Zomig® Rapimelt can be used only in cases of clearly diagnosed migraine. Prior to the appointment of zolmitriptan, as well as other means for arresting migraine, it is necessary to exclude other possible serious neurological diseases in patients with a previously unidentified migraine, as well as in patients with a diagnosed migraine in the presence of atypical symptoms. Zolmitriptan is not indicated for the treatment of hemiplegic, basilar and ophthalmoplegic migraine. In patients taking serotonin 5HT agonists1B/1D- receptors, there were violations of cerebral circulation, including strokes. Patients with migraine may be at risk of developing certain disorders of the cerebral circulation.
Do not use zolmitriptan in patients with Wolff-Parkinson-White syndrome or arrhythmias associated with other additional pathways of impulse conduction.
Very rarely when this class of drugs is used (serotonin 5HT agonists1B/1D-receptors), coronary angiospasm, angina pectoris, and myocardial infarction.
Before prescribing zolmitriptan, patients with risk factors for developing coronary heart disease (eg, smoking, hypertension, hyperlipidemia, diabetes mellitus, family history of coronary artery disease with respect to coronary artery disease) are recommended to carry out a cardiovascular examination, it is necessary to monitor blood pressure and ECG (see Fig. section "Contraindications"). Particular attention should be given to postmenopausal women and men over 40 years of age if these risk factors are present. However, not all patients in the survey can identify cardiovascular diseases,and in very rare cases, serious cardiovascular complications can develop in patients who have not had an indication of a history of cardiovascular disease.
As in the case of the use of other agonists of serotonin 5HT1B/1D-receptors, when zolmitriptan was used, it was reported about sensations of severity, pressure, or constriction in the heart (see "Side Effects" section). If chest pain occurs or symptoms of coronary heart disease, Zolmitriptan should be discontinued before appropriate medical examination.
As in the case of other serotonin 5HT agonists1B/1D-receptors, transient - increased blood pressure was noted in patients regardless of the history of arterial hypertension; very rarely this increase in blood pressure was clinically pronounced. Do not exceed the recommended dose of zolmitriptan.
Side effects can be more frequent with the joint administration of tryptanes and herbal preparations containing St. John's Wort (Hypericum perforatum).There was a development of serotonin syndrome with combined use of tryptanes and selective inhibitorsserotonin reuptake (SSRIs) or serotonin and noradrenaline reuptake inhibitors (SSRIs). Serotonin syndrome may include the following signs and symptoms: changes in mental state, vegetative and neuromuscular symptoms. It is recommended that patients be carefully monitored with the concomitant use of Zomig® Rapimelt and SSRIs or SIOZsin, especially during the initiation of therapy, increasing the dose, or adding another drug that interferes with the metabolism of serotonin (see "Interaction with Other Drugs").
Excessive use of antimigraine drugs can lead to an increased incidence of headache, which potentially requires withdrawal of treatment. If a patient has frequent or daily headaches, despite regular use of drugs to treat this condition, one should remember the possibility of developing a headache with excessive use of drugs for headache therapy.