Zomig Interactions: Alcohol, Medications, and Others

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Before you start treatment with Zomig, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Zomig interacts with herbs or vitamins and supplements, see the “Are there other interactions with Zomig?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Zomig. Keep in mind that this table does not include all drugs that may interact with Zomig. For more information about some of these interactions, see the “Drug interactions explained” section below.

* To learn more about this interaction, see the “When should I avoid Zomig?” section below.

Certain health conditions or other factors could raise your risk of harm if you take Zomig. In such cases, your doctor may not prescribe Zomig for you. These are known as contraindications. The list below includes contraindications of Zomig.

If you have high blood pressure that’s not well-managed: If you have high blood pressure that’s not well-managed with medication, your doctor likely won’t prescribe Zomig. This is because taking Zomig could further increase your blood pressure and raise your risk of heart attack and stroke.

If you have heart disease or an abnormal heart rhythm: If you have heart disease or you’ve had a heart attack before, your doctor likely won’t prescribe Zomig for you. Your doctor also likely won’t prescribe Zomig if you have certain types of abnormal heart rhythm, such as Wolff-Parkinson-White syndrome. This is because taking Zomig could raise your risk of a heart attack. You can ask your doctor about other treatments that may be better options for you.

If you’ve had a stroke: If you’ve had a stroke or transient ischemic attack (also called a ministroke) before, your doctor likely won’t prescribe Zomig. This is because taking Zomig could raise your risk of having another stroke. Your doctor can discuss other treatment options with you.

If you’ve had hemiplegic or basilar migraine: If you’ve had a hemiplegic migraine or a migraine with brainstem aura (basilar migraine) before, your doctor likely won’t prescribe Zomig. This is because taking Zomig could raise your risk of having a stroke. You can ask your doctor about other treatments that may be better options for you.

If you have blood circulation problems: If you have blood circulation problems, such as peripheral vascular disease, Raynaud’s phenomenon, or ischemic bowel disease, your doctor likely won’t prescribe Zomig for you. This is because taking Zomig could worsen your condition. You can ask your doctor about other treatments that may be better options for you.

If you take a certain type of MAOI: Your doctor likely won’t prescribe Zomig if you take a certain type of MAOI (usually prescribed to treat depression) or if you’ve taken one in the past 2 weeks. This is because certain MAOIs can cause the level of Zomig to build up in your body, which can raise your risk of side effects. Your doctor can tell you about other treatments that may be safer for you.

Examples of these MAOIs include:

• isocarboxazid (Marplan)
• phenelzine (Nardil)
• tranylcypromine (Parnate)

If you’ve taken a triptan or ergot medication in the past 24 hours: Triptan and ergot medications can help treat migraine episodes. (Zomig is a triptan.) You should not take Zomig if you’ve taken another triptan or an ergot medication in the past 24 hours. Doing so can raise your risk of serious side effects, such as ischemic bowel disease, heart attack, and stroke.

Examples of other triptans include:

• eletriptan (Relpax)
• rizatriptan (Maxalt)
• sumatriptan (Imitrex)

Examples of ergot medications include:

• dihydroergotamine (Migranal, Trudhesa)
• ergotamine (Ergomar)
• ergotamine/caffeine (Migergot)

You should not take one of these medications for at least 24 hours after taking Zomig.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Zomig or any of its ingredients, your doctor likely won’t prescribe Zomig for you. This is because the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start treatment with Zomig, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Zomig is safe for you.

Zomig is not known to interact with alcohol. But Zomig and alcohol can cause some similar side effects, such as dizziness, sleepiness, and nausea. You may be more likely to experience these side effects if you take Zomig to treat a migraine episode when you’ve been drinking alcohol.

Drinking alcohol can also trigger migraine episodes in some people. If you have questions about how alcohol can affect your condition, talk with your doctor.

If you have questions about taking Zomig with alcohol, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Zomig.

Interaction with SSRIs

Zomig can interact with SSRIs, which are prescribed to treat depression and some other mental health conditions, such as anxiety disorders.

Examples of SSRIs include:

• citalopram (Celexa)
• fluoxetine (Prozac)
• paroxetine (Paxil)

What could happen

Zomig and SSRIs can both cause serotonin syndrome, which is a serious and sometimes life threatening condition caused by a buildup of a chemical called serotonin in your body. Taking Zomig with an SSRI can raise your risk of this side effect.

What you can do

If you take Zomig with an SSRI, your doctor may prescribe a lower dose of Zomig for you. You should not take a higher dose of either medication than your doctor prescribes.

If you take Zomig with an SSRI, contact your doctor right away if you have symptoms of serotonin syndrome. These may include tremor, sweating, flushing (temporary warmth, redness, or deepening of skin color), anxiety, fast heart rate, and diarrhea. These symptoms could occur within minutes or hours of taking a dose of Zomig.

If you have symptoms of serotonin syndrome, you should not take any further doses of Zomig until you’ve talked with your doctor.

If you have questions about taking Zomig with an SSRI, talk with your doctor or pharmacist.

Interaction with opioids

Zomig can interact with opioids, which are strong pain relievers.

Examples of opioid medications include:

• codeine
• morphine (MS Contin)
• oxycodone (Oxycontin)

What could happen

Taking Zomig with an opioid can raise your risk of serotonin syndrome, which is a serious and sometimes life threatening side effect of both drugs.

What you can do

If you take Zomig with an opioid, your doctor may prescribe a lower dose of Zomig or the opioid for you. You should not take a higher dose of either medication than your doctor prescribes.

If you take Zomig and an opioid together, contact your doctor right away if you have symptoms of serotonin syndrome. These may include tremor, sweating, flushing, anxiety, fast heart rate, and diarrhea. These symptoms could occur within minutes or hours of taking a dose of Zomig.

