Zomig

Generic Name: Zolmitriptan
Class: Selective Serotonin Agonists
VA Class: CN105
Chemical Name: (S)-4-[[3-[2-(dimethylamino)ethyl]indol-5-yl]methyl]-2-oxazolidinone
Molecular Formula: C₁₆H₂₁N₃O₂
CAS Number: 139264-17-8

Introduction

Selective serotonin (5-hydroxytryptamine; 5-HT) type 1B and 1D receptor agonist (“triptan”).^{1 2 3 4 5 6 7 8 9 10 11 14 15 21 22 23 24 27}

Uses for Zomig

Vascular Headaches

Acute treatment of migraine attacks with or without aura.^{1 27}

Not recommended for management of hemiplegic or basilar migraine or for prophylaxis of migraine.^{1 27}

Safety and efficacy not established for management of cluster headaches.^{1 27}

Zomig Dosage and Administration

Administration

Administer orally or intranasally.^{1 27 28}

Oral Administration

Administer orally as conventional or orally disintegrating tablets without regard to meals.¹

To achieve a dose <2.5 mg, manually break the scored 2.5-mg conventional tablet in half.¹ Do not break orally disintegrating tablets.¹

Just prior to administration of orally disintegrating tablet, remove tablet from blister package; peel open blister package, place tablet on tongue to dissolve, and swallow with saliva.¹

Administration of orally disintegrating tablet with liquid is not necessary.¹

Intranasal Administration

Administer intranasally as a single spray into 1 nostril.²⁸

Do not spray contents into eyes.²⁸

To administer, blow nose gently and remove protective cap just before use.²⁸ Hold nasal spray device gently and do not press plunger until tip is placed into nostril.²⁸ Block one nostril by pressing firmly on side of nose and put tip into other nostril as far as feels comfortable.²⁸ Tilt head slightly back and breathe gently through nose while pressing plunger firmly with thumb; a click may be heard.²⁸ Keep head tilted slightly back and remove tip of device from nose; breathe gently through mouth for 5–10 seconds.²⁸ Liquid may be felt in nose or back of throat.²⁸ Consult manufacturer’s patient information for complete directions.²⁸

Single-use spray pump; discard after use.²⁷

Dosage

Due to similarity in systemic exposure, dosage adjustments with oral and intranasal formulations should be similar; doses <5 mg can be achieved only through use of oral formulations.²⁷

Adults

Vascular Headaches

Migraine

Oral

Initially, ≤2.5 mg.¹ In clinical studies, single oral doses of 1 (not commercially available in US), 2.5, or 5 mg were effective, but the 2.5- and 5-mg doses were effective in a greater proportion of patients.¹ The 5-mg dose appears to offer little additional benefit and is associated with increased risk of adverse effects.¹

If headache recurs, dose may be repeated after ≥2 hours.¹

Following failure to respond to first dose, reconsider diagnosis of migraine prior to administration of a second dose.¹

Intranasal

5 mg (1 spray) as a single dose; individualize selection of dosage and administration route.²⁷

If headache recurs, dose may be repeated after 2 hours.²⁷

Following failure to respond to first dose, reconsider diagnosis of migraine prior to administration of a second dose.²⁷

Prescribing Limits

Adults

Vascular Headaches

Migraine

Oral

Maximum 10 mg in any 24-hour period.¹

Safety of treating an average of >3 headaches per 30-day period has not been established.¹

Intranasal

Maximum 10 mg in any 24-hour period.²⁷

Safety of treating an average of >4 headaches per 30-day period has not been established.²⁷

Special Populations

Hepatic Impairment

Generally use <2.5 mg as a single oral dose in patients with moderate to severe hepatic impairment; concurrent BP monitoring recommended.¹

Recommended doses can be achieved only with oral formulations; use of intranasal formulation not recommended.²⁷

Cautions for Zomig

Contraindications

• 
  

  Known or suspected ischemic heart disease (e.g., angina pectoris, history of MI, documented silent ischemia).^{1 27}

