Do not use Zomig Nasal Spray:

• If you are allergic to zolmitriptan or any of the other ingredients of this medicine (listed in section 6).
• If you have high blood pressure.
• If you have ever had heart problems, including a heart attack, angina (chest pain caused by exercise or effort), Prinzmetal’s angina (chest pain which happens at rest) or have experienced heart related symptoms such as shortness of breath or pressure over the chest.
• If you have had a stroke or short-lasting symptoms similar to stroke (transient ischaemic attack or TIA).
• If you are at the same time taking some other medicines for migraine (e.g. ergotamine or ergot-type medicines like dihydroergotamine and methysergide) or other triptan medicines for migraine. See section below: ‘Other medicines and Zomig Nasal Spray’ for further information.

Do not use Zomig Nasal Spray if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before using Zomig Nasal Spray.

Warnings and precautions

Talk to your doctor of pharmacist before using Zomig Nasal Spray:

• If you are at risk of getting ischaemic heart disease (poor blood flow in the arteries of the heart). Your risk is greater if you smoke, have high blood pressure, high levels of cholesterol, diabetes or if anyone in your family has ischaemic heart disease.
• If you have been told that you have Wolff-Parkinson-White Syndrome (a type of abnormal heart beat).
• If you have ever had liver problems.
• If you have headaches which are not like your usual migraine headache.
• If you are taking any medicine for treatment of depression (see section below: ‘Other medicines and Zomig Nasal Spray’ for further information).

If you go into hospital tell the medical staff you are using Zomig Nasal Spray.

Zomig Nasal Spray is not recommended for people aged over 65.

Children and adolescents

Zomig Nasal Spray is not recommended for children and adolescents aged under 18 years.

As with other migraine treatments, using too much Zomig Nasal Spray can cause daily headaches or can make your migraine headaches worse. Ask your doctor if you think that this is the case for you. You may need to stop using Zomig Nasal Spray to correct the problem.

Other medicines and Zomig Nasal Spray

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes herbal medicines and medicines you buy without prescription.

In particular, tell your doctor if you are taking any of the following medicines:

Medicines for migraine:

• If you take a triptan other than Zomig Nasal Spray (such as sumatriptan or naratriptan) leave 24 hours before using Zomig Nasal Spray.
• After using Zomig Nasal Spray leave 24 hours before taking another triptan.
• If you take medicines containing ergotamine or ergot-type medicines (such as dihydroergotamine or methysergide), leave 24 hours before using Zomig Nasal Spray.
• After using Zomig Nasal Spray leave 6 hours before taking ergotamine or ergot-type medicines.

Medicines for depression:

• Mono-Amine Oxidase Inhibitors, also known as MAOIs (such as moclobemide).
• SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine, paroxetine, fluvoxamine or sertraline.
• SNRIs (serotonin norepinephrine reuptake inhibitors) such as venlafaxine or duloxetine.

Other medicines:

• Cimetidine (for indigestion or stomach ulcers).
• A quinolone antibiotic (such as ciprofloxacin).

You should not take the herbal remedy St. John’s wort (Hypericum perforatum) at the same time as this medicine. If you already take a St. John’s wort preparation, stop taking the St. John’s wort and mention this to your doctor at your next visit.

Zomig Nasal Spray with food and drink

You can use Zomig Nasal Spray with or without food. It does not affect the way that Zomig Nasal Spray works.

Pregnancy, breast-feeding and fertility

It is not known if using Zomig Nasal Spray during pregnancy is harmful. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.

Driving and using machines

During a migraine attack your reactions may be slower than usual. Bear this in mind when you drive or use any tools or machines.

Zomig Nasal Spray is unlikely to affect driving or using tools or machines. However, it is best to wait to see how Zomig Nasal Spray affects you before you try these activities.