Home Drug Guide Zolmitriptan

Drug Guide

Generic Name

Zolmitriptan

Brand Names Zomig, Zomig-zmt

Classification

Therapeutic: Antimigraine agent

Pharmacological: Serotonin receptor agonist (5-HT1B/1D receptor agonist)

FDA Approved Indications

  • Acute treatment of migraine attacks with or without aura

Mechanism of Action

Zolmitriptan activates 5-HT1B and 5-HT1D receptors in cranial blood vessels and sensory nerves, leading to vasoconstriction and inhibition of neuropeptide release, which alleviates migraine symptoms.

Dosage and Administration

Adult: Typically 1.25 mg to 2.5 mg taken at onset of migraine. May repeat after 2 hours if needed, not exceeding 10 mg in 24 hours.

Pediatric: Not typically recommended for children under 12 years; consult specific pediatric dosing guidelines.

Geriatric: Use with caution; start at lower end of dosing range due to increased sensitivity and comorbidities.

Renal Impairment: Adjust dose in moderate to severe impairment; consult specific guidelines.

Hepatic Impairment: Use with caution; start at lower dose and monitor response.

Pharmacokinetics

Absorption: Rapid absorption with oral administration.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Primarily hepatic via CYP1A2 enzymes.

Excretion: Excreted mainly in urine, both as metabolites and unchanged drug.

Half Life: Approximately 3 hours.

Contraindications

  • History of cerebrovascular or coronary artery disease
  • Uncontrolled hypertension
  • Use with monoamine oxidase inhibitors within 14 days

Precautions

  • Assess cardiac risk before use, especially in patients with risk factors for coronary artery disease.
  • Monitor blood pressure during therapy.

Adverse Reactions - Common

  • Dizziness (Occasional)
  • Somnolence (Uncommon)
  • Nausea (Uncommon)

Adverse Reactions - Serious

  • Serious cardiovascular events (e.g., heart attack, arrhythmia) (Rare)
  • Serotonin syndrome (if combined with other serotonergic agents) (Rare)

Drug-Drug Interactions

  • Other serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs)
  • Ergot alkaloids

Drug-Food Interactions

  • Avoid alcohol and certain foods that may elevate blood pressure

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for cardiovascular history, baseline blood pressure, and migraine characteristics.

Diagnoses:

  • Risk for cardiovascular complications
  • Ineffective pain management

Implementation: Administer at onset of migraine, observe for adverse reactions, especially cardiovascular symptoms.

Evaluation: Assess effectiveness in reducing migraine severity and frequency.

Patient/Family Teaching

  • Instruct on timing of medication intake at migraine onset.
  • Warn about possible side effects and when to seek medical attention.
  • Advise against concurrent use of other serotonergic drugs without medical advice.

Special Considerations

Black Box Warnings:

  • Coronary artery disease, other significant underlying cardiovascular conditions

Genetic Factors: CYP1A2 genetic variations may affect drug metabolism.

Lab Test Interference: None documented.

Overdose Management

Signs/Symptoms: Dizziness, vertigo, hypertension, somnolence, coma in severe cases.

Treatment: Supportive care; manage symptoms; activated charcoal if ingestion is recent; no specific antidote.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.