  
  


• 
  

  Coronary artery vasospasm (e.g., Prinzmetal variant angina).^{1 27}

  
  


• 
  

  Other serious underlying cardiovascular disease (e.g., uncontrolled hypertension).^{1 27}

  
  


• 
  

  Cerebrovascular syndromes (e.g., stroke syndromes, TIAs).²⁷

  
  


• 
  

  Hemiplegic or basilar migraine.^{1 27}

  
  


• 
  

  Treatment within previous 24 hours with another 5-HT₁ receptor agonist or an ergot alkaloid.^{1 27} (See Specific Drugs under Interactions.)

  
  


• 
  

  Concurrent or recent (within 2 weeks) treatment with an MAO-A inhibitor.^{1 27} (See Specific Drugs under Interactions.)

  
  


• 
  

  Known sensitivity to zolmitriptan or any ingredient in the formulation.^{1 27}

  
  

Warnings/Precautions

Warnings

Use only in patients in whom a clear diagnosis of migraine has been established.^{1 27}

Cardiac Effects

Risk of coronary vasospasm, myocardial ischemia and/or infarction, life-threatening cardiac rhythm disturbances, and death with use of 5-HT₁ receptor agonists.^{1 27}

Use not recommended in patients with symptomatic Wolff-Parkinson-White syndrome or cardiac arrhythmias associated with other accessory pathway conduction disorders.^{1 27}

Use not recommended in patients with known or suspected ischemic or vasospastic heart disease or in patients in whom unrecognized CAD is likely (e.g., postmenopausal women; men >40 years of age; patients with risk factors such as hypertension, hypercholesterolemia, smoking, obesity, diabetes, or family history of CAD) unless there is satisfactory evidence from prior cardiovascular evaluation that patient does not have CAD, ischemic heart disease, or other underlying cardiovascular disease.^{1 27}

Administer initial dose to patients with risk factors for CAD who have completed satisfactory cardiovascular evaluation under medical supervision (e.g., in clinician's office, possibly followed by ECG) unless patient previously received the drug.^{1 27}

Periodic cardiovascular evaluation recommended in patients with risk factors for CAD if receiving intermittent long-term therapy.^{1 27}

Patients with symptoms suggestive of angina after receiving zolmitriptan should be evaluated for the presence of CAD or predisposition to Prinzmetal variant angina before receiving additional doses.^{1 27}

Cerebrovascular Events

Possible cerebral or subarachnoid hemorrhage, stroke, and other cerebrovascular events, sometimes fatal, with use of 5-HT₁ receptor agonists.^{1 27}

Risk of certain cerebrovascular events (e.g., stroke, hemorrhage, TIA) may be increased in patients with migraine.^{1 27}

Other Cardiovascular or Vasospastic Effects

Peripheral vascular ischemia and colonic ischemia with abdominal pain and bloody diarrhea reported with use of 5-HT₁ receptor agonists.^{1 27} Further evaluation recommended if signs or symptoms of decreased arterial flow (e.g., ischemic bowel syndrome, Raynaud's syndrome) occur following administration.^{1 27}

Substantial increases in BP, including hypertensive crises, reported rarely with 5-HT₁ receptor agonists in patients with or without history of hypertension.^{1 27}

Increases in mean pulmonary artery pressure observed following administration of a 5-HT₁ receptor agonist to patients with suspected CAD who were undergoing cardiac catheterization.^{1 27}

Serotonin Syndrome

Potentially life-threatening serotonin syndrome reported during concurrent therapy with 5-HT₁ receptor agonists (“triptans”) and SSRIs or selective serotonin- and norepinephrine-reuptake inhibitors (SNRIs).^{27 29} Symptoms may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile BP, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or GI symptoms (e.g., nausea, vomiting, diarrhea).^{27 29}

Local Effects

Possible local irritation or soreness after intranasal administration.²⁷ Adverse effects perceived in nasopharynx, occasionally severe, usually resolve within 1 hour.²⁷

