TM Owner AstraZeneca
Zomig ZMT 5mg Orally Disintegrating Tablet
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Indications & Clinical Uses
- Zomig ZMT 5mg orally disintegrating tablets contain zolmitriptan, a triptan (5-HT1B/1D receptor agonist), for the acute treatment of migraine with or without aura in adults.
- The tablet is placed on the tongue, where it dissolves with saliva and is swallowed, so no water is needed.
- It treats an attack that has started; it is not for preventing migraine or for hemiplegic or basilar migraine.
- The only ZMT-specific label found was an earlier US DailyMed label that named AstraZeneca and covers Zomig tablets and Zomig-ZMT together, so current US marketing status of the ZMT form was not confirmed.
- Do not confuse Zomig ZMT with Zomig conventional tablets or Zomig Nasal: they are different forms, and the 2.5 mg and 5 mg strengths differ, with 2.5 mg being the usual starting dose.
- Each 5 mg ZMT tablet contains 5.62 mg phenylalanine, which matters for people with phenylketonuria.
Side Effects
- Common side effects on the 2.5 mg ZMT dose in the label included nausea (about 9 in 100 people), dizziness (8), tingling or numbness (7) and neck, throat or jaw pain or tightness (7); weakness, sleepiness and a warm or cold sensation were also common with zolmitriptan.
- Serious problems needing urgent help include chest pain or tightness that does not go away, fast or irregular heartbeat, sudden weakness on one side or trouble speaking (stroke), a rise in blood pressure, and serotonin syndrome (agitation, sweating, fever, tremor, diarrhoea).
- Using migraine medicines too often can cause medication overuse headache.
- The labels reviewed carry no boxed warning.
- Seek emergency care for chest pain or stroke symptoms.
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.
- Each tablet contains aspartame as a source of phenylalanine (5.62 mg in the 5 mg tablet), so people with phenylketonuria must be told.
- Keep tablets in the blister until the moment of use, then peel it open and place the tablet on the tongue.
- The usual starting dose is 2.5 mg, a repeat dose can follow after 2 hours, and the total must not exceed 10 mg in 24 hours.
- The earlier US label classed the drug as pregnancy category C, with animal studies showing embryolethality and fetal abnormalities, so use in pregnancy only if the benefit justifies the risk.
- Dizziness and sleepiness may affect driving.
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; MAO-A inhibitors, contraindicated within 2 weeks of stopping; and SSRIs and SNRIs, which raise the risk of serotonin syndrome.
- Do not take Zomig ZMT within 24 hours of another 5-HT1 agonist (another triptan) or an ergot-type medicine such as ergotamine.
- The labels reviewed list no drugs or foods that reduce its effect.
- UK product information (Zomig tablets) also lists fluvoxamine and quinolone antibiotics as raising zolmitriptan levels.
References
Frequently Asked Questions
Zomig ZMT (zolmitriptan orally disintegrating tablet) treats an acute migraine attack, with or without aura, in adults. Take it when the headache starts. It does not prevent migraines and is not for hemiplegic or basilar migraine. The usual starting dose is 2.5 mg, with 5 mg as the higher strength.
Peel open the blister of Zomig ZMT (zolmitriptan) and place the tablet on your tongue, where it dissolves with saliva. You do not need water. Keep tablets in the blister until use, and do not take more than 10 mg in 24 hours.
Common Zomig ZMT side effects include nausea, dizziness, tingling and neck, throat or jaw tightness. Get urgent help for chest pain, irregular heartbeat, signs of stroke, or serotonin syndrome such as agitation, sweating, fever and tremor. Frequent use may cause medication overuse headache.
Avoid Zomig ZMT (zolmitriptan) within 24 hours of another triptan or ergot medicine, and within 2 weeks of an MAO-A inhibitor. Take care with SSRIs, SNRIs and cimetidine. Do not use it with heart disease, stroke history or uncontrolled high blood pressure.
Yes. Zomig ZMT (zolmitriptan) contains aspartame, a source of phenylalanine: 2.81 mg in each 2.5 mg tablet and 5.62 mg in each 5 mg tablet. Tell your healthcare provider if you have phenylketonuria before taking it, and keep the tablet in its blister until you use it.
If your migraine returns, you may take another Zomig ZMT (zolmitriptan) dose after at least 2 hours. Never exceed 10 mg in 24 hours. Frequent use of migraine treatments can cause medication overuse headache, so tell your provider if you need it often.
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