Zomig (zolmitriptan) is a prescription drug that’s used to treat migraine episodes. Zomig can cause side effects that range from mild to serious. Examples include medication overuse headache, heart attack, and dizziness.

For treating migraine episodes, Zomig is used in adults and certain children.

The active ingredient in Zomig is zolmitriptan. (An active ingredient is what makes a drug work.) The drug comes as:

  • a tablet, which you swallow
  • an orally disintegrating tablet,* which dissolves on your tongue
  • a nasal spray

* The name for this form is Zomig-ZMT.

Keep reading to learn about the common, mild, and serious side effects that Zomig can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during their Zomig treatment.

Below are a few of the more common side effects reported in studies of Zomig. These side effects can vary depending on the form of the drug.

In studies of Zomig tablets and orally disintegrating tablets, more common side effects included:

  • dizziness
  • tingling
  • tiredness or drowsiness
  • feeling cold or warm
  • pain, pressure, or tightness in the jaw, neck, or throat*

* To learn more about this side effect, see the “Side effects explained” section below.

More common side effects in people taking Zomig nasal spray in studies included:

Like most medications, Zomig can cause mild side effects.

Examples of mild side effects that have been reported with Zomig include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Zomig unless your doctor recommends it.

Zomig may cause mild side effects other than the ones listed above. For details, see the Zomig prescribing information for the nasal spray and the tablets and orally disintegrating tablets.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Zomig, visit MedWatch.

Treatment with Zomig may lead to serious side effects. But these weren’t common in studies of the drug. Having certain medical conditions increases your risk of serious side effects with Zomig. (For more information, see the “Warnings for Zomig” section below.)

Serious side effects that have been reported with Zomig include:

* To learn more about this side effect, see the “Side effects explained” section below.

If you develop serious side effects while taking Zomig, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Get answers to some frequently asked questions about Zomig’s side effects.

Can long-term use of Zomig cause side effects?

It’s possible, but not likely.

Medication overuse headache can be a side effect from using Zomig too frequently. For more information on this side effect, see the “Side effects explained” section below.

Keep in mind that Zomig is only taken as needed when a migraine episode occurs. It’s not a medication that you’ll take every day.

Talk with your doctor or pharmacist if you have questions about long-term use of Zomig.

Does Zomig cause weight gain?

No, weight gain wasn’t a side effect reported in studies of Zomig.

Some medications used to prevent or treat migraine episodes may cause weight gain, including:

Some of these medications are used off-label to help prevent or treat migraine episodes. Off-label drug use means a drug that’s been approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that has not been approved.

If you’re concerned about weight gain and your medications, talk with your doctor.

Are the side effects of Zomig pills different from those of the nasal spray?

For the most part, no. Side effects reported in studies of Zomig tablets and studies of Zomig nasal spray were mostly the same.

But people who used the nasal spray experienced the following side effects that weren’t reported in people using Zomig tablets:

If you’d like to learn more about how the Zomig nasal spray compares to Zomig tablets, talk with your doctor or pharmacist.

Learn more about some of the side effects Zomig may cause.

Medication overuse headache

Medication overuse headache is possible with Zomig. This is a common condition that can occur when people overuse medications such as Zomig. But this side effect wasn’t reported in studies of Zomig.

With medication overuse headache, migraine headaches occur more often than usual.

What might help

You may be able to prevent medication overuse headache by not taking more Zomig than your doctor prescribes. Your risk of medication overuse headache is higher if you use Zomig 10 days or more per month.

If you’re taking Zomig 10 days or more per month, contact your doctor right away. They may switch you to a different drug, such as one that works to prevent migraine episodes.

Also, tell your doctor right away if you begin having more frequent migraine headaches while taking Zomig. They may have you stop taking it until your overuse headaches go away.

Pain, pressure, or tightness in your jaw, neck, or throat

You may experience pain, pressure, or tightness in your jaw, neck, or throat from taking Zomig.

In many cases, these symptoms aren’t serious. But pain, pressure, or tightness in your jaw, neck, or throat can be symptoms of a heart attack. In rare cases, Zomig can cause a heart attack (see “Heart attack” below).

What might help

If you feel pain, pressure, or tightness in your jaw, neck, or throat while taking Zomig, call your doctor right away. They’ll likely want to examine your symptoms further.

But if your symptoms feel life threatening, immediately call 911 or seek emergency medical help.

Due to the risk of heart-related problems, doctors usually won’t prescribe Zomig to people who have the following:

Blood vessel problems

In rare cases, treatment with Zomig can result in blood vessel problems, which may include:

Symptoms of blood vessel problems vary depending on where they occur, but may include:

What might help

If you notice symptoms of blood vessel problems while taking Zomig, contact your doctor right away. They’ll likely want to examine your symptoms further. They may have you temporarily stop using Zomig until they can figure out the cause of your symptoms.

