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About - Zolmitriptan

By mouth: Treats migraine headaches. This medicine does not prevent migraine headaches. This medicine is a triptan.

Into the nose: Treats migraine headaches.

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Results: 1 to 20 of 22

Meta-analysis of the efficacy and safety of zolmitriptan in the acute treatment of migraine

The authors concluded that zolmitriptan 2.5mg tablet was effective for acute migraine with similar efficacy to almotriptan 12.5mg, eletriptan 40mg and sumatriptan 50mg and greater efficacy than naratriptan 2.5mg for pain-free response at two hours. Findings that were based predominantly on single studies and incomplete reporting of review methods made it difficult to assess the reliability of the conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Zolmitriptan for acute migraine attacks in adults

Migraine is a complex condition with a wide variety of symptoms. It affects about 1 person in 8, mainly women aged 30 to 50 years. For many people, the main feature is a painful, and often disabling, headache. Other symptoms include feeling sick, vomiting, disturbed vision, and sensitivity to light, sound, and smells.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Comparing Triptans

How do triptans compare in treating migraines?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

Migraine: Are there differences in how the triptans work?

Drugs known as triptans can relieve migraine symptoms. There are differences between the various triptans, such as how they are used. It is hard to tell whether some triptans work better or have fewer side effects than others.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 20, 2012

Treating migraine with medication

Migraine attacks can be treated with different types of medication. Apart from commonly used painkillers, products for nausea or special migraine medication called triptans can also be used.Most people will use one or more medications to help them through an attack, especially if the migraine is very painful. Which medications people use depends on how serious the migraine attack is: A "basic" painkiller from a pharmacy might be enough to relieve moderate pain. But a stronger medication is needed for more severe migraines. People who have frequent migraines will often keep a variety of medications ready to be used if needed.The types of medication most commonly used by adults with migraines are:Painkillers from the group of non-steroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (ASA, the drug in "Aspirin"), ibuprofen, diclofenac or naproxen, and acetaminophen (paracetamol)Nausea medication like metoclopramide or domperidoneSpecial migraine medication (triptans) such as almotriptan or eletriptanAnother substance some migraine prescription drugs are based on  is ergotamine, which is derived from a grain fungus called ergot. For almost a century this was the only medicine specifically used to treat migraines. Nowadays, ergotamine is used less because it has more side effects than the triptans. In Germany, ergotamine products are no longer approved for preventing migraines as of 2014.Different types of medication serve different purposes. Some people mainly want relief as quickly as possible. They might go for a drug that acts faster, even if another might provide more relief but take longer to kick in. For others, maximum relief is the most important thing, even if it takes a little longer to start working. People whose migraines last for a long time might prefer drugs with a longer-lasting effect. Some people's options are limited, for example because they have heart disease and are therefore advised not to use triptans.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 20, 2012

Drug Class Review: Triptans: Final Report Update 4 [Internet]

Triptans, also called serotonin 5-hydroxytryptamine (5-HT)(1B/1D) agonists, are used to treat migraine and certain other headaches. Triptans act by binding to serotonin receptors in the brain, which leads to a reversal of blood vessel swelling. Triptans may be taken subcutaneously, orally as tablets, capsules, or quick-dissolving wafers, or intranasally as a spray. Currently, 7 triptans are available in the United States (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan and zolmitriptan), as well as a fixed-dose combination product containing sumatriptan plus naproxen. Comparing the clinical efficacy and harms of the different triptans has been an area of considerable interest to researchers and patients, but is complex because of the large variety of outcome measures that can be measured in studies. The purpose of this review is to compare the efficacy, effectiveness, and harms of triptans.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2009
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Triptans for acute cluster headache

Cluster headaches are excruciating headaches of extreme intensity. They can last for several hours, are usually on one side of the head only, and affect men more than women. Multiple headaches can occur over several days. Fast pain relief is important because of the intense nature of the pain with cluster headache.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Naratriptan for the treatment of acute migraine: meta-analysis of randomised controlled trials

OBJECTIVE: To evaluate the comparative efficacy and tolerability of naratriptan in the treatment of acute attacks of migraine.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Acute and preventive pharmacologic treatment of cluster headache

The authors recommend offering subcutaneous sumatriptan 6mg, intranasal zolmitriptan 5mg and 10mg and 100% oxygen for treatment of cluster headaches. Preventive therapies that should or may be considered were recommended in the review. Given the potential for missed data and the limited evidence for the different treatments, the authors’ recommendations should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Double-blind clinical trials of oral triptans vs other classes of acute migraine medication: a review

Although the migraine clinical trials literature is enormous, we identified only nine published double-blind studies which compare an oral triptan with a non-triptan acute treatment. Of the nine comparative trials that met inclusion criteria for this review, six compared sumatriptan with other drugs, zolmitriptan was studied in two trials and eletriptan in one trial. In seven of the nine studies reviewed herein, differences between active treatments on the primary endpoints were not dramatic. Experience in clinical practice suggests that, for many patients, oral triptans are superior to non-specific acute treatments, creating a discrepancy between clinical trials results and clinical practice experience. Four possible explanations for the disparities between clinical trials and clinical practice are likely: (i) statistically significant differences may not have emerged because the studies lack adequate statistical power; (ii) patients treated with triptans in clinical practice may be relatively more responsive to triptans and relatively less responsive to other agents than those who participate in clinical trials (patient selection); (iii) headache response at 2 h, as measured in clinical trials, may not fully capture the benefits of triptans relative to other therapies, as assessed in clinical practice; (iv) waiting until pain is moderate or severe, as required in clinical trials, may disadvantage triptans relative to comparators.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Meta-analysis examining the efficacy and safety of almotriptan in the acute treatment of migraine

