almotriptan
Almotriptan is a type of migraine medication called a triptan. It treats migraine with or without aura in adults and certain children age 12 to 17 years. Its brand name Axert has been discontinued, so almotriptan is now only available as a generic. Almotriptan is a tablet that's swallowed whole when a migraine starts. You can take another tablet at least 2 hours later if the medication doesn't completely relieve your migraine. Side effects include sleepiness and headache.
What is Almotriptan?
What is Almotriptan used for?
- Treatment of migraine attacks in adults with a history of migraine with or without aura
- Treatment of migraine pain in children age 12 to 17 years with a history of migraine with or without aura that lasts 4 hours or more
How Almotriptan works
Almotriptan is a triptan. It works on receptors in your brain and nervous system that respond to serotonin. Serotonin is a natural chemical in your body that's thought to be involved in causing migraines.
Almotriptan attaches to the serotonin receptors in the brain. It causes the blood vessels in the brain to tighten, which then lessens blood vessel swelling. This helps relieve migraine pain. The medication also helps with migraine pain by stopping other pain signals from releasing through the nervous system.
Drug facts
Side effects of Almotriptan
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults:
- Nausea (1-2%)
- Dry mouth (1%)
- "Pins and needles" feeling in the arms or legs (1%)
Children age 12 years and older:
- Sleepiness (up to 5%)
- Dizziness (3-4%)
- Nausea (1-3%)
- Vomiting (up to 2%)
- Headache (1-2%)
- "Pins and needles" feeling in the arms or legs (1%)
Less Common Side Effects
- Headache
- Dizziness
- Sleepiness
Almotriptan serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: severe chest pain that might travel to the arm, neck, or jaw with shortness of breath, sweating, nausea, or heartburn
- Irregular heart rhythm (arrhythmia): slow heartbeat, skipped heartbeats, pounding in the chest, a fluttering sensation, chest pain, dizziness, weakness, trouble breathing
- Stroke: sudden weakness on one side of your body, drooping face, severe headache, changes in speech or vision, confusion
- Extremely high blood pressure: severe headache, confusion, blurred vision, chest pain, trouble breathing, nausea, a racing heart
- Serotonin syndrome: fever, sweating, shivering, fast heartbeat, anxiety, confusion, movement problems, seizure
- Serious allergic reaction: trouble breathing; rash; hives; swelling of the face, mouth, lips, or throat
The following Almotriptan side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
discharge from the eye
fast, irregular, pounding, or racing heartbeat or pulse
itching, redness, or swelling of the skin
neck pain or rigid neck
redness of the inner lining of the eyelid
skin rash
shortness of breath
tightness in the throat
Rare
Abdominal or stomach cramping or pain
black, tarry stools
blood in the stools
bringing back up of food
chest pain, severe
cool, pale skin
difficulty with swallowing
fainting
heartburn, repeated
increased sweating
loss of appetite
loss of vision
rapid breathing
tightness in the chest
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, numbness, prickly, or tingling feeling
dizziness
headache
sleepiness
Less common
Aching, fullness, or tension in the sinuses
anxious feeling
back pain
belching
change in sense of taste
chills
cough producing mucus
decreased sensitivity to touch
feeling of constant movement of self or surroundings
feeling of spinning
feeling of warmth or heat
flushing or redness of the skin
increased sense of hearing
indigestion
lack or loss of strength
muscle aches or weakness
nosebleed
painful menstrual period
quivering or trembling
restlessness
runny or stuffy nose
trouble sleeping
vomiting
Rare
Abnormal increase in reflexes
abnormally increased feeling of mental and physical well-being
buzzing or ringing in the ears
change in dreams or nightmares
change in sense of smell
change in sense of touch
clumsiness or unsteadiness
continuous, uncontrolled, back-and-forth or rolling eye movements
difficulty in concentrating
double vision
dry throat
feeling of pins and needles
hoarseness
increased sensitivity to sunlight
increased thirst
loss of voice
mental depression
muscle stiffness
nervousness
pain, redness, swelling, or warmth in the joints
stabbing pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Almotriptan
Pros
- A first-choice option for treating a migraine attack in adults
- Approved for certain children 12 years and older
- Might start working as soon as 30 minutes after taking the 12.5 mg strength
Cons
- Might not be a good option for people who have trouble swallowing pills whole during a migraine
- Not used to prevent migraine or to treat other types of headaches
- Must wait at least 2 hours to take another tablet if the first dose didn't fully relieve the migraine
Pharmacist tips for Almotriptan
- Swallow the almotriptan tablet whole with a glass of water as soon as your migraine starts.
