Zolmitriptan

Zolmitriptan is a selective 5-HT1 receptor agonist, particularly at the 5-HT1D receptor. Its selective pharmacological effects provide insight into migraine pathophysiology. Consistent with the 5-HT hypothesis, 5-HT receptor agonists are a mainstay for acute treatment of migraine headaches.

Adult

Nasal: Start with 2.5 mg inhaled into a single nostril. If needed in 2 hr, a second dose may be administered. Dose may be increased to a maximum single dose of 5 mg if needed.

Pediatric

Nasal: (≥12 yr) Start with 2.5 mg inhaled into a single nostril. If needed in 2 hr, a second dose may be administered. Dose may be increased to a maximum single dose of 5 mg if needed. Max. daily dose: 10 mg/24 hr. Oral use not recommended.

Renal adjustment

Reduce dose in renal impairment

Hepatic adjustment

Reduce dose in hepatic impairment

Max dose

10 mg/24 hr (nasal); 5 mg/24 hr (nasal) when receiving concurrent cimetidine

• Ischemic heart disease
• Coronary artery vasospasm
• Exposure to MAO inhibitor within preceding 2 weeks
• Within 24 hours of another triptan
• Within 24 hours of an ergot derivative
• Within 24 hours of SSRIs
• Within 24 hours of SNRIs