Almotriptan

Almotriptan Brand Name– Axert

What is Almotriptan

Almotriptan is a selective serotonin (5-HT 1B/1D) receptor agonist used in the treatment of acute migraine.

Almotriptan is one of a group of anti-migraine medications commonly referred to as “triptans” or serotonin-receptor agonists. Like other “triptans”, almotriptan is indicated for the treatment of acute migraine attacks with or without aura; it is not indicated for migraine prophylaxis or for the treatment of hemiplegic or basilar migraines or cluster headaches.

Almotriptan is metabolized by CYP3A4 isoenzymes and is susceptible to drug interactions with potent inhibitors of CYP3A4 (see Drug Interactions). Oral almotriptan 12.5 mg has comparable efficacy to oral sumatriptan 50 mg; however, in one comparative study, almotriptan received a higher patient acceptability rating regarding adverse effects.

The FDA approved almotriptan in May 2001.

In April 2009, almotriptan received FDA approval for the acute treatment of migraine headache pain in pediatric patients 12 to 17 years of age.

Indications

• migraine

For the acute treatment of migraine attacks in patients with a history of migraine with or without aura

Side Effects

1. abdominal pain
2. anaphylactic shock
3. angina
4. angioedema
5. anxiety
6. arthralgia
7. asthenia
8. back pain
9. blepharospasm
10. blurred vision
11. bowel ischemia
12. chest pain (unspecified)
13. chest pressure syndrome
14. chills
15. colitis
16. confusion
17. conjunctivitis
18. corneal opacification
19. coronary vasospasm
20. depression
21. diaphoresis
22. diarrhea
23. diplopia
24. dizziness
25. drowsiness
26. dysgeusia
27. dysmenorrhea
28. dyspepsia
29. dyspnea
30. epistaxis
31. erythema
32. euphoria
33. fatigue
34. fever
35. flushing
36. gastritis
37. gastroesophageal reflux
38. glossitis
39. headache
40. hyperacusis
41. hypercholesterolemia
42. hyperglycemia
43. hyperhidrosis
44. hyperreflexia
45. hypersalivation
46. hypertension
47. hypertonia
48. hyperventilation
49. hypoesthesia
50. insomnia
51. intracranial bleeding
52. laryngitis
53. laryngospasm
54. malaise
55. mastalgia
56. myalgia
57. myasthenia
58. myocardial infarction
59. myopathy
60. nausea
61. nightmares
62. nystagmus
63. ocular irritation
64. ocular pain
65. otalgia
66. palpitations
67. paresthesias
68. parosmia
69. peripheral vasoconstriction
70. pharyngitis
71. photosensitivity
72. polydipsia
73. pruritus
74. rash
75. restlessness
76. rhinitis
77. scotomata
78. seizures
79. serotonin syndrome
80. sinus tachycardia
81. sinusitis
82. sneezing
83. stroke
84. syncope
85. tinnitus
86. tremor
87. ventricular fibrillation
88. ventricular tachycardia
89. vertigo
90. visual impairment
91. vomiting
92. withdrawal
93. xerophthalmia
94. xerostomia

Monitoring Parameters

• ECG

Contraindications

• angina
• basilar/hemiplegic migraine
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• cerebrovascular disease
• children
• colitis
• coronary artery disease
• diabetes mellitus
• driving or operating machinery
• geriatric
• hepatic disease
• hypercholesterolemia
• hypertension
• infants
• intracranial bleeding
• myocardial infarction
• neonates
• obesity
• peripheral vascular disease
• pregnancy
• Raynaud’s phenomenon
• renal disease
• renal failure
• renal impairment
• stroke
• sulfonamide hypersensitivity
• tobacco smoking
• vasospastic angina
• Wolff-Parkinson-White syndrome

Interactions

• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Tramadol
• Alfentanil
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Celecoxib
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamine; Dextroamphetamine Salts
• Aprepitant, Fosaprepitant
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir
• Atazanavir; Cobicistat
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzhydrocodone; Acetaminophen
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzphetamine
• Boceprevir
• Bromocriptine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Buprenorphine
• Buprenorphine; Naloxone
• Buspirone
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Celecoxib
• Ceritinib
• Chloramphenicol
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clomipramine
• Cobicistat
• Cocaine
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Conivaptan
• Dalfopristin; Quinupristin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Delavirdine
• Desipramine
• Desvenlafaxine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dextroamphetamine
• Dextromethorphan
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Doxepin
• Droxidopa
• Duloxetine
• Elbasvir; Grazoprevir
• Eletriptan
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Ergot alkaloids
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluvoxamine
• Fosamprenavir
• Frovatriptan
• grapefruit juice
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Homatropine; Hydrocodone
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Oxycodone
• Idelalisib
• Imipramine
• Indinavir
• Isavuconazonium
• Isocarboxazid
• Itraconazole
• Ketoconazole
• Lasmiditan
• Letermovir
• Levomilnacipran
• Levorphanol
• Linezolid
• Lisdexamfetamine
• Lithium
• Lopinavir; Ritonavir
• Lorcaserin
• Lumacaftor; Ivacaftor
• Meperidine
• Meperidine; Promethazine
• Methadone
• Methamphetamine
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methylene Blue
• Mifepristone
• Milnacipran
• Mirtazapine
• Mitotane
• Morphine
• Morphine; Naltrexone
• Nalbuphine
• Naproxen; Sumatriptan
• Naratriptan
• Nefazodone
• Nelfinavir
• Nortriptyline
• Ombitasvir; Paritaprevir; Ritonavir
• Ombitasvir; Paritaprevir; Ritonavir
• Oxycodone
• Oxymorphone
• Ozanimod
• Paroxetine
• Pazopanib
• Perphenazine; Amitriptyline
• Phenelzine
• Posaconazole
• Protriptyline
• Rasagiline
• Remifentanil
• Ribociclib
• Ribociclib; Letrozole
• Ritonavir
• Rizatriptan
• Saquinavir
• Selegiline
• Sertraline
• Sibutramine
• Simeprevir
• St. John’s Wort, Hypericum perforatum
• Streptogramins
• Sufentanil
• Sumatriptan
• Tapentadol
• Tedizolid
• Telaprevir
• Telithromycin
• Telotristat Ethyl
• Tipranavir
• Tramadol
• Trandolapril; Verapamil
• Tranylcypromine
• Trazodone
• Tricyclic antidepressants
• Trimipramine
• Tucatinib
• Venlafaxine
• Verapamil
• Vilazodone
• Voriconazole
• Vortioxetine
• Zolmitriptan