- If your migraine comes back or if it doesn't completely go away after you take almotriptan, you can take a second dose of the medication. Be sure you wait at least 2 hours after your first dose to take another. Taking another dose sooner than 2 hours from your previous dose might cause more side effects. Don't take more than a total of 25 mg in a day.
- Call your prescriber if you don't feel like you've gotten any migraine relief at all after you take almotriptan. Don't take another dose of the medication for the same migraine without talking to your prescriber. This medication might not be the best option for you and there might be better treatments available.
- It's possible to feel some tightness, pain, or pressure in the chest, throat, neck, or jaw after you take almotriptan. These symptoms can feel very similar to a heart attack or other heart problems. Call your care team right away if you have these symptoms after you take almotriptan to make sure you're okay.
- Almotriptan can sometimes make you feel tired or dizzy. Don't drive or do anything that needs your full attention until you know how this medication affects you.
- Talk to your prescriber if you finish the entire month's supply of almotriptan before it's time for your next refill or if you have more than 4 migraines in a month. It's not known whether almotriptan works well or is safe for treating more than 4 migraines in a month. There might be a different migraine medication that can help you better.
- Write down when you have headaches and how often you need to take almotriptan or any other migraine medication. Try not to take migraine medications for more than 9 days in a month to prevent medication-overuse headaches.
More on Almotriptan tips
Common questions about Almotriptan
Almotriptan isn't known to be habit-forming or addictive. Speak with your prescriber if you've taken almotriptan or any other migraine medications for more than 9 days in a month. This isn't a sign of addiction but rather that your migraine medication might not be right for you. Your prescriber can talk with you about other options that could help with your migraines better.
Yes, the brand name version of almotriptan called Axert is discontinued and is no longer available. It's not clear why the brand name was discontinued. Generic almotriptan is still available and can be prescribed by a healthcare professional.
Almotriptan and naratriptan are both triptans that are used to treat migraine attacks. They're both tablets that are swallowed whole. Although almotriptan is approved for people age 12 years and older, only adults can take naratriptan. In addition, you need to wait for at least 2 hours to take a second dose of almotriptan if the medication didn't fully relieve your migraine. But you need to wait at least 4 hours after your first dose of naratriptan before you can take another tablet to get more relief. Speak with your prescriber to compare between almotriptan and naratriptan.
In clinical studies, some people started to have migraine pain relief as soon as 30 minutes after they took a tablet of the 12.5 mg strength of almotriptan. Keep in mind that it can take up to 2 hours to feel complete pain relief after you take almotriptan.
You should take almotriptan only when you have a migraine. There are certain limitations as to how often you can take almotriptan and how many migraines you can take the medication for in a given period of time. These limitations are for your safety. Don't take almotriptan for an average of more than 4 migraines in a month because it's not known how safe this is. Also don't take almotriptan or any other migraine medications for more than 9 days in a month. Otherwise, it can lead to medication-overuse headaches, which are daily migraine-like headaches or more frequent migraines. Talk to your prescriber about other treatment options for migraine if you need to take almotriptan or your other migraine medications more often than this.
