Adult Dosing
Acute treatment of migraine attacks
- Start 6.25-12.5 mg PO; if the headache recurs, repeat the dose after 2 hrs
- Max: 25 mg/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients <12 yrs of age have not been established
Acute treatment of migraine attacks
- 12-17 yrs: Start 6.25-12.5 mg PO; if the headache recurs, repeat the dose after 2 hrs
- Max: 25 mg/day
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 10-30 mL/min: Start 6.25 mg/day PO; max: 12.5 mg/day
- <10 mL/min: Dose adjustments not defined
Hepatic Dose Adjustment
- Hepatic impairment: Start 6.25 mg PO; max: 12.5 mg/day
See Supplemental Patient Information
- Serious adverse cardiac events, including acute myocardial infarction, life-threatening disturbances of cardiac rhythm and death may occur within a few hours of administration of almotriptan
- Avoid use in patients in whom unrecognized coronary artery disease (CAD) is predicted by the presence of risk factors
- Cardiovascular events may occur in patients without any cardiac history or coronary artery disease. Because of the possibility of coronary vasospasm, patients with signs or symptoms suggestive of angina should be evaluated for the presence of CAD or a predisposition to Prinzmetal’s variant angina before receiving additional doses; monitor ECG if dosing is resumed or symptoms recur
- Almotriptan should not be given when risk factors for CAD are present (e.g. hypertension, hypercholesterolemia, diabetes, strong family history of CAD, female with surgical or physiological menopause)
- Sensations of tightness, pain, pressure, and heaviness in the precordium, throat, neck, and jaw may occur during therapy
- Cerebral hemorrhage, subarachnoid hemorrhage, stroke, and other cerebrovascular events have been reported with some events resulting in death. Patients with acute migraine may be at increased risk of certain cerebrovascular events (e.g., stroke, hemorrhage, transient ischemic attack)
- Gastrointestinal vascular ischemia with abdominal pain, bloody diarrhea, and rare reports of transient and permanent blindness and significant partial vision loss may occur during therapy
- Potentially life-threatening serotonin syndrome may occur with co-administration of selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). Monitor patients for neurologic changes and GI symptoms if concomitant treatment is clinically indicated
- Increases in blood pressure have been reported very rarely; contraindicated in patients with uncontrolled hypertension
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Hypersensitivity to sulfonamides
- Geriatric patients
Supplemental Patient Information
- Advise patients to promptly notify their physician if they become pregnant or intend to become pregnant during therapy; also advise them to report their physician if they are breastfeeding or plan to breastfeed
- Caution patients against driving vehicle or operating machinery, as almotriptan may cause visual disturbances, dizziness, somnolence, and other CNS symptoms
Pregnancy Category:C
Breastfeeding: Safety unknown. No published experience exists with almotriptan during breastfeeding. If almotriptan is required by the mother, it is not a reason to discontinue breastfeeding; prefer alternate drugs especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT) last accessed 14 January 2010. As per manufacturer's data, caution should be exercised if administered to nursing women.
Pricing data from www.DrugStore.com in U.S.A.
- Axert 12.5 MG TABS [Box] (JANSSEN PHARMACEUTICALS)
12 mg = $308.98
36 mg = $904.98 - Axert 6.25 MG TABS [Box] (JANSSEN PHARMACEUTICALS)
6 mg = $166.98
18 mg = $475.96
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
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