CLINICAL USE

Acute treatment of migraine

DOSE IN NORMAL RENAL FUNCTION

2.5–5 mg, repeated after 2 hours if required; maximum 10 mg in 24 hours

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 287.4
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 25
  • %Excreted unchanged in urine &nbsp &nbsp : 60 (as metabolites)
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp : 2.4
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp : 2.5–3/3–3.5

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Unknown dialysability. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Unknown dialysability. Dose as in normal renal function
  • HDF/high flux &nbsp : Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp: Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: quinolones possibly inhibit metabolism – reduce dose of zolmitriptan
  • Antidepressants: risk of CNS toxicity with MAOIs and moclobemide – reduce dose of zolmitriptan to max 7.5 mg; SSRIs inhibit metabolism of zolmitriptan; possibly increased serotonergic effects with duloxetine; increased serotonergic effects with St John’s wort – avoid concomitant use Cimetidine: inhibits metabolism of zolmitriptan; maximum dose is 5 mg
  • Ergot alkaloids: increased risk of vasospasm Linezolid: risk of CNS toxicity – reduce dose of zolmitriptan

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    – .