It's not recommended to drink alcohol with almotriptan. Drinking alcohol can raise your risk for migraines and headaches. It can also make possible side effects of almotriptan like sleepiness or tiredness more intense. Speak with your prescriber about your drinking habits if you need to take almotriptan.
Discuss the risks and benefits of taking almotriptan if you're pregnant. There aren't enough studies that look at how safe it is to take this medication while pregnant.
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Risks and warnings for Almotriptan
Almotriptan can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack, chest pain (angina), and irregular heart rhythm
- Risk factors: Family history of coronary artery disease | Diabetes (high blood sugar) | High blood pressure | High cholesterol | Smoking | People who are considered obese | Menopause | Male over 40 years of age
In very rare cases, people have had serious heart problems within a few hours after they took triptans like almotriptan. These heart problems can include heart attack, chest pain (angina), and changes to their heart rhythm (arrhythmia). It can happen in people with or without a history of heart disease.
Before you start taking almotriptan, your prescriber will check your risk for heart problems. To be safe, people with certain heart problems shouldn't take almotriptan. If you're at high risk, you might need to take your first dose at your prescriber's office so they can monitor your heart right away. Your prescriber might check your heart periodically if you need to take the medication as needed for a long time.
Get medical help as soon as possible if you have severe chest pain that might travel to the arms, neck, or jaw; trouble breathing; sweating; nausea; weakness; a pounding or fluttering heart; or slow heartbeat. These can be signs of a serious heart problem. Don't take any more almotriptan until a healthcare professional checks that the medication is safe for you.
Stroke or other brain injury
Some people who've taken triptans like almotriptan have had life-threatening strokes or bleeding in the brain (brain hemorrhage). You can't take almotriptan if you've had a stroke or "mini-stroke."
Symptoms of a stroke or brain bleed include sudden weakness on one side of your body, severe headache, drooping face, trouble breathing, or changes in speech or vision. They can be similar to migraine symptoms, so strokes can be mistaken for a migraine. Stop taking almotriptan and get emergency medical help right away if you notice symptoms of a stroke or brain bleed. This is especially important if you haven't had a migraine before.
Extreme narrowing of blood vessels
Almotriptan can cause the blood vessels in certain areas of your body to become very narrow. This can prevent certain parts of your body from getting enough blood, which can lead to problems.
For example, this effect can sometimes cause symptoms similar to Raynaud's phenomenon. It can look like color changes in your hands and feet (can turn pale or more reddish depending on how much blood is flowing through). Other times, the blood vessels in the stomach can narrow and cause stomach pain or bloody diarrhea. And although rare, narrowing of the blood vessels in the eye can cause vision problems.
Let your prescriber know if you have any of these symptoms so they can check whether it's safe for you to continue to take almotriptan.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels
Almotriptan can raise the risk for serotonin syndrome, a potentially life-threatening condition caused by high levels of serotonin in the brain. The risk is even higher if you're taking almotriptan with other medications that also raise serotonin levels in the body. Common examples of these medications include antidepressants.
Symptoms of serotonin syndrome can include fever, sweating, shivering, fast heartbeat, anxiety, confusion, movement problems, and seizure. These symptoms can appear after you start a new medication that raises your serotonin levels. They can also appear when you switch to a higher dose of these medications. Stop taking almotriptan and talk to your prescriber if you notice any symptoms of serotonin syndrome.
Worse headaches if you take almotriptan too often
Taking more than the recommended dose of migraine medications, including almotriptan, or taking them too often can cause them to work less well. It can lead to medication-overuse headaches (also called rebound headaches). This is when you have more migraine-like headaches or more migraine attacks.
Let your prescriber know if you're taking more than one migraine medication and if you need to take them for more than 9 days in a month. Also tell your prescriber if you have more than 4 migraine headaches per month while you're taking almotriptan. Your prescriber can talk with you about better options to help with your migraines.