If you have symptoms of serotonin syndrome, you should not take any further doses of Zomig until you’ve talked with your doctor.

If you have questions about taking Zomig with an opioid, talk with your doctor or pharmacist.

Interaction with cimetidine

Zomig can interact with cimetidine (Tagamet HB), which is a medication prescribed to treat ulcers, heartburn, and certain conditions that cause the body to produce too much stomach acid.

What could happen

Taking Zomig with cimetidine can cause the level of Zomig to build up in your body. This can raise your risk of side effects from Zomig, including:

• dizziness
• sleepiness
• abnormal heart rhythm
• heart attack
• high blood pressure
• serotonin syndrome

What you can do

If you take Zomig with cimetidine, your doctor will likely prescribe a lower dose of Zomig for you. You should not take a higher dose of either medication than your doctor prescribes.

If you take Zomig and cimetidine together, tell your doctor right away if you experience any side effects of Zomig. To learn more about the drug’s possible side effects, see this article.

If you have questions about taking Zomig with cimetidine, talk with your doctor or pharmacist.

Zomig may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Zomig.

Does Zomig interact with supplements?

Before you start treatment with Zomig, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Zomig and herbs

There are currently no reports of Zomig interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during treatment with Zomig.

Zomig and vitamins

There are currently no reports of Zomig interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during treatment with Zomig.

Does Zomig interact with food?

There are currently no reports of Zomig interacting with food. If you have questions about eating certain foods during treatment with Zomig, talk with your doctor.

Does Zomig interact with vaccines or lab tests?

There are currently no reports of Zomig interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during Zomig treatment, talk with your doctor.

Does Zomig interact with cannabis or CBD?

There are currently no reports of Zomig interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Zomig.

Certain medical conditions or other health factors may raise the risk of interactions with Zomig. Before starting Zomig, talk with your doctor about your health history. They’ll determine whether Zomig is right for you.

Health conditions or other factors that might interact with Zomig include:

Heart problems or past heart attack or stroke: If you have heart disease or an abnormal heart rhythm, or you’ve had a heart attack or stroke before, your doctor likely won’t prescribe Zomig for you. For more information, see the “When should I avoid Zomig?” section above.

Risk factors for heart disease: On rare occasions, Zomig may cause heart-related side effects, such as heart attack. If you have risk factors for heart disease, your doctor may want to check your heart health before prescribing Zomig. They may also have you take your first Zomig dose under medical supervision.

Risk factors for heart disease include:

• high blood pressure
• high cholesterol
• obesity
• diabetes
• being a female* age 55 years or older or a male* age 45 years or older
• smoking or vaping tobacco products

High blood pressure: Zomig can cause high blood pressure. If you already have high blood pressure, treatment with Zomig could worsen your condition. Talk with your doctor about whether Zomig is right for you. If your blood pressure isn’t well-managed with medication, your doctor likely won’t prescribe Zomig for you.

Blood circulation problems: If you have blood circulation problems, such as peripheral vascular disease, Raynaud’s phenomenon, or ischemic bowel disease, your doctor likely won’t prescribe Zomig for you. This is because taking Zomig could worsen your condition. You can ask your doctor about other treatments that may be better options for you.

Liver problems: If you have moderate or severe liver problems, your doctor will likely not prescribe Zomig for you. This is because your liver may have difficulty clearing the drug from your body, which can raise your risk of side effects. Talk with your doctor about other treatments that may be better options for you.

Pregnancy: It’s not known whether Zomig treatment is safe during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Zomig.

Breastfeeding: It’s not known whether Zomig treatment is safe while breastfeeding. The drug passes into breast milk, but it isn’t known whether the drug it could cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Zomig or any of its ingredients, your doctor will likely not prescribe Zomig for you. This is because the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

* In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Find answers to some frequently asked questions about Zomig and possible interactions.

Can I take zolmitriptan and ibuprofen together?

Yes, it should be safe to take zolmitriptan with ibuprofen (Advil, Motrin). (Zolmitriptan is the active drug in Zomig. An active drug is the ingredient that makes a drug work.) There is no known interaction between these drugs.

Zomig is prescribed to treat migraine episodes in adults and certain children. Ibuprofen is taken to relieve pain, including from migraine headaches, in adults and certain children. It’s not uncommon for doctors to prescribe these drugs together.

If you have other questions about taking Zomig and ibuprofen together, talk with your doctor or pharmacist.

Can I take zolmitriptan and paracetamol together?

Yes, it should be safe to take zolmitriptan with paracetamol. Zolmitriptan is the active drug in Zomig. Paracetamol is called acetaminophen (Tylenol) in the United States.

There is no known interaction between these drugs. Zomig is prescribed to treat migraine episodes in adults and certain children. Acetaminophen is taken to relieve pain, including from migraine headaches, in adults and certain children. It’s not uncommon for doctors to prescribe these drugs together.

If you have other questions about taking Zomig and acetaminophen together, talk with your doctor or pharmacist.

Taking certain steps can help you avoid interactions with Zomig. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Zomig treatment.

It’s also important to understand Zomig’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Zomig, ask your pharmacist to print a copy for you.)

If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Taking Zomig exactly as prescribed can also help prevent interactions.

If you still have questions about Zomig and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Could I still take Zomig if it interacts with a health condition that I have?
• Do I need to check with you before taking Zomig with over-the-counter drugs?
• Do other migraine treatments have similar interactions to Zomig?

To learn more about Zomig, see these articles:

• All About Zomig
• Side Effects of Zomig: What You Need to Know
• Dosage for Zomig: What You Need to Know

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.