OBJECTIVE: To evaluate the comparative efficacy and safety of oral almotriptan in treating acute migraine attacks.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Triptans in prevention of menstrual migraine: a systematic review with meta-analysis

The authors concluded that triptans were an effective short-term prophylactic treatment for menstrual migraines. Considering migraine frequency, severity and adverse events, frovatriptan 2.5mg twice daily and zolmitriptan 2.5mg three times daily were the most preferable regimens. The conclusion regarding the effectiveness of triptans seems reliable; the recommendations for further research were justified.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The efficacy of triptans in childhood and adolescence migraine

Studies on the acute treatment of migraine in children and adolescents are rare and difficult to design. In particular, the high placebo response in some trials makes it difficult to prove efficacy of a verum drug. All available placebo-controlled trials on the acute migraine treatment in children and adolescents with a triptan were analyzed with respect to different end points (rate of pain free and pain relief at 2 hours; rate of adverse events). We identified 6 crossover and 11 parallel group trials. Although the trials were heterogenous with respect to the triptans and the dosage, pooled data were calculated. The pooled responder rate of triptans for 2 hours pain free was 36.0 % in crossover trials (significant difference to placebo with 17.7 %) and 32.5 % in parallel group trials (significant difference to placebo with 26.3 %). Triptans also showed a significantly higher pain relief rate at 2 hours than placebo both in crossover and parallel group trials. The rate of adverse events was significantly higher after triptans than after placebo. However, triptans were well tolerated in all trials. At least 1 trial with significant efficacy was found for sumatriptan (10-20 mg nasal spray), zolmitriptan (2.5-5 mg tablet), rizatriptan (5-10 mg tablet), and almotriptan (12.5-25 mg tablet). Placebo rates for efficacy were considerably lower in crossover trials than in parallel group trials. This analysis suggests that parallel group trials on the acute treatment of migraine in children and adolescents with a triptan show a very low therapeutic gain because of a high placebo rate. The verum response rates, however, are very similar to those seen in adulthood trials. However, there is sufficient evidence that at least some triptans are efficacious even in childhood and adolescence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Treatment of children with migraine in the emergency department: a qualitative systematic review

This review aimed to assess the effectiveness of treatments administered in the emergency department for children with migraine and status migrainosus. The authors concluded that there was a lack of evidence in an emergency department setting. This was a relatively well-conducted systematic review. The authors' conclusions were appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Marketed oral triptans in the acute treatment of migraine: a systematic review on efficacy and tolerability

BACKGROUND: In the current literature, there is neither a reported systematic review comparing the efficacy of triptans at 30 minutes and 1 hour after the migraine treatment, nor data related to efficacy of new marketed triptans.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Efficacy, safety, and tolerability of Telcagepant in the treatment of acute migraine: a meta-analysis

Although triptans are widely used for treating acute migraine, they are contraindicated or not effective in a large proportion of patients. Hence, alternative treatments are needed. Calcitonin gene-related peptide receptor antagonists, such as telcagepant, have been under investigation as a treatment for acute migraine. A meta-analysis of the efficacy of telcagepant vs. placebo and triptans (zolmitriptan or rizatriptan) was performed. Randomized controlled trials were indentified from databases using the following search terms: migraine; calcitonin gene-related peptide; calcitonin gene-related peptide receptor antagonists; efficacy; safety, and telcagepant. The primary outcome measure was pain freedom 2 hours after first treatment. The secondary outcome measure was pain relief 2 hours after first treatment. Eight trials were included in the meta-analysis (telcagepant = 4011 participants). The difference in pain freedom at 2 hours significantly favored telcagepant over placebo (odds ratio = 2.70, 95% confidence interval = 2.27-3.21, P < 0.001) and triptans over telcagepant (odds ratio = 0.68, 95% confidence interval = 0.56-0.83, P < 0.001). The difference in pain relief at 2 hours significantly favored telcagepant over placebo (odds ratio = 2.48, 95% confidence interval = 2.18-2.81, P < 0.001). The difference in pain relief at 2 hours did not significantly favor telcagepant over triptans or vice versa (odds ratio = 0.76, 95% confidence interval = 0.57-1.01, P = 0.061). These findings indicate that telcagepant can be effective for treating acute migraine. Calcitonin gene-related peptide receptor antagonists represent a potentially important alternative means of treating acute migraine.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Acute migraine therapy: recent evidence from randomized comparative trials

The review found that triptan/NSAID combination therapy was more effective than one agent. All triptans were similarly effective, but almotriptan was better tolerated than sumatriptan. Limitations of the review methodology, including a limited validity assessment, meant that the reliability of the results could not be assessed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Acute treatment and prevention of menstrually related migraine headache: evidence-based review

This review found evidence to support the use of a number of medications in the acute treatment and short-term prevention of menstrually related migraine. Overall the review was well conducted, but the authors' specific recommendations for particular treatment regimes, especially where based on more limited evidence, should be treated with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Self-Harm: Longer-Term Management

This is the first NICE guideline on the longer-term management of both single and recurrent episodes of self-harm.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2012
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Migraine in Children: Preventive Pharmacologic Treatments [Internet]

To assess the comparative effectiveness and safety of preventive pharmacologic treatments for community-dwelling children with episodic or chronic migraine.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: June 2013
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Systematic Reviews in PubMed

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