Home Drug Guide Almotriptan Malate

Drug Guide

Generic Name

Almotriptan Malate

Brand Names Axert

Classification

Therapeutic: Antimigraine Agent

Pharmacological: Selective 5-HT1B/1D Receptor Agonist

FDA Approved Indications

  • Acute treatment of migraine attacks with or without aura

Mechanism of Action

Almotriptan binds to serotonin (5-HT) receptors, specifically 5-HT1B and 5-HT1D, causing vasoconstriction of cranial blood vessels and inhibiting the release of pro-inflammatory neuropeptides, thereby alleviating migraine symptoms.

Dosage and Administration

Adult: Initially, 12.5 mg taken orally; if needed, can be repeated after 2 hours. Max dose is 25 mg in 24 hours.

Pediatric: Not approved for use in pediatric patients.

Geriatric: Use with caution due to increased risk of vascular events; start with the lowest dose.

Renal Impairment: Use caution; consider dose adjustment due to reduced clearance.

Hepatic Impairment: Use with caution; dose adjustments may be needed, especially in severe impairment.

Pharmacokinetics

Absorption: Rapid, with peak plasma levels in approximately 1.5-3 hours.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized mainly via monoamine oxidase-A (MAO-A) and conjugation pathways.

Excretion: Excreted primarily in urine (about 60%) and feces.

Half Life: Approximately 3-4 hours.

Contraindications

  • History of ischemic heart disease, cerebrovascular syndromes, uncontrolled hypertension, or other significant cardiovascular conditions.
  • Use with concomitant ergot-containing drugs or other 5-HT1 agonists within 24 hours.

Precautions

  • Use cautiously in patients with risk factors for cardiovascular disease, liver impairment, or a history of stroke.

Adverse Reactions - Common

  • Dizziness (Common)
  • Tingling or flushing sensation (Common)
  • Nausea or somnolence (Common)

Adverse Reactions - Serious

  • Serious cardiovascular events (e.g., myocardial infarction, ischemic stroke) (Rare)
  • Allergic reactions, including anaphylaxis (Rare)

Drug-Drug Interactions

  • Other serotonergic drugs, such as SSRIs, SNRIs, triptans, ergot derivatives, which may increase the risk of serotonin syndrome.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Evaluate for cardiovascular risk factors before administering.

Diagnoses:

  • Risk for ineffective cerebral perfusion related to vasoconstriction.

Implementation: Administer as prescribed, monitor blood pressure and heart rate, observe for adverse effects.

Evaluation: Assess relief of migraine symptoms within 2 hours of administration.

Patient/Family Teaching

  • Instruct patient to take at the first sign of migraine.
  • Warn about potential side effects like dizziness, flushing.
  • Advise against use with other serotonergic drugs without healthcare provider approval.
  • Report chest pain or unusual symptoms immediately.

Special Considerations

Black Box Warnings:

  • Serious cardiovascular events have been reported; contraindicated in patients with ischemic cardiac; cerebrovascular disease.
  • Potential for medication overuse headache.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Dizziness, nausea, vomiting, chest pain, drowsiness.

Treatment: Supportive care; no specific antagonist. Monitor cardiovascular status.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable until expiration date when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.