Zolmitriptan spray

What is this medicine?

Zolmitriptan is a headache medicine that narrows blood vessels around the brain. Zolmitriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Zolmitriptan is used to treat migraine headaches. Zolmitriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Zolmitriptan should not be used to treat a common tension headache, a headache that causes loss of movement on one side of your body, or any headache that seems to be different from your usual migraine headaches. Use this medication only if your condition has been confirmed by a doctor as migraine headaches.

Zolmitriptan may also be used for purposes not listed in this medication guide.

What should I tell my health care providers before I take this medicine?

You should not take this medication if you are allergic to zolmitriptan, or if you have:

• coronary heart disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;

• a history of heart disease, heart attack, or stroke, including "mini-stroke";

• severe or uncontrolled high blood pressure;

• ischemic bowel disease; or

• a headache that seems different from your usual migraine headaches.

Do not use zolmitriptan if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

To make sure you can safely take zolmitriptan, tell your doctor if you have any of these other conditions:

• liver disease;

• kidney disease;

• high blood pressure, a heart rhythm disorder; or

• coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

FDA pregnancy category C. It is not known whether zolmitriptan will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Zolmitriptan disintegrating tablets may contain phenylalanine. Talk to your doctor before using this form of zolmitriptan if you have phenylketonuria (PKU). It is not known whether zolmitriptan passes into breast milk or if it could harm a nursing baby. Do not take this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child younger than 18 years old.

How should I use this medicine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Overuse of migraine headache medicine can actually make your headaches worse.

Take zolmitriptan as soon as you notice headache symptoms, or after an attack has already begun.

Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to see if you have any serious side effects.

Take one zolmitriptan tablet whole with a full glass of water.

To take zolmitriptan orally disintegrating tablets (Zomig-ZMT):

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

• Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet two (2) hours after the first. Do not take more than 10 mg of zolmitriptan in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

Contact your doctor if you have more than four headaches in one month (30 days).

If you use zolmitriptan long-term, your doctor may want to check your heart function using an electrocardiograph or ECG (sometimes called an EKG), a machine that measures electrical activity of the heart. This will help your doctor determine if it is still safe for you to use this medication. Visit your doctor regularly.

What if I miss a dose?

Since zolmitriptan is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after taking zolmitriptan. After taking a zolmitriptan tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 10 mg of zolmitriptan in 24 hours.

What may interact with this medicine?

Tell your doctor about all other medicines you use, especially:

• cimetidine (Tagamet); or

• an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

This list is not complete and other drugs may interact with zolmitriptan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

What side effects may I notice from this medicine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using zolmitriptan and call your doctor at once if you have a serious side effect such as:

• feeling of pain or tightness in your jaw, neck, or throat;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• sudden numbness or weakness, especially on one side of the body;

• sudden severe headache, confusion, problems with vision, speech, or balance;

• fast or pounding heartbeats, dizziness;

• sudden and severe stomach pain and bloody diarrhea;

• numbness or tingling and a pale or blue-colored appearance in your fingers or toes; or

• (if you are also taking an antidepressant) -- agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Less serious side effects may include:

• pressure or heavy feeling in any part of your body;

• dry mouth, upset stomach;

• feeling of pain or pressure in your neck or throat;

• drowsiness, weakness; or

• warmth, redness, or mild tingling under your skin.

This is not a complete list of side effects and others may occur.

What should I watch for while using this medicine?

Do not take zolmitriptan within 24 hours before or after using another migraine headache medicine, including:

• zolmitriptan nasal spray, almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or sumatriptan (Imitrex, Treximet); or

• ergot medicine such as ergotamine (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or methylergonovine (Methergine).

Zolmitriptan may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Where should I keep this medicine?

Store at room temperature away from moisture and heat.