Zomig

What is the most important information I should know about Zomig?
• Do not take this medication without first talking to your doctor if you have heart disease including angina (chest pain), history of a heart attack, or high blood pressure. Serious, even fatal, side effects involving the heart have been reported with Zomig and other similar medicines.
• Do not take Zomig if the headache you are experiencing is not like other migraines that you have had.
• Never take more of this medication than is prescribed by your doctor. If your symptoms are not being treated, contact your doctor.
• Zomig may cause dizziness or drowsiness. Use caution when driving, operating machinery, or performing other hazardous activities until you can evaluate the effects of the medication.




What is Zomig?
• Zomig is a headache medicine. It is believed to work by causing vasoconstriction (narrowing) of blood vessels (arteries and veins) around the brain. Zomig also reduces the release of substances in the body that contribute to headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.
• Zomig is used to treat vascular headaches such as migraines. Zomig will not prevent migraines. It will only treat a migraine that is already occurring.
• Zomig may also be used for purposes other than those listed in this medication guide.




What should I discuss with my healthcare provider before taking Zomig?
• Do not take Zomig without first talking to your doctor if you
· have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days;
· have taken an ergot-based medication within the last 24 hours--ergot-based medicines include methysergide (Sansert), ergotamine (Ergostat, Medihaler Ergotamine), dihydroergotamine mesylate (D.H.E., Migranal Nasal Spray), and ergotamine combination products (Cafergot, Ercaf, Wigraine, Cafatine, Cafatine-PB, Cafetrate);
· have taken almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or sumatriptan (Imitrex) within the last 24 hours;
· have basilar or hemiplegic migraine headaches;
· have had a heart attack, have angina (chest pain), have irregular heartbeats, or have another type of heart disease;
· have a history of stroke or transient ischemic attack (TIA or "mini-stroke");
· are experiencing a headache that is not like other migraines you have had; or
· have an allergy to Zomig or another similar medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), or sumatriptan (Imitrex).
• Taking Zomig may be dangerous if you have any of the conditions, or have taken any of the medications, listed above.
• Before taking Zomig, tell your doctor if you have
· risk factors for heart disease such as high blood pressure, a family history of heart disease, high cholesterol (a type of fat in the blood), are overweight, have diabetes, smoke cigarettes, are postmenopausal, or are a male over 40 years of age;
· liver disease;
· kidney disease; or
· seizures or epilepsy.
• You may not be able to take Zomig, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Each 2.5 mg Zomig-ZMT orally disintegrating tablet contains 2.81 mg phenylalanine. Each 5 mg Zomig-ZMT tablet contains 5.62 mg phenylalanine. Individuals with phenylketonuria may need to monitor their intake of this additive.
• Zomig is in the FDA pregnancy category C. This means that it is not known whether Zomig will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• It is not known whether Zomig passes into human breast milk. Do not take Zomig without first talking to your doctor if you are breast-feeding a baby.




How should I take Zomig?
• Take Zomig exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take Zomig as soon as you notice symptoms of a migraine, or at any time during an attack.
• Take one or one-half regular Zomig tablet with a glass of water, as directed by your doctor.
• Administration with liquid is not necessary for the Zomig-ZMT orally disintegrating tablets. Just prior to taking a dose, peel open the blister pack and place the tablet on the tongue, where it will dissolve and be swallowed with the saliva. The Zomig-ZMT tablets should not be broken.
• Use the nasal spray as directed by your healthcare provider. Blow your nose gently before use. Remove the protective cap just before use. Hold the nasal sprayer device with your fingers and thumb. Do not press the plunger until you have put the tip of the device into your nostril. Block one nostril by pressing on the side of the nose with your finger. Either nostril can be used. Put the tip of the sprayer into the other nostril as far as feels comfortable and tilt your head slightly back. Breathe in gently through the nose and press the plunger firmly with your thumb at the same time. Keep your head slightly tilted back and remove the tip from your nose. Breathe gently through your mouth for 5-10 seconds. You may feel liquid in your nose or the back of your throat. This is normal and will soon pass.
• If your symptoms do not improve, contact your doctor before taking any more doses of Zomig.
• If your symptoms go away and then return, you can take a another dose of Zomig every 2 hours, if needed, up to a maximum of 10 mg in 24 hours unless otherwise directed by your doctor. Never take more than this amount. Any single form or combination of Zomig regular tablets, orally-disintegrating tablets, and nasal spray should not exceed 10 mg in 24 hours.
• Store Zomig at room temperature away from moisture, heat, and the reach of children. Throw away an unused medication on the expiration date.




What happens if I miss a dose of Zomig?
• Since Zomig is taken to treat migraines as they occur and not to prevent them, missing a dose does not usually occur. Take only the doses you need, according to your doctor's instructions.




What happens if I overdose with Zomig?
• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Zomig overdose are not well known but may include sedation.




What should I avoid while taking Zomig?
• Zomig may cause dizziness or drowsiness. Use caution when driving, operating machinery, or performing other hazardous activities until you can evaluate the effects of the medication.




What are the possible side effects of Zomig?
• If you experience any of the following serious side effects, stop taking Zomig and seek emergency medical attention or contact your doctor immediately:
· an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
· severe or prolonged chest pain or an irregular heartbeat;
· chest, neck, or jaw pain, tightness, or heaviness;
· sudden or severe stomach pain;
· problems seeing; or
· unusual weakness or numbness.
• Other, less serious side effects may be more likely to occur. Continue to take Zomig and talk to your doctor if you experience
· dry mouth;
· unusual taste in the mouth;
· nausea;
· muscle tiredness or weakness;
· tightness, heaviness, or pressure on a body part (other than the chest, neck, or jaw);
· drowsiness or dizziness; or
· tingling, tightness, warmth, or heaviness in a body part.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.




What other drugs will affect Zomig?
• Do not take Zomig if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) within the last 14 days. The combination could cause seizures, nausea, vomiting, sweating, flushing, and dizziness.
• Do not take Zomig if you have taken any of the following medicines within the previous 24 hours:
· an ergot-based medication such as methysergide (Sansert), ergotamine (Ergostat, Medihaler Ergotamine), dihydroergotamine mesylate (D.H.E., Migranal Nasal Spray), an ergotamine combination product (Cafergot, Ercaf, Wigraine, Cafatine, Cafatine-PB, Cafetrate), and others; or
· almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or sumatriptan (Imitrex).
• Taking Zomig within 24 hours of any of the medicines listed above may be dangerous.
• Before taking Zomig, tell your doctor if you are taking a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). You may not be able to take Zomig, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed.
• Before taking Zomig, talk to your doctor if you are taking cimetidine (Tagamet, Tagamet HB). You may require a dosage adjustment or special monitoring during treatment.
• Drugs other than those listed here may also interact with Zomig. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.