Zolmitriptan

Finding the right triptan for migraine management is often a process of finding the medicine that works reliably and is tolerated well for an individual patient. Each triptan in the class shares the same core mechanism but varies in formulation, onset, duration, and interaction profile. Zolmitriptan tablets are a Prescription Only Medicine used for the acute treatment of migraine with or without aura in adults. Available in 2.5 mg and 5 mg strengths, Zolmitriptan is also available in orodispersible tablet and nasal spray formulations, which are separate products. A prescription can only be issued following a clinical consultation.

IMPORTANT — MAO-A INHIBITOR INTERACTION: Patients taking a reversible MAO-A inhibitor (such as moclobemide) must use a maximum single dose of 2.5 mg of Zolmitriptan. The total dose must not exceed 5 mg in any 24-hour period. Moclobemide inhibits the MAO-A enzyme responsible for Zolmitriptan metabolism, causing Zolmitriptan blood levels to rise significantly. Traditional (irreversible) MAOIs are contraindicated with Zolmitriptan. Always inform your prescriber if you take any MAOI or moclobemide before Zolmitriptan is prescribed.

Zolmitriptan tablets are an oral prescription medicine belonging to the triptan class of antimigraine medicines. The active ingredient is Zolmitriptan. Zomig is a widely recognised brand name for Zolmitriptan from AstraZeneca; generic Zolmitriptan tablets are also available.

Zolmitriptan is licensed in the UK for the acute treatment of migraine attacks, with or without aura, in adults. This licence applies specifically to the oral tablet formulation. Zolmitriptan is also available as an orodispersible tablet (Zomig Rapimelt), which dissolves on the tongue without water, and as a nasal spray. The nasal spray formulation carries an additional licence for cluster headache; this does not apply to the tablet formulation. This page covers standard oral tablets only.

Zolmitriptan is available in two tablet strengths: 2.5 mg and 5 mg. The 2.5 mg tablet is the recommended starting dose for most patients. The 5 mg tablet may be used if 2.5 mg provides inadequate relief in subsequent attacks. Patients taking moclobemide (a reversible MAO-A inhibitor) must use the 2.5 mg dose and must not exceed 5 mg in any 24-hour period.

Zolmitriptan relieves migraine through the same mechanism as other triptans, selective agonism of serotonin receptors involved in migraine pain pathways.

5-HT1B/1D Receptor Agonism

Zolmitriptan selectively activates 5-HT1B and 5-HT1D serotonin receptors. Activation of 5-HT1B receptors in the walls of dilated intracranial blood vessels causes vasoconstriction, addressing the vascular component of migraine headache. Activation of 5-HT1D receptors on trigeminal nerve terminals inhibits the release of vasoactive neuropeptides, substances that drive neurogenic inflammation and pain signal transmission in the trigeminal pathway. Together these actions target two core mechanisms of migraine pain.

Active Metabolite

Zolmitriptan is metabolised in the liver to form an active metabolite, N-desmethyl Zolmitriptan, which is also a potent 5-HT1B/1D agonist and contributes to the overall antimigraine effect. This metabolite has a similar potency to Zolmitriptan itself. The formation of this active metabolite is partly mediated by MAO-A, which is why inhibitors of MAO-A, particularly moclobemide, increase Zolmitriptan levels and require dose adjustment rather than absolute avoidance. Irreversible MAOIs, which inhibit both MAO-A and MAO-B, are fully contraindicated.

After an oral tablet dose, peak blood levels of Zolmitriptan are typically reached within one to three hours. The active metabolite has a similar time to peak. Many patients experience pain relief within one to two hours of taking a dose, though individual response varies.

Always take Zolmitriptan exactly as your prescriber instructs. The information below summarises key points from the current UK SmPC. Read the Patient Information Leaflet supplied with your medicine before taking it.

• Take Zolmitriptan as soon as possible once the headache phase of your migraine begins. It works most effectively when taken early in the attack. Do not take it during the aura phase; wait until the headache starts.
• Swallow the tablet whole with water. Do not crush or chew the tablet.
• The recommended starting dose is 2.5 mg for most adults. If this provides adequate relief, continue with 2.5 mg for future attacks. If 2.5 mg provides insufficient relief, your prescriber may recommend 5 mg for subsequent attacks.
• If you take moclobemide, you must use the 2.5 mg dose only. Do not take more than 5 mg total in any 24-hour period.
• If the first dose does not relieve your migraine, do not take a second dose for the same attack. A second dose for the same attack is not recommended if the first dose has failed.
• If your migraine initially responds but then returns, a second dose may be taken for the recurrent headache. A minimum of two hours must pass between doses.
• The maximum dose in any 24-hour period is 10 mg. For patients taking moclobemide, the maximum is 5 mg in 24 hours.
• Do not take Zolmitriptan on more than 10 days in any calendar month. Overuse of acute headache medicines can cause medication overuse headache, a chronic daily headache condition.
• Zolmitriptan tablets can be taken with or without food.
• If nausea makes swallowing tablets difficult during a migraine, speak to your prescriber about the orodispersible tablet (Zomig Rapimelt) or the nasal spray formulations.

