References

Zomig^® (zolmitriptan) Tablets and Zomig-ZMT^® (zolmitriptan) Orally Disintegrating Tablets Prescribing Information, AstraZeneca Pharmaceuticals LP, Wilmington, DE.
Dowson AJ, MacGregor EA, Purdy RA, Becker WJ, Green J, Levy SL. Zolmitriptan orally disintegrating tablet is effective in the acute treatment of migraine. Cephalalgia. 2002;22(2):101-106.
Spierings EL, Rapoport AM, Dodick DW, Charlesworth B. Acute treatment of migraine with zolmitriptan 5 mg orally disintegrating tablet. CNS Drugs. 2004;18(15):1133-1141.
Zomig^® (zolmitriptan) Nasal Spray Prescribing Information, AstraZeneca Pharmaceuticals LP, Wilmington, DE.
Charlesworth BR, Dowson AJ, Purdy A, Becker WJ, Boes-Hansen S, Färkkilä M. Speed of onset and efficacy of zolmitriptan nasal spray in the acute treatment of migraine: a randomised, double-blind, placebo-controlled, dose-ranging study versus zolmitriptan tablet. CNS Drugs. 2003;17(9):653-667.
Data on file, eSTaR#302139.
Data on file, eSTaR#302140.
Rapoport AM, Ramadan NM, Adelman JU, et al. Optimizing the dose of zolmitriptan (ZOMIG, 311C90) for the acute treatment of migraine. A multicenter, double-blind, placebo-controlled, dose range–finding study. Neurology. 1997;49(5):1210-1218.
Solomon GD, Cady RK, Klapper JA, Earl NL, Saper JR, Ramadan NM. Clinical efficacy and tolerability of 2.5 mg zolmitriptan for the acute treatment of migraine. Neurology. 1997;49(5):1219-1225.
Visser WH, Klein KB, Cox RC, Jones D, Ferrari MD. 311C90, a new central and peripherally acting 5-HT1D receptor agonist in the acute oral treatment of migraine: a double-blind, placebo-controlled, dose-range finding study. Neurology. 1996;46(2):522-526.
Geraud G, Olesen J, Pffafenrath V, et al. Comparison of the efficacy of zolmitriptan and sumatriptan: issues in migraine trial design. Cephalalgia. 2000;20(1):30-38.
Dahlof C, Diener HC, Goadsby PJ, et al. Zolmitriptan, a 5-HT1B/1D receptor agonist for the acute oral treatment of migraine: a multicentre, dose-range finding study. Eur J Neurol. 1998;5(6):535-543.
Levy D, Strassman AM, Burstein R. A critical view on the role of migraine triggers in the genesis of migraine pain. Headache. 2009;49(6):953-957.

Important Safety Information and Indication

Important Safety Information

Zomig is contraindicated in patients with
- History of coronary artery disease (CAD) or coronary artery vasospasm
- Symptomatic Wolff-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack, or hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent (within 24 hours) use of another 5-HT₁ agonist (eg, another triptan), or an ergotamine-containing medication
- Monamine oxidase (MAO)-A inhibitor used in past 2 weeks
- Known hypersensitivity to ZOMIG, ZOMIG-ZMT, or ZOMIG Nasal Spray
Myocardial ischemia, myocardial infarction and Prinzmetal Angina: Perform cardiac evaluation in patients with multiple risk factors and, if satisfactory, administer first dose of ZOMIG in a medically supervised setting
Arrhythmias: Discontinue ZOMIG if these occur
Sensations of tightness, pain and pressure in the chest, throat, neck, and jaw commonly occur after treatment with 5-HT₁ agonists like ZOMIG, and is usually non-cardiac in origin: Perform a cardiac evaluation if these patients are at cardiac risk
Cerebrovascular events, some fatal; non-coronary Gastrointestinal Ischemic Reactions and Peripheral Vasospastic Reactions; and increases in blood pressure (which have been very rarely associated with serious clinical events) have been reported with ZOMIG. Discontinue use of ZOMIG if any of these events occur
Overuse of acute migraine drugs may lead to exacerbation headache (medication overuse headache). Detoxification of patients, including withdrawal of the overused drugs, and treatment of withdrawal symptoms may be necessary
Serotonin syndrome may occur with triptans, including ZOMIG, particularly during co-administration with selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and MAO inhibitors. Discontinue ZOMIG if serotonin syndrome is suspected
Phenylketonuric patients should be informed that Zomig-ZMT^® (zolmitriptan) Orally Disintegrating Tablets contain phenylalanine
The most common adverse reactions (≥5% and > placebo) for Zomig Tablets and Zomig-ZMT Orally Disintegrating Tablets were neck/throat/jaw pain, dizziness, paresthesia; asthenia; somnolence; warm/cold sensation; nausea; heaviness sensation; and dry mouth
The most common adverse reactions (≥5% and > placebo; in any dosage strength) in clinical trials for Zomig Nasal Spray were: unusual taste, paresthesia, hyperesthesia, and dizziness

Indication

Zomig is indicated for the acute treatment of migraine with or without aura in adults. Only use ZOMIG if a clear diagnosis of migraine has been established. If a patient has no response to ZOMIG treatment for the first migraine attack, reconsider the diagnosis of migraine before ZOMIG is administered to treat any subsequent attacks. ZOMIG is not indicated for the prevention of migraine attacks. Safety and effectiveness of ZOMIG have not been established for cluster headache.

Please click here for full Prescribing Information for Zomig Tablets and Zomig-ZMT Orally Disintegrating Tablets.

Please click here for full Prescribing Information for Zomig Nasal Spray.

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