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Overview

Welcome to Dwaey, specifically on MYCODERM page.
This medicine contains an important and useful components, as it consists of
Butyl hydroxybenzoate, Salicylic acid, Sodium propionateis available in the market in concentration

Name

Zolmitriptan 5% Nasal prep

Precaution

Before using **Zolmitriptan 5% Nasal Spray**, patients should take the following precautions: - **Cardiovascular Concerns**: Zolmitriptan can cause **vasoconstriction** (narrowing of blood vessels), so it should be used cautiously in patients with a history of **cardiovascular disease**, including **ischemic heart disease**, **angina**, **stroke**, or **peripheral vascular disease**. It can worsen these conditions and lead to serious heart-related side effects. - **Serotonin Syndrome**: There is a risk of **serotonin syndrome** if **Zolmitriptan** is taken in combination with other serotonergic medications (e.g., **SSRIs**, **SNRIs**, **MAO inhibitors**). Symptoms of serotonin syndrome include **agitation**, **confusion**, **fever**, **muscle twitching**, and **increased heart rate**. Immediate medical attention is required if these symptoms appear. - **Hepatic and Renal Impairment**: Caution should be exercised in patients with **liver** or **kidney disease**, as the drug may be metabolized or cleared differently. Dosage adjustments may be needed for those with impaired function. - **Elderly Patients**: Older patients may have an increased risk of side effects due to slower metabolism or pre-existing health conditions. Monitoring is recommended. - **Pregnancy and Breastfeeding**: **Category C** for pregnancy, meaning **zolmitriptan** should be used only if the potential benefit outweighs the risk. It is not recommended during breastfeeding, as it is unknown whether zolmitriptan is excreted in breast milk.

Indication

**Zolmitriptan 5% Nasal Spray** is indicated for: - **Acute Treatment of Migraines**: Zolmitriptan is primarily prescribed to relieve **migraine attacks** with or without **aura** (visual disturbances). It is not intended to prevent migraines, but rather to treat an attack once it has started. - **Cluster Headaches**: Zolmitriptan may also be used to treat **cluster headaches**, which are characterized by sudden, severe pain, typically around one eye or on one side of the head.

Contra indication

Zolmitriptan nasal spray should **not be used** in the following cases: - **Hypersensitivity**: Patients who have had an allergic reaction to **zolmitriptan** or any of the components in the nasal spray should avoid using it. - **Heart Disease**: Zolmitriptan is contraindicated in patients with **ischemic heart disease**, **angina**, or a history of **heart attack** or **stroke**, due to the risk of serious cardiovascular complications. - **Severe Hepatic Impairment**: It should not be used in patients with **severe liver disease** since the drug’s metabolism may be significantly affected. - **Severe Renal Impairment**: Avoid use in patients with **severe kidney impairment** (creatinine clearance <30 mL/min) as it can lead to increased drug levels and toxicity. - **Concurrent Use of Other Triptans or Ergotamine Derivatives**: Zolmitriptan should not be combined with other **5-HT1 agonists** (e.g., sumatriptan) or **ergotamine-containing medications** because it increases the risk of **vasoconstriction** and ischemic events.

Side Effect

Common side effects of **Zolmitriptan Nasal Spray** include: - **Nasal irritation** or **dryness** at the site of administration - **Dizziness** or feeling **lightheaded** - **Drowsiness** or **fatigue** - **Taste disturbances**, such as a bad taste in the mouth - **Tingling or numbness** in the hands, feet, or face - **Flushing** (redness or warmth in the face or upper body) Serious side effects to watch for include: - **Chest tightness or pain**, which may indicate serious cardiovascular issues, such as a heart attack or ischemic event. - **Severe dizziness** or **fainting** may indicate low blood pressure or other serious effects. - **Serotonin syndrome**: Symptoms include **high fever**, **muscle rigidity**, **rapid heart rate**, **agitation**, and **confusion**. - **Severe allergic reactions**: Symptoms include **swelling of the throat**, **difficulty breathing**, or a **rash**.

Pregnancy Category ID

3

Mode of Action

Zolmitriptan is a **5-HT1 serotonin receptor agonist** that works by: - **Vasoconstriction**: It selectively binds to serotonin receptors in the brain, particularly the **5-HT1B** and **5-HT1D** receptors, to cause the **narrowing of blood vessels** in the brain, which helps reduce the dilation that contributes to migraine pain. - **Inhibition of neuropeptide release**: Zolmitriptan inhibits the release of **calcitonin gene-related peptide (CGRP)**, which is involved in the transmission of pain and inflammation during a migraine attack. - **Relieving migraine symptoms**: By constricting blood vessels and blocking pain transmission, zolmitriptan helps to alleviate the pain and other symptoms of a migraine.

Interaction

Several drug interactions can affect the efficacy and safety of **Zolmitriptan 5% Nasal Spray**: - **Other Serotonergic Drugs**: Co-administration with **SSRIs**, **SNRIs**, or **MAO inhibitors** may increase the risk of **serotonin syndrome**, a potentially life-threatening condition. - **Other Triptans**: The use of zolmitriptan together with other **triptans** (e.g., sumatriptan, rizatriptan) should be avoided within a **24-hour period** due to the increased risk of vasoconstriction and other cardiovascular effects. - **Ergotamine and Dihydroergotamine**: Combining zolmitriptan with **ergotamine derivatives** can enhance the vasoconstriction effects and should be avoided within **24 hours**. - **CYP450 Enzyme Inhibitors**: Zolmitriptan is metabolized by the **CYP1A2 enzyme**. Medications like **fluvoxamine** (an SSRI) may inhibit this enzyme and increase zolmitriptan levels, increasing the risk of side effects. - **Alcohol**: Alcohol may increase the risk of **dizziness**, **drowsiness**, and other side effects associated with zolmitriptan.

Pregnancy Category Note

Information not available

Adult Dose

For **migraine**: - The recommended initial dose of **Zolmitriptan 5% Nasal Spray** is **5 mg** at the onset of a migraine. - If symptoms persist or return after **2 hours**, a second dose of **5 mg** may be administered. - The maximum recommended dose in **24 hours** is **10 mg**. For **cluster headaches**: - The typical dose is **5 mg**, and it should be taken at the onset of a cluster headache attack. - It may be repeated after **2 hours** if symptoms continue, but no more than **2 doses** (10 mg) should be used in a 24-hour period.

Child Dose

**Zolmitriptan Nasal Spray** is **not recommended for use in children** under 18 years old, as its safety and efficacy in this population have not been established. The use of zolmitriptan in pediatric patients should be avoided unless specifically directed by a healthcare provider. --- **Important Note**: Before using **Zolmitriptan Nasal Spray**, patients must consult with their healthcare provider to ensure that this medication is suitable for their condition. Medical guidance is essential to minimize risks and ensure the correct dosage and administration. Always follow the prescribed regimen and inform your healthcare provider of any other medications being used.

Renal Dose

For patients with **renal impairment**, **Zolmitriptan Nasal Spray** should be used with caution: - **Mild to moderate renal impairment**: No dose adjustment is necessary, but caution is advised. - **Severe renal impairment**: In patients with severe kidney disease, the use of zolmitriptan should be avoided or used with close medical supervision, as dosage adjustments may be necessary due to altered drug clearance.

Administration

Information not available