It is permitted to use the drug together with paracetamol and rifampicin, or with substances of pizotifen or fluoxetine, with medications propranolol and metoclopramide, as well as with caffeine.
According to the information obtained after the tests with volunteers, there is no pharmacokinetic interaction of the drug with ergotamine. But thus, as in theory the probability of occurrence of coronarospasm may increase, it is recommended to use Rapimig at least 24 hours after the use of ergotamine. In addition, ergotamines are recommended to be consumed at least 6 hours after taking Rapimig.
Using moclobemide (the substance is a specific inhibitor of the MAO-A element), an insignificant increase in the AUC (by 26%) level of zolmitriptan and its active degradation product (by a factor of 3) occurred. Because of this, people who use MAO-A inhibitors are advised to use zolmitriptan in daily dosages of not more than 5 mg. Medications can not be combined if moclobemide is taken in amounts greater than 150 mg 2 times per day.
Due to the use of cimetidine (the general inhibitor of element P 450), the half-life of zolmitriptan increased by 44%, and the level of AUC by 48%. At the same time, cimetidine doubled the half-life and AUC of the N-dimethylated active decomposition product (183C91). Persons who use cimetidine should not take more than 5 mg of zolmitriptan per day. The existing general profile of drug interaction does not allow excluding the probability of interaction of the active component with inhibitors of the CYP 1A2 element. Because of this, in case of combination with substances such as quinolones (eg, ciprofloxacin), as well as fluvoxamine, it is also required to reduce dosage.
There is no pharmacokinetic interaction of zolmitriptan with fluoxetine (SSRIs), as well as selegiline (an inhibitor of the MAO-B element). But in case of a combination with reverse inhibitors of serotonin reuptake (either noradrenaline and serotonin), as well as tryptans, the development of serotonin intoxication is possible (this includes changes in the state of the psyche, anomalies of the neuromuscular function, and vegetative lability). These manifestations can have a severe form. If there is a medicinal expediency of using zolmitriptan with drugs SSRIs or SIZZSiN, it is required to perform an appropriate examination of the patient (in particular this concerns the initial period of treatment), increasing the dose or using a different serotonergic drug.
Like other 5HT 1B / 1D conductor agonists, zolmitriptan can inhibit the absorption of other drugs