Axert (Almotriptan)

Axert (Almotriptan Malate) Medication Information

Uses

Axert is a 5HT1B/1D receptor agonist (triptan) indicated for: 

• Acute treatment of migraine attacks in adults with a history of migraine with or without aura.
• Acute treatment of migraine headache pain in adolescents age 12 to 17 years with a history of migraine with or without aura, and who have migraine attacks usually lasting 4 hours or more.

Dosage

There are oral tablets available in several different strengths:

• 6.25 mg
• 12.5 mg

Side Effects

The most common side effects of Axert include:

• Nausea/vomiting
• Dry mouth
• Paresthesia
• Dizziness
• Somnolence
• Headache

Speak with your doctor or pharmacist for a full list of side effects that applies to you.

Precautions

Serious adverse cardiac events, including acute myocardial infarction, and life-threatening disturbances of cardiac rhythm.

It is strongly recommended that Axert not be given to patients in whom unrecognized coronary artery disease (CAD) is predicted by the presence of risk factors. In very rare cases, serious cardiovascular events have been reported in association with Axert use in the absence of known cardiovascular disease. If Axert is considered, patients should first have a cardiovascular evaluation. If the evaluation is satisfactory, first dose should take place in a physician’s office setting.

Sensations of pain, tightness, pressure and heaviness in the chest, throat, neck and jaw: generally not associated with myocardial ischemia, but patients with signs or symptoms suggestive of angina should be evaluated for the presence of CAD.

Cerebrovascular events, some fatal.

Gastrointestinal ischemic events and peripheral vasospastic reactions (e.g. Raynaud’s syndrome). 

Potentially life-threatening serotonin syndrome, particularly in combination with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). Monitor patients for neurologic changes and gastrointestinal symptoms if concomitant treatment is clinically warranted.

Increase in blood pressure, very rarely associated with significant clinical events.

Use with caution in patients with a known hypersensitivity to sulfonamides.

Interactions

Some of the common drug interactions with Axert:

• Ergotamine-containing medication
• Triptans
• SSRIs
• SNRIs
• Ketoconazole 

For a more complete list speak with your doctor or pharmacist 

Storage

Store at controlled room temperature (77ºF).

Pharmacist Tips

• There is a risk of serotonin syndrome with the use of Axert or other triptans, particularly during combined use with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)
• AXERT may cause dizziness, somnolence, visual disturbances and other CNS symptoms that can interfere with driving or operating machinery.
• Tell your physician if you develop a rash, itching, or breathing difficulties after taking Axert.
• The choice of dose should be made on an individual basis.

Almotriptan FAQs

Can I repeat my dose?

If the headache is relieved after the initial Axert dose but returns, the dose may be repeated after 2 hours. The effectiveness of a second dose has not been established in placebo-controlled trials. The maximum daily dose should not exceed 25 mg.

Can I take this if I am pregnant?

There are no adequate and well-controlled studies in pregnant women; therefore, Axert should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Can I take this while breastfeeding?

It is not known whether almotriptan is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Axert is administered to a nursing woman.

How does Axert work during a migraine attack?

Axert reduces swelling of blood vessels surrounding the brain. This swelling is associated with the headache pain of a migraine attack. It also blocks the release of substances from nerve endings that cause more pain and other symptoms of migraine. Finally it interrupts the sending of specific pain signals to your brain.

What can trigger a migraine attack?

Certain things may trigger migraine attacks in some people. Some of these triggers are:

• Certain foods or drinks, such as cheese, chocolate, citrus fruit (oranges, grapefruit, lemons, lime, and others), caffeine, and alcohol. 
• Stress. 
• Change in behavior, such as too much or too little sleep, missing a meal, or a change in diet.
• Hormone changes in women, such as during monthly menstrual periods.

What should I do in the case of an overdose?

Call your doctor or poison control center or go to the ER.

Related Drugs

• Amerge
• Imitrex
• Frova
• Maxalt
• Relpax
• Zomig

Reference:

Axert {package insert}. Gurabo, Puerto Rico: Janssen-Ortho, LLC; 2009.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021001s010s011lbl.pdf