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In controlled clinical trials, single doses of 1, 2.5 and 5 mg of zolmitriptan were effective for the acute treatment of migraines in adults. A greater proportion of patients had headache response following a 2.5 or 5 mg dose than following a 1 mg dose. In the only direct comparison of 2.5 and 5 mg, there was little added benefit from the larger dose but side effects are generally increased at 5 mg. Patients should, therefore, be started on 2.5 mg or lower. A dose lower than 2.5 mg can be achieved by manually breaking a 2.5 mg tablet in half.
If the headache returns, the dose may be repeated after 2 hours, not to exceed 10 mg within a 24 hour period. Controlled trials have not adequately established the effectiveness of a second dose if the initial dose is ineffective.
The safety of treating an average of more than three headaches in a 30 day period has not been established.
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