Almotriptan
- Atc Codes:N02CC05
- CAS Codes:181183-52-8
- PHARMGKB ID:181183-52-8
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Belgium: Almogran; Denmark: Almogran; Finland: Almogran; France: Almogran; Germany: Almogran, Almotriptan; Greece: Almogran; Ireland: Almogran; Italy: Almogran, Almotrex; Luxembourg: Almogran; Netherlands: Almogran; Portugal: Almogran; Spain: Almográn; Sweden: Almogran; UK: Almogran.
North America
Canada: Axert; USA: Almotriptan, Axert.
Drug combinations
Chemistry
Almotriptan Malate: C~17~H~25~N~3~O~2~S C~4~H~6~O~5~. Mw: 469.55. (1) 1-[[[3-[2-(Dimethylamino)ethyl]-1H-indol-5-yl]methyl]sulfonyl]pyrrolidine, hydroxybutanedioate (1:1); (2) 1-[[[3-[2-(Dimethylamino)ethyl]indol-5-yl]methyl]sulfonyl]pyrrolidine malate (1:1). CAS-181183-52-8 (1998).
Pharmacologic Category
Antimigraine Agents; Selective Serotonin Agonists. (ATC-Code: N02CC05).
Mechanism of action
Selective agonist for serotonin (5-HT~1B~, 5-HT~1D~, 5-HT~1F~ receptors) in cranial arteries. Causes vasoconstriction and reduces sterile inflammation associated with antidromic neuronal transmission correlating with relief of migraine.
Therapeutic use
Acute treatment of migraine attacks with or without aura.
Pregnancy and lactiation implications
Use in pregnancy should be limited to situations where benefit outweighs risk to fetus. Use caution during lactation.
Unlabeled use
Contraindications
Hypersensitivity to almotriptan or any component of the formulation. Use as prophylactic therapy for migraine. Hemiplegic or basilar migraine. Cluster headache. Known or suspected ischemic heart disease (angina pectoris, myocardial infarction, documented silent ischemia, coronary artery vasospasm, Prinzmetal’s variant angina). Peripheral vascular syndromes (including ischemic bowel disease). Uncontrolled hypertension. Use within 24 hours of another 5-HT~1~ agonist or of ergotamine derivative. Concurrent administration or within 2 weeks of discontinuing an MAO inhibitor (MAO type A inhibitors).
Warnings and precautions
Cardiac events (coronary artery vasospasm, transient ischemia, myocardial infarction, ventricular tachycardia/fibrillation, cardiac arrest and death) or cerebrovascular events (cerebral/subarachnoid hemorrhage and stroke) may occur. Elevated blood pressure reported. Vasospasm-related events reported (peripheral vascular ischemia and colonic ischemia). Avoid use in patients with risk factors for coronary artery disease. Use with caution in hepatic and renal impairment. Serotonin syndrome (agitation, confusion, hallucinations, hyper-reflexia, myoclonus, shivering, and tachycardia) may occur with concomitant proserotonergic drugs or agents which reduce the metabolism of almotriptan. Concurrent use of serotonin precursors (e.g. tryptophan) is not recommended (risk of serotonin syndrome).