If your doctor confirms you’re having blood vessel problems from Zomig, they’ll likely suggest switching to another medication to treat migraine.

Heart attack

Heart attack is a rare but serious side effect Zomig may cause.

Certain people are at higher risk of this side effect if they take Zomig. This includes people who already have heart problems.

It also includes people who have risk factors of cardiovascular disease (heart and blood vessel problems), which include:

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

Common symptoms of a heart attack can include:

What might help

If you think you’re having symptoms of a heart attack, immediately call 911 or seek emergency medical help. This is a life threatening condition that requires treatment in a hospital.

Due to the risk of heart attack and other heart-related side effects, doctors usually won’t prescribe Zomig to people with the following conditions:

Your doctor will check your risk of cardiovascular disease and heart-related side effects before prescribing Zomig. Depending on your risk, you may take your first Zomig dose at their office, where they’ll monitor your heart using an electrocardiogram (EKG). Your doctor will also likely monitor your heart health closely while you’re taking Zomig.

Allergic reaction

Like most drugs, Zomig can cause an allergic reaction in some people. While this side effect wasn’t reported in studies, it has occurred since the drug became available on the market.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage symptoms, they may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Zomig, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Zomig, they may have you switch to a different treatment.

Keeping track of side effects

During your Zomig treatment, consider keeping notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Zomig affects you. They can then use this information to adjust your treatment plan if needed.

Zomig may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Zomig. The list below includes factors to consider.

Heart problems, including high blood pressure that isn’t managed. Doctors usually will not prescribe Zomig to people with heart problems, including high blood pressure that isn’t managed. This is because Zomig can cause heart problems, such as a heart attack, which can be fatal in rare cases. (For more information, see the “Side effects explained” section above.)

If you already have heart problems, taking Zomig may worsen them. Talk with your doctor about other treatments for your migraine episodes that may be safer.

High cholesterol. Having high cholesterol increases your risk of side effects from Zomig, including heart problems. If you have high cholesterol, talk with your doctor before you begin taking Zomig. This will help your doctor to determine whether taking Zomig is safe for you.

Blood circulation problems. Doctors usually will not prescribe Zomig to people with blood circulation problems. Examples include peripheral vascular disease (PVD) and lack of blood flow to your digestive tract or spleen. This is because Zomig can cause blood circulation problems. If you already have such problems, Zomig can worsen them. In this case, your doctor will recommend other treatments for your migraine headaches.

Tobacco use. Smoking or using tobacco increases your risk of certain side effects Zomig may cause, including heart problems. Before you start taking Zomig, tell your doctor whether you smoke or use tobacco. This will help your doctor determine whether Zomig is safe for you to take.

Stroke. Doctors usually will not prescribe Zomig to people who’ve had a stroke in the past. This is because Zomig can cause stroke in rare cases. If you’ve had a stroke, you have a higher risk of this side effect with Zomig. Talk with your doctor about other treatments for your migraine episodes.

Moderate or severe liver problems. After you take a dose of Zomig, your liver breaks down and helps get rid of the medication. If you have moderate or severe liver problems, your liver may have trouble breaking down the medication. This can increase levels of the drug in your body, which in turn may increase your risk of side effects. Based on the severity of your liver problems, your doctor will let you know whether it’s safe for you to take Zomig.

Allergic reaction. If you’ve had an allergic reaction to Zomig or any of its ingredients, your doctor will likely not prescribe Zomig. Ask them what other medications are better options for you.

Alcohol use and Zomig

There’s no known interaction between alcohol and Zomig.

But drinking alcohol can trigger migraine episodes in some people.

If you drink alcohol and have migraine, talk with your doctor. They can tell you how much alcohol is safe for you to consume.

Pregnancy and breastfeeding while taking Zomig

It’s not known whether it’s safe to use Zomig while pregnant or breastfeeding.

If you’re pregnant or breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor about safe treatments for your migraine.

If you’re interested in taking Zomig for migraine, talk with your doctor or pharmacist. Asking questions about the drug can help you decide whether it’s a good treatment option for you. Here are a few examples to get you started:

  • What should I know about alternatives to Zomig? Can they cause similar side effects?
  • Are there treatments I can take to prevent migraine headaches that are safe to take with Zomig?
  • If I have side effects from taking Zomig, is there a lower dose I can try?

To learn more about Zomig, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

Can other medications increase my risk of side effects from Zomig?

Anonymous

A:

Yes, certain other medications can increase your risk of side effects if taken with Zomig.

Due to the risk of serious side effects, certain medications should not be used with Zomig. Examples include:

In addition, taking certain antidepressants while using Zomig can increase your risk of serotonin syndrome. Examples include:

Before you begin taking Zomig, be sure to tell your doctor and pharmacist about any medications you take. They can check whether Zomig is safe to take with your medications.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Was this helpful?

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.