Almotriptan is prescribed to treat the acute headache phase of migraine attacks with or without aura. Almotriptan is the only oral triptan approved in the USA for the treatment of migraine in adolescent from 12 to 17 years of age.
Almotriptan is a selective and potent serotonin (5-hydroxytryptamine 1B/1D) agonist. Almotriptan binds to specific serotonin receptors on meningeal arteries inhibiting the release of vasoactive peptides and causing constriction of the arteries. It has a limited effect on arteries supplying blood to the brain and little effect on cardiac and pulmonary vessels.
Dosage & Administration
Acute Treatment of Migraine Attacks: The recommended dose of Almotriptan in adults and adolescents age 12 to 17 years is 6.25 mg to 12.5 mg, with the 12.5 mg dose tending to be a more effective dose in adults. If the headache is relieved after the initial almotriptan malate dose but returns, the dose may be repeated after 2 hours. The maximum daily dose should not exceed 25 mg. The safety of treating an average of more than four migraines in a 30-day period has not been established.
Hepatic Impairment: The recommended starting dose of almotriptan malate in patients with hepatic impairment is 6.25 mg. The maximum daily dose should not exceed 12.5 mg over a 24-hour period
Renal Impairment: The recommended starting dose of almotriptan malate in patients with severe renal impairment is 6.25 mg. The maximum daily dose should not exceed 12.5 mg over a 24-hour period
These drugs have been reported to cause prolonged vasospastic reactions. Cases of life-threatening serotonin syndrome have been reported during combined use of triptans and selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs).
As with other 5-HT1B/1D receptor agonists, almotriptan should not be used in patients with a history, symptoms or signs of ischaemic heart disease (myocardial infarction, angina pectoris, documented silent ischaemia, Prinzmetal's angina) or severe hypertension and uncontrolled mild or moderate hypertension. Concomitant administration with ergotamine, ergotamine derivatives (including methysergide) and other 5-HT1B/1D agonists is contraindicated.
Serious cardiac reactions, including myocardial infarction, have occurred following the use of almotriptan malate Tablets. These reactions are extremely rare and most have been reported in patients with risk factors predictive of CAD (Coronary Artery Disease).
Pregnancy & Lactation
Pregnancy Category C. There is no data regarding excretion of almotriptan in human milk.
Precautions & Warnings
Hypersensitivity to the active substance or to any of the excipients. Patients with severe hepatic impairment, with a previous cerebrovascular accident (CVA) or transient ischaemic attack (TIA) Peripheral vascular disease.
Keep below 30° C temperature in a dry place. Protected from light. Do not freeze. Keep out of the reach of children.
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