058) withdrew from the trial because of adverse reaction.
The most common adverse reactions ( ≥ 5% and > placebo) in these trials were neck/throat/jaw pain, dizziness, paresthesia, asthenia, somnolence, warm/cold sensation, nausea, heaviness sensation, and dry mouth.
Table 1 lists the adverse reactions that occurred in ≥ 2% of the 2,074 patients in any one of the zolmitriptan tablets 1 mg, 2.5 mg, or 5 mg dose groups in the controlled clinical trials of zolmitriptan tablets in patients with migraines (Studies 1, 2, 3, 4, and 5) [see Clinical Studies]. Only adverse reactions that were at least 2% more frequent in a zolmitriptan tablets group compared to the placebo group are included.
Several of the adverse reactions appear dose related, notably paresthesia, sensation of heaviness or tightness in chest, neck, jaw, and throat, dizziness, somnolence and possibly asthenia and nausea.
Table 1: Adverse Reaction Incidence in Five Pooled
Placebo-Controlled Migraine Clinical Trials1
|Zolmitriptan tablets 1 mg
|Zolmitriptan tablets 2.5 mg
|Zolmitriptan tablets 5 mg
|Paresthesia (all types)||2%||5%||7%||9%|
|PAIN AND PRESSURE SENSATIONS||7%||13%||14%||22%|
|Chest - pain/ tightness/ pressure and/or heaviness||1%||2%||3%||4%|
|Neck/throat/jaw -pain/ tightness/ pressure||3%||4%||7%||10%|
|Heaviness other than chest or neck||1%||1%||2%||5%|
|Other-Pressure/ tightness/ heaviness||0||2%||2%||2%|
|1Only adverse reactions that were at least 2% more frequent in a zolmitriptan tablets group compared to the placebo group are included.|
There were no differences in the incidence of adverse reactions in controlled clinical trials in the following subgroups: gender, weight, age, use of prophylactic medications, or presence of aura. There were insufficient data to assess the impact of race on the incidence of adverse reactions.
Less Common Adverse Reactions with Zolmitriptan Tablets
In the paragraphs that follow, the frequencies of less commonly reported adverse clinical reactions are presented. Because the reports include reactions observed in open and uncontrolled studies, the role of zolmitriptan tablets in their causation cannot be reliably determined. Furthermore, variability associated with adverse reaction reporting, the terminology used to describe adverse reactions, etc., limit the value of the quantitative frequency estimates provided. Adverse reaction frequencies were calculated as the number of patients who used zolmitriptan tablets and reported a reaction divided by the total number of patients exposed to zolmitriptan tablets (n=4,027). Reactions were further classified within body system categories and enumerated in order of decreasing frequency using the following definitions: infrequent adverse reactions (those occurring in 1/100 to 1/1,000 patients) and rare adverse reactions (those occurring in less than 1/1,000 patients).
General: Infrequent were allergic reactions.
Adverse Reactions with Zolmitriptan Orally Disintegrating Tablets
The adverse reaction profile seen with zolmitriptan orally disintegrating tablets was similar to that seen with zolmitriptan tablets.
The following adverse reactions were identified during post approval use of zolmitriptan tablets. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
The reactions enumerated include all except those already listed in the Clinical Trials Experience section above or the Warnings and Precautions section.
As with other 5-HT1B/1D agonists, there have been reports of anaphylaxis, anaphylactoid, and hypersensitivity reactions including angioedema in patients receiving zolmitriptan tablets. Zolmitriptan tablets are contraindicated in patients with a history of hypersensitivity reaction to zolmitriptan tablets.
Read the entire FDA prescribing information for Zolmitriptan Tablets Generic (zolmitriptan)