Almotriptan drug interactions

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AXERT® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Warnings and Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Clinical Pharmacology
Nonclinical Toxicology
Clinical Studies
How Supplied/Storage and Handling
Patient Counseling Information
Labels and Packages
Clinical Trials on Almotriptan

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]

Drug Interactions

  • Do not use Almotriptan and ergotamine-containing or ergot-type medications within 24 hours of each other
  • Do not use Almotriptan and other 5-HT1 agonists (e.g., triptans) within 24 hours of each other
  • SSRI or SNRI: life-threatening serotonin syndrome reported during combined use with triptans
  • Ketoconazole: use single dose of Almotriptan 6.25 mg; maximum Almotriptan daily dose 12.5 mg

For additional detailed information on drug interactions, see Clinical Pharmacology, Pharmacokinetics (12.3).

Ergot-Containing Drugs

These drugs have been reported to cause prolonged vasospastic reactions. Because, in theory, vasospastic effects may be additive, ergotamine-containing or ergot-type medications (like dihydroergotamine, ergotamine tartrate, or methysergide) and Almotriptan (almotriptan malate) should not be used within 24 hours of each other [see Contraindications (4.5)].

5-HT1 Agonists (e.g., Triptans)

Concomitant use of other 5-HT1 agonists (e.g., triptans) within 24 hours of treatment with Almotriptan is contraindicated [see Contraindications (4.6)].

Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors

Cases of life-threatening serotonin syndrome have been reported during combined use of triptans and selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) [see Warnings and Precautions (5.5)].

Ketoconazole and Other Potent CYP3A4 Inhibitors

Co-administration of almotriptan and oral ketoconazole, a potent CYP3A4 inhibitor, resulted in an approximately 60% increase in exposure of almotriptan. Increased exposures to almotriptan may be expected when almotriptan is used concomitantly with other potent CYP3A4 inhibitors.

In patients concomitantly using potent CYP3A4 inhibitors, the recommended starting dose of Almotriptan is 6.25 mg. The maximum daily dose should not exceed 12.5 mg within a 24-hour period. Concomitant use of Almotriptan and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment.