How does this medication work? What will it do for me?

Almotriptan belongs to the class of medications known as 5-hydroxytryptamine receptor agonists. Almotriptan is used to treat migraine headaches, with or without aura (warning signs that occur before the migraine headache begins). It is not used to prevent migraine headaches or to treat any other type of migraine headache including hemiplegic (one side of the head only), ophthalmoplegic (affecting the eye area only), or basilar (at the bottom of the head only) migraine. It is not intended to be used to treat cluster headaches.

Migraine headaches are thought to be caused by the dilation (widening) of the blood vessels in the head. Almotriptan works by causing the blood vessels of the head to constrict. For most people, almotriptan eliminates or reduces the symptoms of migraine attacks including headache, nausea, vomiting, and sensitivity to light and sound.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

6.25 mg
Each white-to-off-white, film-coated, round, biconvex tablet, debossed with "M" on one side of the tablet and "AL1" on the other, contains 6.25 mg of almotriptan. Nonmedicinal ingredients: hydroxypropyl methylcellulose, mannitol, microcrystalline cellulose, povidone, polyethylene glycol, sodium starch glycolate, sodium stearyl fumarate, and titanium dioxide.

12.5 mg
Each white-to-off-white, film-coated, round, biconvex tablet, debossed with "M" on one side of the tablet and "AL2" on the other, contains 12.5 mg of almotriptan. Nonmedicinal ingredients: hydroxypropyl methylcellulose, mannitol, microcrystalline cellulose, povidone, polyethylene glycol, sodium starch glycolate, sodium stearyl fumarate, and titanium dioxide.

How should I use this medication?

The recommended dose of almotriptan is one 6.25 mg or one 12.5 mg tablet taken at the first sign of a migraine headache. If the headache returns, the dose may be repeated after 2 hours, but no more than 25 mg (2 doses or 12.5 mg) should be taken within a 24-hour period. If you have no pain relief after taking the first dose, do not take a second dose without first talking with your doctor. If you need to treat more than 4 headaches in a 30-day period, talk with your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

Store this medication at room temperature, protect from heat, light and moisture, and keep it out of reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to almotriptan or any ingredients of the medication
  • have a history of heart attack or silent heart ischemia
  • have angina pectoris (chest pain) or Prinzmetal angina (coronary artery vasospasm)
  • have cerebrovascular (e.g., stroke or transient ischemic attacks) or peripheral vascular syndromes (e.g., ischemic bowel disease, Raynaud's syndrome)
  • have certain types of migraine headaches (e.g., basilar, hemiplegic, or ophthalmoplegic)
  • have heart disease or a history of heart disease (e.g., heart valve disease, ischemic heart disease, congenital heart disease, abnormal heart rhythms)
  • have taken ergotamine-containing or ergot-type medications (such as dihydroergotamine or methysergide) or another 5-hydroxytryptamine receptor agonist (e.g., eletriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan) in the previous 24 hours
  • have uncontrolled high blood pressure

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness
  • dry mouth
  • headache
  • nausea
  • sleepiness or drowsiness
  • tingling sensation

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • eye irritation, discharge, or pain
  • fainting
  • flu-like symptoms (sudden lack of energy, fever, cough, sore throat)
  • muscle pain, stiffness, or weakness
  • skin rash or itching
  • unexplained weight gain or loss
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • bloody stools or diarrhea
  • chest pain (severe)
  • rapid, pounding, or irregular heartbeat
  • significantly elevated blood pressure
  • signs of an allergic reaction (shortness of breath or difficulty breathing; hives; swelling of the eyes, mouth, lips, or throat)
  • signs of heart attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of tightness or pressure of the chest; nausea; vomiting; sweating; anxiety)
  • signs of serotonin syndrome (agitation, hallucinations, rapid heartbeat, loss of coordination, high body temperature)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: People who are allergic to sulfonamides (i.e., "sulfa" antibiotics) may also experience allergic reactions to almotriptan. Before you take almotriptan, inform your doctor about any previous adverse reactions you have had to medications, especially sulfonamides. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Blood pressure: Almotriptan may cause blood pressure to increase. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severe or uncontrolled high blood pressure should not take almotriptan.

Drowsiness/reduced alertness: Almotriptan may cause dizziness or drowsiness. Do not operate machinery or drive a car after taking this medication until you know how it affects you.

Headache type: Almotriptan should only be used where there is a clear diagnosis of migraine headache.

Heart problems: Almotriptan works by causing the blood vessels to narrow. Because of this, almotriptan can cause serious heart problems, including heart attack and stroke. People with heart disease or a history of heart disease should not take almotriptan (see, "Who should NOT take this medication?"). Talk to your doctor if you have any concerns.

It is strongly recommended that almotriptan not be taken by people who are at risk for, but have not been diagnosed with, heart disease unless an examination shows that the person does not have this condition. People at risk for heart disease include those with high blood pressure, high cholesterol, diabetes, or a strong family history of heart disease; people who smoke or are obese; women in early or natural menopause; and men over 40 years old. If you belong to one of these groups, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your kidney function regularly with urine or blood tests while you are taking this medication.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

Serotonin syndrome: People who take almotriptan along with other medications such as selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine, paroxetine, sertraline) or serotonin norepinephrine reuptake inhibitors (SNRIs; e.g., venlafaxine) may experience a syndrome called serotonin syndrome. Symptoms of serotonin syndrome include agitation, hallucinations, fast heart beat, hyperthermia, nausea, shivering, vomiting, or diarrhea. Coma and death are possible. Your doctor will monitor you if you are taking almotriptan at the same time as an SSRI or SNRI.

Pregnancy: This medication should not be taken during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if almotriptan passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age. Its use by people in this age group is not recommended.

What other drugs could interact with this medication?

There may be an interaction between almotriptan and any of the following:

  • amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
  • antipsychotics (e.g., chlorpromazine, fluphenazine, haloperidol, pimozide, quetiapine, risperidone)
  • "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • delavirdine
  • ergotamine-containing or ergot-type medications (e.g., dihydroergotamine, methysergide)
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • metoclopramide
  • monoamine oxidase inhibitors (e.g., moclobemide, phenelzine, tranylcypromine)
  • other 5-hydroxytryptamine receptor agonists (e.g., eletriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
  • peginterferon alfa-2b
  • protease inhibitors (e.g., indinavir, lopinavir, ritonavir)
  • selective norepinephrine reuptake inhibitors (SNRIs; e.g., venlafaxine)
  • selective serotonin receptor agonists (SSRIs; e.g., fluoxetine, fluvoxamine, paroxetine, sertraline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.