No clinically important nasopharyngeal changes observed by examination following repeated use for up to 1 year’s duration.²⁷

General Precautions

Ocular Effects

Possible accumulation of zolmitriptan and/or its metabolites in melanin-rich tissues (e.g., eye) over time, resulting in potential toxicity in these tissues with extended use.^{1 27}

Phenylketonuria

Each 2.5- or 5-mg Zomig-ZMT orally disintegrating tablet contains aspartame, which is metabolized in GI tract to provide 2.81 or 5.62 mg of phenylalanine, respectively.¹ Conventional tablets do not contain aspartame.¹

Specific Populations

Pregnancy

Category C.^{1 27}

Lactation

Distributed into milk in rats; not known whether distributed into human milk.^{1 27} Caution advised if zolmitriptan is used.^{1 27}

Pediatric Use

Safety and efficacy not established in children <18 years of age; use not recommended.^{1 27}

Geriatric Use

Pharmacokinetic profile similar to that in younger adults.^{1 27} However, patients >65 years of age were excluded from clinical studies; safety and efficacy not established.^{1 27}

Hepatic Impairment

Substantial elevation of BP observed in some patients with moderate-to-severe hepatic impairment following 10-mg oral dose.^{1 27} Use with caution in patients with hepatic impairment;^{1 27} BP monitoring and dosage adjustment recommended.^{1 27}

Common Adverse Effects

Dizziness,^{1 27} paresthesia,^{1 27} hyperesthesia,^{1 27} neck/throat/jaw/chest symptoms (e.g., pain, tightness, pressure, heaviness),^{1 27} nausea,^{1 27} somnolence,^{1 27} warm or cold sensation,¹ asthenia,^{1 27} dry mouth,^{1 27} dyspepsia¹ ; with intranasal therapy, also nasal cavity disorder/discomfort,²⁷ unusual taste.²⁷

Interactions for Zomig

Appears to be metabolized by CYP1A2; active N-desmethyl metabolite appears to be further metabolized by MAO-A.^{22 23 24 26}

Specific Drugs

Drug	Interaction	Comments
Acetaminophen	Increased time to peak plasma acetaminophen concentrations1 27
Antidepressants, SSRIs (e.g., citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) and SNRIs (e.g., duloxetine, venlafaxine)	Potentially life-threatening serotonin syndrome27 29 Zolmitriptan pharmacokinetics or effect on BP not altered by fluoxetine pretreatment1 27 30	Observe carefully if used concomitantly, particularly during treatment initiation, dosage increases, or when another serotonergic agent is initiated27 29
Cimetidine	Increased half-life and systemic exposure to zolmitriptan and its active metabolite1 27
Ergot alkaloids (e.g., ergotamine, dihydroergotamine, methysergide)	Additive vasospastic effects1 27	Use within 24 hours contraindicated1 27
5-HT1 receptor agonists	Additive vasospastic effects1 27	Use within 24 hours contraindicated1 27
MAO inhibitors	Increased plasma concentrations of zolmitriptan and its active metabolite with concurrent use of MAO-A inhibitors; 1 27 selegiline (selective MAO-B inhibitor) did not affect pharmacokinetics of zolmitriptan or its active metabolite27	Use of oral or intranasal zolmitriptan within 2 weeks of MAO-A inhibitor contraindicated1 27
Metoclopramide	Metoclopramide (single 10-mg dose) did not affect pharmacokinetics of zolmitriptan or its metabolites1 27
Oral contraceptives	Increased plasma zolmitriptan concentrations1 27
Propranolol	Increased plasma zolmitriptan concentrations; peak zolmitriptan concentration may be delayed1 27
Xylometazoline	Topical application of xylometazoline to nasal mucosa 30 minutes prior to intranasal zolmitriptan did not affect zolmitriptan pharmacokinetics27

