Which patient profile is most likely to be prescribed zolmitriptan for a migraine?

• A. An 18-year-old female with BMI 28
• B. An 18-year-old male with BMI 30
• C. A 40-year-old male with hypertension
• D. A 25-year-old female with BMI 22

Answer: (B)

Zolmitriptan is used for the acute treatment of migraine by activating 5-HT1B/1D receptors, which causes constriction of cranial blood vessels and reduces neurogenic inflammation. It is intended for adult patients and older adolescents who do not have contraindicating cardiovascular conditions. The key safety limits are significant cardiovascular disease and uncontrolled hypertension, since the vasoconstrictive action can raise blood pressure or precipitate ischemic events.

Among the profiles given, the one with an explicit cardiovascular risk factor—hypertension—would raise safety concerns and is not suitable for zolmitriptan. The other profiles lack such contraindications, and the person is within the typical adult age range for this medication. Therefore, the 18-year-old male with BMI 30 is the profile most consistent with being prescribed zolmitriptan.