Zolmitriptan 2.5 mg Tablets

Zolmitriptan 2.5 mg is the recommended starting dose for most adults. Clinical evidence shows that 2.5 mg is effective for acute migraine in many patients and is associated with a lower frequency of side effects than the 5 mg dose. If 2.5 mg provides good relief, there is no clinical reason to increase to 5 mg. Patients taking moclobemide must not exceed 2.5 mg per dose.

Zolmitriptan 5 mg Tablets

Zolmitriptan 5 mg may be more effective for patients whose migraines do not respond adequately to 2.5 mg. It may also be prescribed when 2.5 mg has provided only partial relief in previous attacks. The 5 mg dose is associated with a higher rate of side effects than 2.5 mg. The maximum dose in any 24-hour period is 10 mg (two 5 mg tablets, or the equivalent). All dose decisions are made by your prescriber. Patients taking moclobemide must not use the 5 mg dose as a single dose or exceed 5 mg total in 24 hours.

Like all triptans, Zolmitriptan can cause side effects. The information below is based on the current UK SmPC. Refer to the Patient Information Leaflet for the full list.

Common Side Effects (may affect up to 1 in 10 people)

• Sensations of warmth, tingling, heaviness, tightness, or pressure — characteristic triptan class effects that may affect the chest, neck, throat, face, or limbs. They are typically brief and transient.
• Dizziness.
• Drowsiness or somnolence.
• Nausea.
• Dry mouth.
• Muscle weakness.

Important: Chest Symptoms

Chest tightness, pressure, or pain can occur after taking Zolmitriptan. In most cases these are related to the vasoconstriction mechanism of the medicine and are not cardiac in origin. However, Zolmitriptan is contraindicated in patients with known or suspected cardiovascular disease. If you experience severe chest pain or tightness, stop taking Zolmitriptan and seek urgent medical attention.

Serious Side Effects: Seek Urgent Medical Attention

Go to your nearest accident and emergency department or call 999 immediately if you experience:

• Severe chest pain or tightness that could indicate a cardiac event. Zolmitriptan causes vasoconstriction and must not be used in patients with known cardiovascular disease.
• Signs of a stroke such as sudden weakness on one side of the body, sudden difficulty speaking, or a sudden severe headache different from your usual migraine.
• Signs of serotonin syndrome: agitation, confusion, rapid heart rate, muscle twitching, high temperature, and loss of coordination. This is a rare but serious risk, particularly when Zolmitriptan is combined with other serotonergic medicines.
• Signs of a severe allergic reaction such as sudden swelling of the face, lips, tongue, or throat, or difficulty breathing.

Report any suspected side effect to your prescriber, pharmacist, or via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Zolmitriptan Tablets May Be Suitable If You:

• Are an adult aged 18 or over with a confirmed diagnosis of migraine with or without aura.
• Have migraine attacks that have not been adequately controlled with standard analgesics such as paracetamol or ibuprofen.
• Do not have any of the cardiovascular or other contraindications listed below.
• Are already prescribed Zolmitriptan and require a repeat prescription through an online prescribing service.

Zolmitriptan Tablets Are Contraindicated If You:

• Have a history of myocardial infarction, ischaemic heart disease, coronary artery vasospasm (including Prinzmetal's angina), or any other significant cardiovascular disease.
• Have had a stroke or transient ischaemic attack (TIA).
• Have peripheral vascular disease.
• Have uncontrolled hypertension. Zolmitriptan can cause small, transient increases in blood pressure.
• Have hemiplegic or basilar migraine.
• Are taking an irreversible MAOI or have taken one within two weeks. Irreversible MAOIs include phenelzine and tranylcypromine.
• Are taking ergotamine or an ergot derivative (such as dihydroergotamine). Do not take Zolmitriptan within 24 hours of ergotamine or vice versa.
• Are taking another triptan medicine. Do not take two different triptans within 24 hours.
• Have severe liver impairment. Zolmitriptan is extensively metabolised by the liver. Maximum dose is 5 mg in 24 hours in patients with moderate liver impairment; Zolmitriptan should be avoided in severe liver impairment.
• Have a known allergy or hypersensitivity to Zolmitriptan or any excipient listed in the SmPC.

