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almotriptan (Rx)Brand and Other Names:Axert

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 6.25mg
  • 12.5mg
more...

Migraine

Indicated for acute treatment of migraine attacks in patients with a history of migraine with or without aura

Initial 6.25-12.5 mg PO at onset; may repeat once after 2 hours

Not to exceed 25 mg/day

Renal Impairment, Severe

CrCl <30 mL/min: Initial 6.25 mg PO

Not to exceed 12.5 mg/day

Hepatic Impairment

Initial: 6.25 mg PO

Not to exceed 12.5 mg/day

Dosage Forms & Strengths

tablet

  • 6.25mg
  • 12.5mg
more...

Migraine

Indicated for acute treatment of migraine headache pain in adolescents with a history of migraine attacks with or without aura usually lasting ≥4 hr (when untreated)

<12 years: Safety and efficacy not established

≥12 years: 6.25-12.5 mg PO at onset of headache; may repeat once after 2 hr

Not to exceed 25 mg/day

Migraine: See adult dosing

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Interactions

Interaction Checker

almotriptan and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Somnolence (1-5%)

            Dizziness (3-4%)

            Nausea (1-3%)

            Vomiting (2%)

            Dry mouth (1-2%)

            Headache (1-2%)

            Nausea (1-2%)

            Paresthesia (1-2%)

            Paresthesia (1%)

            Somnolence (>1%)

            <1%

            Infrequent (0.01-0.001%)

            • Anxiety, asthenia, chills, CNS stimulation, fatigue, hypesthesia, tremor
            • Pruitus, rash
            • Diaphoresis, dysmenorrhea, hyperglycemia, increased thirst
            • Abdominal cramp, gastroenteritis
            • Back pain, myalgia, neck pain, rigid neck, Increased CPK
            • Bronchitis, chest pain, dyspnea, pharyngitis, rhinitis, sinusitis
            • Conjunctivitis, tinnitis, vertigo

            Rare (<0.001%)

            • Hypertension, syncope
            • Fever, insomnia, nervousness, nightmares
            • Erythema, photosensitivity
            • Colitis, esophegeal reflux, gastritis
            • Arthralgia, arthritis, muscle weakness, myopathy
            • Laryngitis, sneezing
            • Eye abnormalities, nystagmus
            • Hypercholesteremia, hyperventilation, increased gamma glutamyl transpeptidase, increased salvation

            Postmarketing Experience

            Hypersensitivity reactions (including angioedema, anaphylactic reactions and eye disorders including visual impairment, vision blurred) reported

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            Warnings

            Contraindications

            Hypersensitivity, severe hepatic or renal impairment, migraine prophylaxis

            Ischemic heart disease, uncontrolled HTN, hemiplegic or basilar migraines, cluster HA, cerebrovascular syndromes, PVD

            Do not use within 24 hr of another 5-HT1 agonist or ergot derivative, or within 2 weeks of MAOIs

            Cautions

            Overuse of acute migraine drugs (eg, ergotamine, triptans, opioids, or combination of these drugs for ≥10 days/month) may lead to exacerbation of headache (medication overuse headache); detoxification of patients, including withdrawal of overused drugs, and treatment of withdrawal symptoms (often includes a transient worsening of headache) may be necessary

            After dose is administered, patients who experience angina symptoms or chest pain, pressure, and tightness, should be evaluated for coronary artery disease or Prinzmetal's angina before receiving additional doses

            Hemorrhage and stroke have been reported with 5-HT1 agonist administration

            Significant increase in blood pressure has been reported with 5-HT1 agonists

            Transient and permanent blindness and partial vision loss have been reported with 5-HT-1 agonisits

            Serotonin syndrome may develop if administered concomitantly with proserotonergic drugs

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Selective 5-HT1 receptor agonist in cranial arteries. Causes vasoconstriction and reduces inflammation associated with antidronic neuronal transmission associated with relief of migraine

            Pharmacokinetics

            Half-Life: 3-4 hr

            Peak Plasma Time: 1-3 hr

            Bioavailability: 70%

            Protein bound: 35%

            Vd: 180-200 L

            Absorption: Well absorbed

            Metabolism: CYP3A4, CYP2D6

            Excretion: Urine (75%)

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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