Zomig Pharmacokinetics

Absorption

Bioavailability

Well absorbed after oral administration, with peak plasma concentrations attained within 1.5 hours (conventional tablets) or 3 hours (orally disintegrating tablets).¹ Rapidly absorbed via the nasopharynx after intranasal administration, with peak plasma concentrations attained within 3 hours.²⁷

Mean absolute bioavailability after oral administration is approximately 40%;¹ mean bioavailability of nasal solution is 102% compared with oral tablet.²⁷

Mean plasma concentrations after oral administration are increased by up to 1.5-fold in females compared with males.^{1 27}

Food

Food does not substantially affect bioavailability.^{1 27}

Distribution

Plasma Protein Binding

25%.^{1 27}

Elimination

Metabolism

Undergoes hepatic metabolism to form 3 principal metabolites, including N-desmethyl zolmitriptan (5-HT_1B/1D potency is 2–6 times that of zolmitriptan).^{1 22 23 24 27} Formation of N-desmethyl zolmitriptan may depend on CYP1A2; MAO-A appears to mediate metabolism of N-desmethyl zolmitriptan.^{22 23 24 26}

Elimination Route

Excreted in urine (65%) and feces (30%) as unchanged drug and metabolites;^{1 24} dose recovered in urine as unchanged drug (8%) and indole acetic acid (31%), N-oxide (7%), and N-desmethyl (4%) metabolites.¹

Half-life

Approximately 3 hours for zolmitriptan and active N-desmethyl metabolite after oral or intranasal administration.^{1 13 23 24 27}

Special Populations

In patients with severe hepatic impairment, peak plasma concentrations, time to achieve peak plasma concentrations, and AUC are 1.5-, 2-, and 3-fold higher, respectively, than in healthy individuals after oral administration.^{1 27} Pharmacokinetics of nasal spray not evaluated in patients with hepatic impairment.²⁷

In patients with severe renal impairment (Cl_cr 5–25 mL/minute), clearance is reduced by 25% after oral administration; no substantial change in clearance in patients with moderate renal impairment (Cl_cr 26–50 mL/minute).¹ Pharmacokinetics of nasal spray not evaluated in patients with renal impairment.²⁷

Stability

Storage

Oral

Conventional and Orally Disintegrating Tablets

20–25°C; protect from light and moisture.¹

Intranasal

Solution

20–25°C.²⁷

ActionsActions

• 
  

  Binds with high affinity to 5-HT_1B and 5-HT_1D receptors.^{1 2 3 4 5 6 7 8 9 10 11 14 15 21 22 23 24 27}

  
  


• 
  

  Structurally and pharmacologically related to other selective 5-HT_1B/1D receptor agonists (e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan).^{21 22}

  
  


• 
  

  Precise mechanism of action not established; may ameliorate migraine through selective constriction of certain intracranial blood vessels, inhibition of neuropeptide release, and reduced transmission in trigeminal pain pathway.^{1 21 22 23 27}

  
  

Advice to Patients

• 
  

  Importance of immediately informing clinician of occurrence of tightness, pain, pressure, or heaviness in chest, throat, jaw, or neck; sudden or severe abdominal pain; shortness of breath or wheezing; heart throbbing; facial swelling (e.g., eyelids, face, lips); tongue, mouth or throat swelling; rash or hives and of not taking zolmitriptan again until evaluated by a clinician.^{1 27} Importance of informing clinician of any other symptoms not understood by patient.^{1 27}

  
  


• 
  

  Importance of adhering to prescribed directions for use.^{1 27 28} Importance of patient reading manufacturer's patient information before initial use and each time prescription is refilled.^{1 28}

  
  


• 
  

  For patients taking zolmitriptan orally disintegrating tablets, importance of not removing tablet from blister package until just before administering dose;¹ importance of peeling blister open and placing tablet on tongue to dissolve and be swallowed with saliva.¹

  
  


• 
  

  Importance of informing patients with phenylketonuria that orally disintegrating tablets contain aspartame.¹

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, dietary supplements, and herbal supplements, as well as any concomitant illnesses (e.g., cardiovascular disease).^{1 27}