Tell your prescriber about all medicines you take. Key interactions for Zolmitriptan:

• Moclobemide (a reversible MAO-A inhibitor): moclobemide inhibits the MAO-A enzyme responsible for Zolmitriptan metabolism, significantly increasing Zolmitriptan blood levels. Zolmitriptan is not absolutely contraindicated with moclobemide, but the dose must be limited to a maximum of 2.5 mg per attack and no more than 5 mg in any 24-hour period. Always inform your prescriber if you take moclobemide.
• Irreversible MAOIs (such as phenelzine, tranylcypromine, isocarboxazid): contraindicated. Do not take Zolmitriptan within two weeks of stopping an irreversible MAOI.
• Cimetidine: inhibits the metabolism of Zolmitriptan, doubling its blood levels. The maximum Zolmitriptan dose in patients taking cimetidine is 5 mg in 24 hours.
• SSRIs, SNRIs, and other serotonergic medicines: combined use may increase the risk of serotonin syndrome. Monitor for signs of serotonin syndrome if these medicines are taken together.
• Ergotamine and ergot derivatives: do not take within 24 hours of Zolmitriptan.
• Other triptans: do not combine or take within 24 hours.

Your prescriber will review your complete medicines list before any Zolmitriptan prescription is issued.

Zolmitriptan is a Prescription Only Medicine. The clinical consultation is the essential first step. A prescription will only be issued if a registered prescriber concludes, based on their individual assessment of your circumstances, that Zolmitriptan is clinically appropriate for you.

During your online consultation with Pharmacy Planet, a registered prescriber will review the information you provide. This includes your migraine history, cardiovascular health, liver function if relevant, current medicines, and any history of stroke or TIA. The prescriber will specifically check whether you take moclobemide or cimetidine, as both require dose adjustment. Patients with moderate liver impairment also require dose limitation.

Not all consultations will result in a prescription. The prescriber may determine that a different triptan is more suitable for your individual circumstances, request further clinical information, or advise that a face-to-face consultation with your GP is needed before prescribing proceeds. This process is designed to protect your safety.

If you are under the care of your GP for migraine management, please keep them informed of all medicines prescribed through online services. Coordinated care between online prescribers and your regular GP supports safe and effective migraine control.

Store below 30°C. Store in the original packaging to protect from light and moisture. Keep out of the sight and reach of children. Do not use after the expiry date printed on the packaging. Do not dispose of medicines via household waste or wastewater. Return unused or out of date tablets to your pharmacist for safe disposal. Full storage instructions are provided in the Patient Information Leaflet supplied with your medicine.

Pharmacy Planet is a GPhC-registered online pharmacy providing access to prescription medicines through a clinically led consultation process. Our registered prescribers and pharmacists are committed to patient safety, clinical accuracy, and responsible prescribing. We follow GPhC standards, MHRA guidance, and ASA advertising regulations in all aspects of our service. For medicines with dose-limiting interactions such as Zolmitriptan with moclobemide and cimetidine, our prescribers review all current medicines before any prescription is issued. Every prescription is reviewed and dispensed by qualified healthcare professionals.

If you have questions about Zolmitriptan, Zomig, or acute migraine therapy, our pharmacy team is available to help. We are committed to transparent, patient centred care.

References

1. Electronic Medicines Compendium (eMC). Zomig 2.5 mg and 5 mg tablets — Summary of Product Characteristics. https://www.medicines.org.uk/emc. Accessed May 2026.
2. National Institute for Health and Care Excellence (NICE). Headaches in over 12s: diagnosis and management. NICE guideline CG150. https://www.nice.org.uk/guidance/cg150. Accessed May 2026.
3. NHS. Zolmitriptan. https://www.nhs.uk/medicines/Zolmitriptan. Accessed May 2026.
4. Joint Formulary Committee. British National Formulary (BNF). Zolmitriptan. BMJ Group and Pharmaceutical Press. https://bnf.nice.org.uk. Accessed May 2026.
5. Medicines and Healthcare products Regulatory Agency (MHRA). Yellow Card — report a side effect. https://yellowcard.mhra.gov.uk. Accessed May 2026.

Triptan Tablets for Acute Migraine

The table below compares commonly prescribed triptan tablets available at Pharmacy Planet. All medicines listed below help treat acute migraine attacks. Key differences lie in starting dose, the propranolol interaction (rizatriptan), the moclobemide and cimetidine interaction (Zolmitriptan), and the sumatriptan 50 mg Pharmacy Medicine status.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation.