ZOLMITRIPTAN

5 mg. If symptoms persist or return within 24 hours, a second dose has been shown to be effective. If a second dose is required, it should not be taken within 2 hours of the initial dose. 5 mg doses, subsequent attacks can be treated with 5 mg doses of zolmitriptan.

In those patients who respond, significant efficacy is apparent within 1 hour of dosing. Zolmitriptan is equally effective whenever the tablets are taken during a migraine attack; although it is advisable that zolmitriptan is taken as early as possible after the onset of migraine headache.

In the event of recurrent attacks, it is recommended that the total intake of zolmitriptan in a 24 hour period should not exceed 10 mg. Zolmitriptan is not indicated for prophylaxis of migraine. Paediatric population (under 12 years of age) The safety and efficacy of zolmitriptan tablets in children aged 0-12 years has not yet been established.

No data are available. Use of zolmitriptan in children is therefore not recommended. Adolescents (12 - 17 years of age) The efficacy of zolmitriptan tablets was not demonstrated in a placebo controlled clinical trial for patients aged 12 to 17 years.

Use of zolmitriptan in adolescents is therefore not recommended. Elderly The safety and efficacy of zolmitriptan in individuals aged over 65 years have not been systematically evaluated. 2). Therefore for patients with moderate or severe hepatic impairment a maximum dose of 5 mg in 24 hours is recommended.

2). Method of administration To be taken by oral administration.

Summary of the safety profile Zolmitriptan is well tolerated. Adverse reactions are typically mild/moderate, transient, not serious and resolve spontaneously without additional treatment. Possible adverse reactions tend to occur within 4 hours of dosing and are no more frequent following repeated dosing.

Tabulated list of adverse reactions Adverse reactions are classified according to frequency and system organ class.

Frequency categories are defined according to the following convention:

Very common (≥1/10), Common (≥1/100 to < 1/10), Uncommon (≥1/1,000 to < 1/100), Rare (≥1/10,000 to < 1/1,000), Very rare (<1/10,000). The following undesirable effects have been reported following administration of zolmitriptan: System Organ Class Frequency Undesirable Effect Immune system disorders Rare Anaphylaxis/Anaphylactoid Reactions; Hypersensitivity reactions.

Nervous system disorder Common Abnormalities or disturbances of sensation; Dizziness; Headache; Hyperaesthesia; Paraesthesia; Somnolence; Warm sensation. Common Palpitations. Uncommon Tachycardia. Cardiac disorders Very rare Angina pectoris; Coronary vasospasm; Myocardial infarction.

Vascular disorders Uncommon Transient increases in systemic blood pressure Gastrointestinal disorders Common Abdominal pain; Dry mouth; Nausea; Vomiting Dysphagia. Very rare Bloody diarrhoea; Gastrointestinal infarction or necrosis; Gastrointestinal ischaemic events; Ischaemic colitis; Splenic infarction.

Skin and subcutaneous tissue disorders Rare Angioedema; Urticaria. Musculoskeletal and connective tissue disorders Common Muscle weakness; Myalgia. Uncommon Polyuria; Increased urinary frequency. Renal and urinary disorders Very rare Urinary urgency.

General disorders and administration site conditions Common Asthenia; Heaviness, tightness, pain or pressure in throat, neck, limbs or chest. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store

Zolmitriptan should only be used where a clear diagnosis of migraine has been established. Care should be taken to exclude other potentially serious neurological conditions. There are no data on the use of zolmitriptan in hemiplegic or basilar migraine.

Migraineurs may be at risk of certain cerebrovascular events. Cerebral haemorrhage, subarachnoid haemorrhage, stroke, and other cerebrovascular events have been reported in patients treated with 5HT1B/1D agonists. Zolmitriptan should not be given to patients with symptomatic Wolff- Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathways.

In very rare cases, as with other 5HT 1B/1D agonists, coronary vasospasm, angina pectoris and myocardial infarction have been reported. 3). These evaluations, however, may not identify every patient who has cardiac disease, and in very rare cases, serious cardiac events have occurred in patients without underlying cardiovascular disease.

8) have been reported after the administration of zolmitriptan. If chest pain or symptoms consistent with ischaemic heart disease occur, no further doses of zolmitriptan should be taken until after appropriate medical evaluation has been carried out.

As with other 5HT1B/1D agonists transient increases in systemic blood pressure have been reported in patients with and without a history of hypertension. Very rarely these increases in blood pressure have been associated with significant clinical events.

As with other 5HT1B/1D agonists, there have been rare reports of anaphylaxis/anaphylactoid reactions in patients receiving zolmitriptan. Prolonged use of any type of painkiller for headaches can make them worse. If this situation is experienced or suspected, medical advice should be obtained and treatment should be discontinued.

The diagnosis of medication overuse headache should be suspected in patients who have frequent or daily headaches despite (or because of) the regular use of headache medications. Serotonin Syndrome has been reported with combined use of triptans, and serotonergic drugs, such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs).

Serotonin Syndrome is a potentially life-threatening condition, and diagnosis is likely when (in presence of a serotonergic agent) one of the following is observed: Spontaneous clonus • Inducible or ocular clonus with agitation or diaphoresis, • Tremor and hyperreflexia • Hypertonia and body temperature >38ºC and inducible or ocular clonus.

5). Withdrawal of the serotonergic drugs usually brings about a rapid improvement. Treatment depends on the type and severity of the symptoms. This medicinal product contains lactose. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.

1. Uncontrolled hypertension. Ischaemic heart disease. Coronary vasospasm/Prinzmetal's angina. A history of cerebrovascular accident (CVA) or transient ischaemic attack (TIA). Concomitant administration of zolmitriptan with ergotamine or ergotamine derivatives or other 5-HT1 receptor agonists.