Almotriptan 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).
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.