OBJECT DRUGS

• Almotriptan (Axert)
• Eletriptan (Relpax)

PRECIPITANT DRUGS

Calcium Channel Blockers:

• Diltiazem (Cardizem, etc.)
• Verapamil (Isoptin, etc.)

Comment:

Almotriptan and eletriptan are CYP3A4 substrates, and CYP3A4 inhibitors such as diltiazem or verapamil may increase the risk of toxicity. Hypertension, tachycardia or coronary vasospasm may occur if administered with CYP3A4 inhibitors.

Class 2: Use Only if Benefit Felt to Outweigh Risk

• Use Alternative:
• Triptans: Naratriptan (Amerge), Zolmitriptan (Zomig), and Sumatriptan (Imitrex), are not CYP3A4 substrates.
• Calcium channel blockers other than diltiazem and verapamil are unlikely to inhibit the metabolism of almotriptan and eletriptan.
• Monitor: If the combination is used, monitor for evidence of vasoconstriction such as hypertension.