  
  


• 
  

  Importance of informing patients of risk of serotonin syndrome with concurrent use of zolmitriptan and an SSRI or SNRI.^{27 29} Importance of seeking immediate medical attention if symptoms of serotonin syndrome develop.^{27 29}

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^{1 27}

  
  


• 
  

  Importance of informing patients of other important precautionary information.^{1 27} (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Zolmitriptan

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Nasal	Solution	5 mg/0.1 mL	Zomig Nasal Spray	AstraZeneca
Oral	Tablets, film-coated	2.5 mg	Zomig	AstraZeneca
		5 mg	Zomig	AstraZeneca
	Tablets, orally disintegrating	2.5 mg	Zomig-ZMT (with aspartame)	AstraZeneca
		5 mg	Zomig-ZMT (with aspartame)	AstraZeneca

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Zomig 2.5MG Tablets (ASTRAZENECA): 6/$156 or 18/$441.97

Zomig 5MG Solution (ASTRAZENECA): 6/$216 or 18/$615.99

Zomig 5MG Tablets (ASTRAZENECA): 3/$95.99 or 9/$259.96

Zomig ZMT 2.5MG Dispersible Tablets (ASTRAZENECA): 6/$155.99 or 18/$452.99

Zomig ZMT 5MG Dispersible Tablets (ASTRAZENECA): 3/$85.99 or 9/$230.98

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions August 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

1. AstraZeneca Pharmaceuticals LP. Zomig (zolmitriptan) tablets and Zomig-ZMT(zolmitriptan) orally disintegrating tablets prescribing information. Wilmington, DE; 2005 May.

2. Visser WH, Klein KB, Cox RC et al. 311C90, a new central and peripherally acting 5-HT1D receptor agonist in the acute oral treatment of migraine: a double-blind, placebo-controlled, dose-range finding study. Neurology. 1996; 46:522-6.

3. Dahlof C, Diener HC, Goadsby PJ et al. Zolmitriptan, a 5-HT1B/1D receptor agonist for the acute oral treatment of migraine: a multicentre, dose-range fnding study. Eur J Neurol 1998; 5:535-43. [PubMed 10210888]

4. Rapoport AM, Ramadan NM, Adelman JU et al. Optimizing the dose of zolmitriptan (Zomig, 311C90) for the acute treatment of migraine. A multicenter, double-blind, placebo-controlled, dose range-finding study. Neurology. 1997; 49:1210-8. [IDIS 397204] [PubMed 9371896]

5. Solomon GD, Cady RK, Klapper JA et al. Clinical efficacy and tolerability of 2.5 mg zolmitriptan for the acute treatment of migraine. Neurology. 1997; 49:1219-25. [IDIS 397205] [PubMed 9371897]

6. Dowson AJ, MacGregor EA, Purdy RA et al. Zolmitriptan orally disintegrating tablet is effective in the acute treatment of migraine. Cephalalgia. 2002; 22:101-6. [PubMed 11972576]

7. The International 311C90 Long-term Study Group. The long-term tolerability and efficacy of oral zolmitriptan (Zomig, 311C90) in the acute treatment of migraine. An international study. Headache. 1998; 38:173-83. [PubMed 9563207]

8. Tepper SJ, Donnan GA, Dowson AJ et al. A long-term study to maximize migraine relief with zolmitriptan. Curr Med Res Opin. 1999; 15:254-71. [PubMed 10640258]

9. Tuchman M, Edvinsson L, Geraud G et al. Zolmitriptan provides consistent migraine relief when used in the long-term. Curr Med Res Opin. 1999; 15:272-81. [PubMed 10640259]

10. Gallagher RM, Dennish G, Spierings ELH et al. A comparative trial of zolmitriptan and sumatriptan for the acute oral treatment of migraine. Headache. 2000; 40:119-28. [PubMed 10759911]

11. Gruffyd-Jones K, Kies B, Middleton A et al. Zolmitriptan versus sumatriptan for the acute oral treatment of migraine: a randomized, double-blind, international study. Eur J Neurol. 2001; 8:237-45.

