Product Code Database
Zolmitriptan, sold under the brand name Zomig among others, is a serotonergic medication which is used in the acute treatment of migraine attacks with or without aura and . It is taken by mouth as a swallowing or disintegrating tablet or as a nasal spray.
include tightness in the neck or throat, Orofacial pain, dizziness, paresthesia, asthenia, somnolence, warm/cold sensations, nausea, chest pressure, and dry mouth. The drug acts as a selective serotonin 5-HT1B and 5-HT1D receptor agonist. Structurally, it is a triptan and a tryptamine derivative.
It was in 1990 and was approved for medical use in 1997.
A 2014 Cochrane review has shown that zolmitriptan 5mg nasal spray was significantly more effective than the 5mg oral tablet.
As for cardiovascular , zolmitriptan can increase systolic blood pressure in the elderly and increase diastolic blood pressure in both the elderly and young people. Additionally, there is the side effect of a dose dependence increase in sedation. There is a risk for medication withdrawal headache or medication overuse headache.
Zolmitriptan has a weak affinity for serotonin 5-HT1A receptors; these receptors have been implicated in the development of serotonin syndrome.
| + | |
| 16–316 (Ki) 3,020–>10,000 () 55% () | |
| 0.47–20 (Ki) 3.8–60 () 99–102% () | |
| 0.11–4 (Ki) 0.29–1.6 () 86–106% () | |
| 10–>10,000 (Ki) 6.6–62 () 101% () | |
| 28–617 (Ki) 10–420 () 97% () | |
| >10,000 (Ki) >10,000 () | |
| 65–>10,000 (Ki) >10,000 () | |
| 79,400 (Ki) (guinea pig) () | |
| >3,160 (mouse) | |
| >3,160 (guinea pig) | |
| 398 (rat) | |
| >3,160 | |
| 87–96 (Ki) 525 () | |
| 79,000 | |
| >100,000 | |
| Notes: The smaller the value, the more avidly the drug binds to the site. All proteins are human unless otherwise specified. Refs: (2025). 9780128233573 ISBN 9780128233573 | |
Zolmitriptan is a selective serotonin 5-HT1B and 5-HT1D receptor agonist with weak affinity for the serotonin 5-HT1A receptor. It also has affinity for other serotonin receptors, including the serotonin 5-HT1E, 5-HT1F, 5-HT2B, 5-HT5A, and 5-HT7 receptors. Conversely, its affinities for the serotonin 5-HT2A, 5-HT2C, 5-HT3, 5-HT4, and 5-HT6 receptors are negligible or undetectable. It is likewise inactive as a serotonin 5-HT2A receptor agonist.
Zolmitriptan's major metabolite, N-desmethylzolmitriptan (183C91), is also active and has about 2- to 6-fold the affinity of zolmitriptan for the serotonin 5-HT1B and 5-HT1D receptors.
Its action on serotonin 5-HT1B and 5-HT1D receptors causes vasoconstriction in intracranial ; as well it can inhibit the release of pro-inflammatory from trigeminal perivascular . It crosses the blood–brain barrier as evidenced by the presence of zolmitriptan within the cells of the trigeminal nucleus caudalis and nucleus tractus solitarii.
The experimental log P of zolmitriptan is 1.6 to 1.8. For comparison, the experimental log P of sumatriptan is 0.8 to 0.93. Zolmitriptan is much more lipophilic than sumatriptan.
Analogues of zolmitriptan include other triptans like sumatriptan, naratriptan, rizatriptan, eletriptan, almotriptan, and frovatriptan.
AstraZeneca's U.S. patent on Zomig tablets expired on November 14, 2012, and its pediatric exclusivity extension expired on May 14, 2013. The patent in certain European countries has already expired too, and generic drug maker Actavis released a generic version in those countries, starting in March 2012.
Pharmacokinetics
Absorption
Zolmitriptan has a rapid onset of action and has been detected in the brain as early as within 5minutes of intranasal administration. On average, zolmitriptan has an oral bioavailability of 40%, a mean volume of distribution of 8.3L/kg after oral administration, and 2.4L/kg after intravenous administration. According to a study of healthy volunteers, food intake seems to have no significant effect on the effectiveness of zolmitriptan in both men and women.
Distribution
Zolmitriptan is a more lipophilic compound with greater central permeability than certain other like sumatriptan. It has been found to cross the blood–brain barrier and enter the central nervous system both in animals and humans. In a clinical pharmacokinetic study, brain concentrations were about 20% of plasma concentrations. However, in another clinical study, the drug achieved relatively low occupancy of central serotonin 5-HT1B receptors (4–5%) as measured by positron emission tomography (PET) medical imaging.
Metabolism
Zolmitriptan is drug metabolism into three major by the human liver cytochrome P450 —primarily CYP1A2. Two-thirds of the parent compound breaks down into the active metabolite N-desmethylzolmitriptan (183C91), while the remaining one-third separates into the other two inactive : zolmitriptan N-oxide and an indole acetic acid derivative. N-Desmethylzolmitriptan circulates at higher levels than those of zolmitriptan. This metabolite is deamination by monoamine oxidase A (MAO-A).
Elimination
Zolmitriptan has an elimination half-life of about 3hours before it undergoes kidney elimination; its clearance is greater than the glomerular filtration rate suggesting that there is some renal tubular secretion of the compound.
Chemistry
Zolmitriptan, also known as (4 S)-2-oxo-1,3-oxazolidin-4-ylmethyl- N, N-dimethyltryptamine, is a tryptamine derivative and a 5-substituted derivative of the psychedelic drug dimethyltryptamine (DMT). It is specifically the derivative of DMT in which the hydrogen atom at position 5 of the indole ring has been substituted with a (4 S)-2-oxo-1,3-oxazolidin-4-ylmethyl functional group.
History
Zolmitriptan was in 1990 and was first described in the scientific literature by 1994. It was first introduced for medical use in the United States in 1997.
Society and culture
Brand names
Zolmitriptan is marketed by AstraZeneca with the brand names Zomig, Zomigon (Argentina, Canada, and Greece), AscoTop (Germany) and Zomigoro (France).
Economics
In 2008, Zomig generated nearly $154 million in sales. . Drug Topics (May 26, 2009). Retrieved on August 25, 2009.
Legal status
In Russia, versions of zolmitriptan which are not registered in the National registry of medications may be regarded as narcotic drugs (derivatives of dimethyltriptamine).
Research
Obsessive–compulsive disorder
Zolmitriptan showed no effect on obsessive–compulsive disorder (OCD) symptoms nor on mood or anxiety in a clinical study.
Social deficits and aggression
Zolmitriptan, in a modified-release drug formulation with code name ML-004 (or ML004), is under development by MapLight Therapeutics for the treatment of pervasive developmental disorders (e.g., autism), agitation, and aggression. The drug has been found to reduce aggression in rodents and has also been reported to decrease aggression in humans. As of June 2023, zolmitriptan is in phase 2 for pervasive developmental disorders, phase 1 clinical trials for agitation, and is in the preclinical stage of development for aggression.
Further reading
External links
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