Zolmitriptan

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 : 287.4

%Protein binding : 25

%Excreted unchanged in urine : 60 (as metabolites)

Volume of distribution (L/kg) : 2.4

half-life – normal/ESRD (hrs) : 2.5–3/3–3.5

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unknown dialysability. Dose as in normal renal function

HD : Unknown dialysability. Dose as in normal renal function

HDF/high flux : Unknown dialysability. Dose as in normal renal function

CAV/VVHD : 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

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Route

Oral

Rate of Administration

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Comments

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See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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