Zolmist Nasal Spray (zolmitriptan) is a generic version of the better-known brand name medication Zomig. Both products provide the same benefit, but generics are less costly.

Zolmist Nasal Spray belongs to the triptan class of drugs, predominantly used to treat migraine headaches. An abortive treatment, the medication only works once a headache has begun---it will not prevent a migraine if taken before first symptoms, nor will it reduce migraine frequency.

As a nasal spray this medication works quickly---relief begins in just 5 to 10 minutes. This speed of action makes Zolmist Nasal Spray suitable for severe migraines as well as cluster headaches, which are notoriously difficult to treat. It is the fastest-acting triptan formulation outside of injections.

Managing Migraines & Cluster Headaches

Like all triptans---in fact all abortive headache treatments---results are best if the medication is used at the earliest symptoms that headache has begun. In cluster headaches the first symptom is often pain. In migraines it may be pain, but also includes auras, neck tension, or similar symptoms that precede pain.

Zolmist Nasal Spray is, as the name suggests, a nasal spray. It comes in a vial with a built-in dispenser at top; each actuation delivers 5 mg of zolmitriptan in a fine mist. Patients should insert the dispenser into a nostril as far as it can go comfortably and deliver a dose while inhaling through the nose gently. In other words, very similar to other nasal sprays. More detailed instructions are included with each device.

Treating both migraines and cluster headaches is very similar:

• At the first symptoms, insert the tip of the device into a nostril.
• Use a finger to hold the other nostril closed and tip the head back slightly.
• While inhaling gently through the nose, press the plunger on the device.
• Keep head tipped back for several minutes while breathing through the mouth.
• Relief should begin in 5 to 10 minutes. Effects peak after 2 hours, and begin wearing off after 4 hours.
• If the headache returns or persists, a second dose may be administered after 2 hours.
• Never take more than 2 doses, or 10 mg, of Zolmist Nasal Spray in a 24 hour period.

There may be an odd taste in the mouth or a feeling of liquid in the back of the throat after using Zolmist Nasal Spray. This is normal and will pass in a few moments. Most patients find their headaches, if not completely eliminated, are reduced to such an extent that they're not disruptive.

Other headache mitigation techniques---sleeping, laying in a dark room, taking a warm shower and so forth---are advisable if they help. However, be very wary of taking other headache medications, particularly other triptans. Consult a doctor if unsure.

Adverse Effects

Zolmist Nasal Spray, like all triptans, is a vasoconstrictor. This means it constricts blood vessels, as well as inhibits production of some chemicals in the brain that cause pain. Patients who have conditions that cause circulation issues, blood pressure concerns, or are taking other medications that produce similar effects, are at considerably greater risk of experiencing complications.

Patients are strongly advised not to use Zolmist Nasal Spray---or any triptan medication---without first discussing risks with a doctor if there is any history of:

• Heart or blood vessel problems
• Severe or untreated hypertension
• Inadequate blood supply to the intestine (ischemic bowel disease)
• High risk factors for heart disease, heart attack, or stroke

Other medications of significant concern include:

• SSRIs, SNRIs, MAOIs and some other antidepressants
• Medications containing ergotamine (also a migraine treatment and vasoconstrictor)
• Other medications containing triptans
• Recreational drugs, including alcohol, that raise blood pressure
• St John’s Wort

The effects of triptan medications on unborn or nursing babies is unclear; this medication should not be used while pregnant or breastfeeding without explicit doctor approval.