Products
Almotriptan is commercially available in the form of film-coated tablets (Almogran). It has been approved in many countries since 2004.
Structure and properties
Almotriptan (C17H25N3O2S, Mr = 335.5 g/mol) is present in drugs as almotriptan-D,L-hydrogenmalate, a white to slightly yellowish crystalline powder that is soluble in water.
Effects
Almotriptan (ATC N02CC05) has vasoconstrictive, analgesic, and anti-inflammatory properties. It is a selective agonist of serotonin 5-HT1B and 5-HT1D receptors and has a short half-life of approximately 3-4 hours.
Indications
For the acute treatment of migraine.
Dosage
According to the drug label. Almotriptan is taken independently of meals as soon as a migraine headache occurs. Special attention must be paid to low maximum doses, dosing interval, and vasoconstriction risks.
Contraindications
- Hypersensitivity
- Severe liver dysfunction
- Certain cardiovascular and vascular diseases.
- Combination with ergotamine, ergotamine derivatives, and other 5-HT1B/1D agonists (triptans).
For complete precautions, see the drug label.
Interactions
In combination with other serotonergic agents, serotonin syndrome may rarely develop. Almotriptan is metabolized by MAO-A as well as CYP3A4 and CYP2D6. Corresponding interactions are possible. For example, the potent CYP3A inhibitor ketoconazole leads to a large increase in plasma concentration.
Adverse effects
The most common adverse effects include dizziness, somnolence, fatigue, nausea, and vomiting.