High blood pressure
- Risk factors: Uncontrolled high blood pressure
A rise in blood pressure can happen after taking almotriptan in people with and without a history of high blood pressure. In studies, people had a small rise in blood pressure over the first 4 hours after they took 12.5 mg of almotriptan. In some rare cases, people who've taken the medication have had notably higher blood pressure that can be dangerous. Don't take almotriptan if you have uncontrolled high blood pressure.
Your prescriber might recommend checking your blood pressure occasionally at home when you take almotriptan. Get medical help as soon as possible if you have a severe headache, confusion, blurred vision, chest pain, trouble breathing, nausea, or a racing heart. These can be signs of extremely high blood pressure.
Serious allergic reaction
- Risk factors: Sulfa allergy
It's possible to have a life-threatening allergic reaction to almotriptan. These reactions can include anaphylaxis and swelling of the face, mouth, lips, or throat. People with a sulfa allergy should watch out for these allergic reactions because the medication contains a component that's similar to sulfa. Stop taking almotriptan and call 911 right away if you have a rash; swelling of the face, mouth, or throat; closing of the throat; or trouble breathing.
Almotriptan dosage
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 6 tablets of 6.25mg | 1 dose pack | $65.64 | $65.64 |
| 12 tablets of 12.5mg | 1 dose pack | $133.72 | $133.72 |
Typical dosage for Almotriptan
Almotriptan tablets come in two strengths: 6.25 mg and 12.5 mg.
The typical dose is 1 tablet by mouth once as a single dose for migraine.
If your migraine comes back or if it doesn't completely go away, you can take another tablet 2 hours after the first dose. Don't take more than a total of 25 mg (four 6.25 mg tablets or two 12.5 mg tablets) in a 24-hour period.
The starting dose and maximum dose might differ if you have kidney problems or severe liver problems.
Interactions between Almotriptan and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Avitriptan
- Dihydroergotamine
- Eletriptan
- Ergoloid Mesylates
- Ergonovine
- Ergotamine
- Frovatriptan
- Linezolid
- Methylergonovine
- Methysergide
- Naratriptan
- Rizatriptan
- Sumatriptan
- Tranylcypromine
- Zolmitriptan
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Amitriptyline
- Amoxapine
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Bromocriptine
- Brompheniramine
- Buprenorphine
- Buspirone
- Butorphanol
- Carbamazepine
- Chlorpheniramine
- Citalopram
- Clomipramine
- Cocaine
- Codeine
- Cyclobenzaprine
- Desipramine
- Desvenlafaxine
- Dextroamphetamine
- Dextromethorphan
- Dihydrocodeine
- Dolasetron
- Doxepin
- Duloxetine
- Escitalopram
- Fenfluramine
- Fentanyl
- Fluoxetine
- Fluvoxamine
- Granisetron
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Imipramine
- Isocarboxazid
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Lisdexamfetamine
- Lithium
- Lorcaserin
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Methylene Blue
- Milnacipran
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nefazodone
- Nortriptyline
- Ondansetron
- Oxycodone
- Oxymorphone
- Palonosetron
- Paroxetine
- Pentazocine
- Propoxyphene
- Reboxetine
- Remifentanil
- Sertraline
- Sibutramine
- St John's Wort
- Sufentanil
- Tapentadol
- Tramadol
- Trazodone
- Tryptophan
- Venlafaxine
- Vilazodone
- Vortioxetine
- Ziprasidone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Almotriptan cost?
$65.64
Almotriptan contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Almotriptan will not be safe for you to take.
- Coronary artery disease (CAD)
- Coronary artery vasospasm, such as Prinzmetal's angina
- History of stroke or transient ischemic attack ("mini-stroke")
- Hemiplegic or basilar migraine
- Uncontrolled high blood pressure
- Peripheral vascular disease
- Ischemic bowel disease
- Have taken an ergot-containing or ergot-type medication like dihydroergotamine (Migranal) in the last 24 hours
- Have taken a different triptan in the last 24 hours
What are alternatives to Almotriptan?
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