Class
- Triptan
Almotriptan
Commonly Prescribed for
(FDA approved in bold)
- Migraine
Almotriptan
How the Drug Works
- Selective 5-HT1 receptor agonist, working predominantly at the B, D and F receptor subtypes. Effectiveness may be due to blocking the transmission of pain signals from the trigeminal nerve to the trigeminal nucleus caudalis and preventing release of inflammatory neuropeptides rather than just causing vasoconstriction
Almotriptan
How Long Until It Works
- 1 hour or less
Almotriptan
If It Works
- Continue to take as needed. Patients taking acute treatment more than 2 days/week are at risk for medication overuse headache, especially if they have migraine
Almotriptan
If It Doesn’t Work
- Treat early in the attack – triptans are less likely to work after the development of cutaneous allodynia, a marker of central sensitization
- For patients with partial response or reoccurrence, add an NSAID
- Change to another agent
Almotriptan
Best Augmenting Combos for Partial Response or Treatment-Resistance
- NSAIDs or neuroleptics are often used to augment response
Almotriptan
Tests
- None required
Adverse Effects (AEs)
Almotriptan
How Drug Causes AEs
- Direct effect on serotonin receptors
Almotriptan
Notable AEs
- Tingling, flushing, sensation of burning, vertigo, sensation of pressure, heaviness, nausea
Almotriptan
Life-Threatening or Dangerous AEs
- Rare cardiac events including acute MI, cardiac arrhythmia, and coronary artery vasospasm have been reported with almotriptan
Almotriptan
Weight Gain
- Unusual
Almotriptan
Sedation
- Unusual
Almotriptan
What to Do About AEs
- In most cases, only reassurance is needed. Lower dose, change to another triptan or use an alternative headache treatment
Almotriptan
Best Augmenting Agents for AEs
- Treatment of nausea with antiemetics is acceptable. Other AEs improve with time
Dosing and Use
Almotriptan
Usual Dosage Range
- 6.25–12.5 mg
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