Almotriptan

Almotriptan is a selective serotonin receptor agonist in the triptan class, used for the acute treatment of migraine in adults. It targets the 5-HT1B and 5-HT1D receptors, which leads to constriction of cranial blood vessels and inhibition of pro-inflammatory neuropeptide release, helping to relieve migraine pain and associated symptoms.

Indications include relief of an episode of acute migraine with or without aura in adults. It is not indicated for preventive treatment. Onset of relief typically occurs within 1 to 3 hours after a single oral dose.

The usual dosing is 12.5 mg taken as needed for an attack, with the option to repeat once after at least 2 hours if symptoms return or persist. The maximum recommended daily dose is 25 mg per day. Patients should follow medical advice regarding dosing and should not exceed the recommended maximum.

Contraindications include ischemic heart disease, history of myocardial infarction or stroke, coronary vasospasm, and other significant cardiovascular conditions. It should not be used in patients with uncontrolled hypertension or in those with cerebrovascular disease. Caution is advised in patients with hepatic impairment. Co-administration with ergot-containing medications or other triptans is generally avoided, and care is needed with concomitant serotonergic drugs due to the potential for serotonin syndrome. Pregnant or breastfeeding individuals should use it only if clearly needed and prescribed by a clinician.

Common adverse effects include dizziness, nausea, fatigue, and somnolence. Some patients may experience chest discomfort or tightness, flushing, or paresthesias. Serious cardiovascular events are rare but possible, and serious adverse effects warrant medical attention.