Zolmitriptan Nasal Spray

Zolmitriptan Nasal Spray
Zolmitriptan Nasal Spray

Uses Of Zolmitriptan Nasal Spray

Zolmitriptan nasal spray is used for migraine headaches. Zolmitriptan is a serotonin receptor agonist, meaning that it stops pain signals sent from the brain, which in turn may prevent the release of substances that cause nausea, pain, and other symptoms of migraine headaches. While zolmitriptan may not prevent migraines entirely, it may help reduce the number of headaches you have.

Side Effects Of Zolmitriptan Nasal Spray

Zolmitriptan nasal spray may cause side effects, including those listed below. Contact your doctor if these symptoms are severe or persist:

  • burning or tingling feeling
  • dizziness
  • dry mouth
  • fatigue
  • nasal irritation
  • nausea
  • sensitive skin, especially around the nose
  • unusual taste in the mouth
  • weakness

Some side effects can be serious. If you experience any of these symptoms, call your physician or medical care provider immediately:

  • bloody diarrhea
  • blue color or paleness of fingers and toes
  • cold sweats
  • difficulty breathing or swallowing
  • feeling faint
  • loss of voice
  • pain or tightness in chest, neck, throat, or jaw
  • pain for tingling in hands or feet
  • pounding or irregular heartbeat
  • rash or hives
  • shortness of breath
  • slowness or difficulty of speech
  • sudden or severe stomach pain
  • sudden weight loss
  • swelling of the eyes, face, lips, tongue, or throat
  • throwing up
  • vision problems
  • weakness or numbness in the arms or legs

Warnings & Precautions

Before using zolmitriptan nasal spray:

  • tell your doctor and pharmacist if you are allergic to any medications, including zolmitriptan, or to any of the ingredients in zolmitriptan nasal spray.
  • do not use zolmitriptan nasal spray if you have taken the following types of medications in the past 24 hours: selective serotonin receptor agonists [e.g., almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet)] or ergot-type medications [e.g., bromocriptine (Parlodel), cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), ergotamine (Cafergot, Ergomar, Wigraine), methylergonovine (Methergine), methysergide (Sansert), pergolide (Permax)].
  • do not use zolmitriptan nasal spray if you are taking a monoamine oxidase A (MAO-A) inhibitor [e.g.,  isocarboxazid (Marplan), phenelzine (Parnate), tranylcypromine (Nardil)] or if you have taken an MAO-A in the past 2 weeks.
  • tell your doctor and pharmacist about any prescription or over-the-counter medications, vitamins, or herbal supplements you are taking, especially: acetaminophen (Tylenol); antidepressants [e.g., amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), trimipramine (Surmontil)]; nonsteroidal anti-inflammatory medications (NSAIDs) [e.g., aspirin,  ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn)]; cimetidine (Tagamet); oral contraceptives ; propranolol (Inderal); selective serotonin reuptake inhibitors (SSRIs) [e.g., citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft)]; and selective serotonin/norepinephrine reuptake inhibitors (SNRIs) [e.g., desvenlafaxine (Pristiq), duloxetine (Cymbalta), sibutramine (Meridia), and venlafaxine (Effexor)].
  • tell your doctor if you have or have ever had heart disease, a heart attack, angina (chest pain), irregular heartbeat, a stroke or ‘mini-stroke’, or circulation problems [e.g., varicose veins, blood clots in the legs, Raynaud’s disease, ischemic bowel disease].
  • tell your doctor if you smoke or are overweight; if you have or have ever had high blood pressure, high cholesterol, diabetes, or liver or kidney disease; if you have gone through menopause ; or if any family members currently have or have ever had heart disease or stroke.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. (Call your doctor immediately if you become pregnant while using zolmitriptan nasal spray. Consult with your doctor about effective methods of birth control while using this medication.
  • be aware that zolmitriptan nasal spray may make you drowsy. Do not drive a car or operate machinery until you know how this medication may affect you.
  • talk to your doctor about your headache symptoms to ensure that they are caused by migraines treatable by zolmitriptan nasal spray. This medication should not be used to treat hemiplegic or basilar migraines or other types of headaches (e.g., cluster headaches).

Zolmitriptan Nasal Spray Dosage

Zolmitriptan is a nasal spray that is inhaled through the nose, usually at the first sign of a migraine headache. A second dose may be necessary if your symptoms initially improve, but return after two or more hours. Follow the directions on your prescription label carefully, and use zolmitriptan exactly as directed as prescribed by your doctor.

You may be asked to take your first dose of zolmitriptan nasal spray in a medical facility in which you can be monitored for serious reactions.

Call your doctor if your headaches do not get improve or occur more frequently after starting zolmitriptan nasal spray, which can happen if you use the medication more often or longer than prescribed. You should not use zolmitriptan nasal spray or any other headache medication for more than 10 days per month. Call your doctor if you use zolmitriptan to treat more than three headaches in a 1-month period.

To use the nasal spray, follow these steps:

  • Read all of the manufacturer’s instructions before taking your first dose.
  • Blow your nose gently.
  • Remove the protective cap from the sprayer.
  • Hold the sprayer between your fingers and thumb. Do not yet press the plunger.
  • Use your other hand to block one nostril by pressing it closed.
  • Put the tip of the sprayer into your other nostril as far as comfortable and tilt your head back. Be sure not to press the plunger or spray the medication in your eyes.
  • Breathe in gently through your nose and press the plunger firmly with your thumb. (It may feel stiff and you may hear a click.)
  • Keep your head tilted back and remove the tip of the sprayer from your nose.
  • Breathe gently through your mouth for 5-10 seconds, during which time you may feel liquid in your nose or throat.
  • The sprayer contains only one dose of medication. After you have used it, dispose of it in a receptacle out of the reach of children and pets.


Keep all appointments with your doctor, as your blood pressure needs to be monitored regularly.

Keep a ‘headache diary’ in which you record when you have headaches and when you use zolmitriptan nasal spray.

Never allow anyone else to use your medication. Consult with your pharmacist if you have questions about refilling your prescription for zolmitriptan nasal spray.