TM Owner Amneal Pharmaceuticals (US); Grunenthal (UK)
Zomig 5mg Tablet
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Indications & Clinical Uses
- Zomig 5mg tablets contain zolmitriptan, a triptan (selective 5-HT1B/1D serotonin receptor agonist) taken by mouth for the acute treatment of migraine with or without aura in adults.
- In the US the label covers adults only; the UK product information (Grunenthal) says the same use but notes that it is not recommended for children under 12 years and has not been shown to work in adolescents aged 12 to 17.
- It is for treating an attack that has started, not for preventing migraine, and not for hemiplegic or basilar migraine.
- Zomig also comes as an orally disintegrating tablet (Zomig-ZMT) and as a nasal spray; the tablet, ZMT and nasal forms are different products, and the 2.5 mg and 5 mg strengths differ, so take only the form and strength you were prescribed.
- The usual starting dose is 2.5 mg, and 5 mg is the higher strength.
Side Effects
- Common side effects include neck, throat or jaw pain or tightness, dizziness, tingling or numbness (paraesthesia), weakness, sleepiness, sensations of warmth or cold, nausea, heaviness and dry mouth; US trial rates for individual effects were about 2 to 10 per 100 people, and chest tightness was also reported.
- Serious reactions need urgent help: chest pain or tightness that does not pass, fast or irregular heartbeat, sudden weakness on one side, trouble speaking, severe stomach pain, and signs of serotonin syndrome (agitation, sweating, fever, tremor, diarrhoea).
- Blood pressure can rise.
- Using acute migraine medicines too often can cause medication overuse headache.
- The label has no boxed warning.
- Stop treatment and seek medical help if you have chest pain, symptoms of stroke or an allergic reaction.
Precautions & Warnings
- Zolmitriptan must not be used if you have ischaemic heart disease, coronary vasospasm, a history of stroke or transient ischaemic attack (TIA), hemiplegic or basilar migraine, peripheral vascular disease, ischaemic bowel disease or uncontrolled high blood pressure, or if you have taken another triptan or an ergot-type medicine within 24 hours or a monoamine oxidase-A (MAO-A) inhibitor within 2 weeks.
- Heart and blood vessel risk factors should be assessed before the first dose, and myocardial ischaemia or infarction, arrhythmias, cerebrovascular events, high blood pressure and serotonin syndrome are labelled warnings.
- Do not take more than 10 mg in 24 hours, and repeat a dose only after 2 hours if symptoms return.
- Animal studies showed harm to the fetus, so use in pregnancy only if the benefit justifies the risk, and discuss it with your healthcare provider.
- Dizziness and sleepiness can occur, so take care when driving or using machines.
- Confirm the diagnosis of migraine with your prescriber before use.
Avoid Interactions
- Tell your healthcare provider about every medicine, herbal product and supplement you use.
- Medicines that increase the effect or toxicity: cimetidine, which roughly doubles zolmitriptan exposure so a lower maximum dose is used; fluvoxamine and quinolone antibiotics such as ciprofloxacin (CYP1A2 inhibitors, in the UK information); MAO-A inhibitors, contraindicated within 2 weeks; and serotonergic medicines such as SSRIs and SNRIs, which raise the risk of serotonin syndrome.
- Do not combine with another triptan or with an ergot medicine such as ergotamine within 24 hours.
- The sections reviewed list no foods to avoid.
- Also tell your prescriber if you use St John's wort or other supplements.
References
Frequently Asked Questions
Zomig (zolmitriptan) tablets treat an acute migraine attack, with or without aura, in adults. Take it once the headache starts; it does not prevent migraine. The 5 mg tablet is the higher strength, and the usual starting dose is 2.5 mg.
Swallow Zomig (zolmitriptan) tablets whole with water at the start of a migraine. If symptoms return, you may take another dose after at least 2 hours. Never take more than 10 mg in 24 hours. The tablet form is for adults; check the strength on your pack, because 2.5 mg is the usual starting dose.
Common Zomig side effects include neck, throat or jaw tightness, dizziness, tingling, weakness, sleepiness, warm or cold sensations, nausea and dry mouth. Get urgent help for chest pain, fast heartbeat, signs of stroke or serotonin syndrome such as agitation, sweating and tremor.
Avoid taking Zomig (zolmitriptan) with other triptans or ergot medicines within 24 hours, or with MAO-A inhibitors within 2 weeks. Take care with SSRIs and SNRIs (serotonin syndrome) and cimetidine, which needs a lower maximum dose. Do not use it with heart disease, stroke history or uncontrolled high blood pressure.
You can take up to 10 mg of Zomig (zolmitriptan) in any 24 hours, so no more than two 5 mg tablets. Wait at least 2 hours before a repeat dose. Using migraine medicines too often can cause medication overuse headache.
Animal studies with Zomig (zolmitriptan) showed harm to the fetus, so it should be used in pregnancy only if the benefit justifies the risk. Talk to your healthcare provider before taking it if you are pregnant, planning pregnancy or breastfeeding.

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