almotriptan

Contraindicated in:

Hypersensitivity;
Ischemic cardiovascular, cerebrovascular, or peripheral vascular syndromes (including ischemic bowel disease);
History of significant cardiovascular disease;
Uncontrolled hypertension;
Basilar or hemiplegic migraine;
Concurrent MAO-A inhibitor therapy or within 2 wk of discontinuing MAO-A inhibitor therapy.

Use Cautiously in:

Cardiovascular risk factors (hypertension, hypercholesterolemia, cigarette smoking, obesity, diabetes, strong family history, menopausal women, or men >40 yr); use only if cardiovascular status has been evaluated and determined to be safe and 1st dose is administered under supervision;
Hypersensitivity to sulfonamides (cross-sensitivity may occur);
Renal impairment;
Hepatic impairment;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Children <12 yr (safety and effectiveness not established).

Adv. Reactions/Side Effects ⬆ ⬇

CV: CORONARY ARTERY VASOSPASM, MI, myocardial ischemia, VENTRICULAR ARRHYTHMIAS

GI: dry mouth, nausea

Neuro: drowsiness, headache, paresthesia

Interactions ⬆ ⬇

Drug-drug:

MAO-A inhibitors may ↑ levels and risk of toxicity; concurrent use or use within 2 wk of MAO inhibitor contraindicated.
Other 5-HT1 agonists or ergot-type compounds (dihydroergotamine) may result in additive vasoactive properties; avoid use within 24 hr of each other.
↑risk of serotonin syndrome with SSRIs, SNRIs, TCAs, meperidine, bupropion, or buspirone; avoid concurrent use.
CYP3A4 inhibitors, including ketoconazole, itraconazole, ritonavir, and erythromycin, may ↑ levels and risk of toxicity.

Availability ⬆ ⬇

(Generic available)

Tablets: 6.25 mg; 12.5 mg

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥12 yr): 6.25–12.5 mg initially, may repeat in 2 hr; not to exceed 2 doses per 24-hr period.

Hepatic/Renal Impairment

PO (Adults ): 6.25 mg initially, may repeat in 2 hr; not to exceed 2 doses per 24-hr period.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as an agonist at specific 5-HT₁ receptor sites in intracranial blood vessels and sensory trigeminal nerves.

Therapeutic effects:

Cranial vessel vasoconstriction with associated decrease in release of neuropeptides and resultant decrease in migraine headache.

Classifications ⬆ ⬇

Therapeutic Classification: vascular headache suppressants

Pharmacologic Classification: five ht1 agonists

Pharmacokinetics ⬆ ⬇

Absorption: 70% absorbed following oral administration.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: 27% metabolized by monoamine oxidase-A (MAO-A); 12% metabolized by the CYP3A4 and CYP2D6 isoenzymes. 40% excreted unchanged in urine; 13% excreted in feces as unchanged and metabolized drug.

Half-Life: 3–4 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1–3 hr	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Instruct patient to administer almotriptan as soon as symptoms of a migraine attack appear, but it may be administered any time during an attack. If migraine symptoms return, a 2nd dose may be used. Allow ≥2 hr between doses, and do not use >2 doses in any 24-hr period.
Caution patient not to take almotriptan within 24 hr of another vascular headache suppressant.
Advise patient that lying down in a dark room following almotriptan administration may further help relieve symptoms.
Advise patient that overuse (use more than 10 days/month) may lead to exacerbation of headache (migraine-like daily headaches, or as a marked ↑ in frequency of migraine attacks). May require gradual withdrawal of almotriptan .
Advise patient to notify health care professional immediately if signs/symptoms of cardiac ischemia (chest pain or tightness; tingling or discomfort in arms, back, neck, jaw or stomach; flushing, drowsiness, dizziness, tiredness, sweating, nausea) occur.
May cause dizziness or drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Advise patient to avoid alcohol, which aggravates headaches, during almotriptan use.
Advise patient to notify health care professional immediately if signs or symptoms of serotonin syndrome occur.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0378- Mylan Pharmaceuticals Inc.
- 0378-5245- Almotriptan Malate
  - 0378-5245-85- 1 BLISTER PACK in 1 CARTON (0378-5245-85) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-5245-32)

0378- Mylan Pharmaceuticals Inc.
- 0378-5246- Almotriptan Malate
  - 0378-5246-85- 2 BLISTER PACK in 1 CARTON (0378-5246-85) / 6 TABLET, FILM COATED in 1 BLISTER PACK (0378-5246-32)

27241- Ajanta Pharma USA Inc.
- 27241-041- almotriptan
  - 27241-041-11- 1 BLISTER PACK in 1 CARTON (27241-041-11) / 6 TABLET, FILM COATED in 1 BLISTER PACK (27241-041-68)

27241- Ajanta Pharma USA Inc.
- 27241-042- almotriptan
  - 27241-042-21- 2 BLISTER PACK in 1 CARTON (27241-042-21) / 6 TABLET, FILM COATED in 1 BLISTER PACK (27241-042-68)

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Indications ⬇

Contraind./Precautions ⬆ ⬇