12. Oldman AD, Smith LA, McQuay HJ et al. Pharmacological treatment for acute migraine: quantitative systematic review. Pain. 2002; 97:247-57.

13. Ferrari MD, Goadsby PJ, Roon KI et al. Triptans (serotonin, 5-HT1B/1D agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials. Cephalalgia. 2002; 22:633-58. [PubMed 12383060]

14. Matchar DB, Young WB, Rosenberg JH et al. Evidence-based guidelines for migraine headache in the primary care setting: pharmacological management of acute attacks. From American Academy of Neurology web site ().

15. Silberstein SD, for the US Headache Consortium. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology. 2000; 55:754-63. [IDIS 453389] [PubMed 10993991]

16. American Medical Association Council on Scientific Affairs. Aspartame: review of safety issues. JAMA. 1985; 254:400-2. [IDIS 202002] [PubMed 2861297]

17. Gossel TA. A review of aspartame: characteristics, safety and uses. US Pharm. 1984; 9:26,28-30.

18. Food and Drug Administration. Aspartame as an inactive ingredient in human drug products; labeling requirements. Proposed rule. [21 CFR Part 201] Fed Regist. 1983; 48:54993-5.

19. Food and Drug Administration. Food additives permitted for direct addition to food for human consumption; aspartame. Final rule. [21 CFR Part 172] Fed Regist. 1983; 48:31376-82.

20. Anon. Aspartame and other sweeteners. Med Lett Drugs Ther. 1982; 24:1-2.

21. Tfelt-Hansen P, De Vries P, Saxena PR. Triptans in migraine. A comparative review of pharmacology, pharmacokinetics, and efficacy. Drugs. 2000; 60:1259-87.

22. Deleu D, Hanssens Y. Current and emerging second-generation triptans in acute migraine therapy: a comparative review. J Clin Pharmacol. 2000; 40:687-700. [IDIS 449430] [PubMed 10883409]

23. Dowson AJ, Charlesworth B. Review of zolmitriptan and its clinical applications in migraine. Expert Opin Pharmacother. 2002; 3:993-1005. [PubMed 12083998]

24. Spencer CM, Gunasekara NS, Hills C. Zolmitriptan. A review of its use in migraine. Drugs. 1999; 58:347-74. [PubMed 10473025]

25. GlaxoSmithKline. Amerge (naratriptan hydrochloride) tablets prescribing information. Research Triangle Park, NC; 2002 Oct.

26. AstraZeneca, Wilmington, DE: Personal communication.

27. AstraZeneca. Zomig (zolmitriptan) nasal spray prescribing information. Wilmington, DE; 2006 July.

28. AstraZeneca. Zomig (zolmitriptan) nasal spray patient summary of information. Wilmington, DE; 2005 Jun.

29. Food and Drug Administration. Public health advisory: combined use of 5-hydroxytryptamine receptor agonists (triptans), selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/norepinephirne reuptake inhibitors (SNRIs) may result in life-threatening serotonin syndrome. Rockville, MD; 2006 Jul 19. From the FDA website: (, , and ).

30. Smith DA, Cleary EW, Watkins S et al. Zolmitriptan (311C90) does not interact with fluoxetine in healthy volunteers. Int J Clin Pharmacol Ther. 1998; 36:301-5. [PubMed 9660035]

More Zomig resources

• Zomig Side Effects (in more detail)
• Zomig Use in Pregnancy & Breastfeeding
• Drug Images
• Zomig Drug Interactions
• Zomig Support Group
• 23 Reviews for Zomig - Add your own review/rating

• Zomig Prescribing Information (FDA)


• Zomig Consumer Overview


• Zomig Advanced Consumer (Micromedex) - Includes Dosage Information


• Zomig MedFacts Consumer Leaflet (Wolters Kluwer)


• Zolmitriptan Professional Patient Advice (Wolters Kluwer)

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