Migraine Medications
Gary W. Jay in Clinician’s Guide to Chronic Headache and Facial Pain, 2016
Triptan tablets show, essentially, when broadly evaluated, a comparable efficacy (58). Sumatriptan, rizatriptan, almotriptan, and eletriptan all show a relatively rapid (30 minute) onset of action and good two-hour efficacy (58). Zolmitriptan shows a good 2-hour efficacy and a 45-minute onset of action (58). Naratriptan and frovatriptan show a two-hour onset of action and lower efficacy (two hours after administration) when compared to the other triptans in tablet form, but they do have the longest half-lives (58).
Migraine: diagnosis and treatment
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby in Headache in Clinical Practice, 2018
The newly-developed 5-HT1B,1D agonist, almotriptan, has shown significant headache relief for the acute treatment of migraine. A single oral dose of 6.25 mg or 12.5 mg of almotriptan or placebo was administered during three different migraine attacks.94,95 The overall percentages of attacks were 38.4%, 59.9% and 70.3% for placebo, 6.25 mg and 12.5 mg respectively. Pain-free values at two hours were 15.5%, 29.9% and 38.8% for placebo,6.25mg and 12.5mg respectively.
Primary Headache Disorders
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Almotriptan is an oral triptan with a broad Tmax range of 1.4 to 3.8 hours. It has an elimination half-life of 3.5 hours, and its efficacy, tolerability, and recurrence profiles are favorable. Almotriptan is available in oral tablets (6.25, 12.5 mg) with 12.5 mg being the recommended dose. Unusual for this triptan is its incidence of chest pain side effects that are similar to placebo (Dahlof et al., 2001).
Almotriptan: a review of 20 years’ clinical experience
Published in Expert Review of Neurotherapeutics, 2019
Almotriptan (ALT) has been available for approximately 20 years for the acute treatment of migraine with or without aura since it was first approved in Spain in 1999. It was approved in the US and across EU in the early 2000s, and clinical data has accumulated for more than 15,000 patients in studies and from an estimated >150 million treated migraine attacks in daily clinical practice (based upon data for the number of original patented tablets dispensed across 20 countries). The last major review of ALT was written almost 10 years ago [14]. The current narrative review considers the extensive body of evidence accumulated on ALT, including data published in the last decade. A systematic literature search of PubMed (all entries since January 2010) identified randomized clinical trials, observational studies and postmarketing studies of almotriptan for the treatment of migraine. Meta-analyses of triptan data that included ALT were also identified.
Pharmacotherapy for acute migraines in children and adolescents
Published in Expert Opinion on Pharmacotherapy, 2019
P. Barbanti, L. Grazzi, G. Egeo
The efficacy and safety of almotriptan in doses ranging from 6.25 to 12.5 mg in pediatric migraine patients was first suggested by a small open-label study of 15 patients aged 11–17 years reporting rapid pain relief in 86.7% of children with no untoward effects [32]. Almotriptan efficacy was then confirmed in a large (866 patients aged 12–17 years) multicenter, parallel-group RCT testing 3 different doses (6.25, 12.5, 25 mg). At 2 h, almotriptan 25 mg outperformed placebo for pain relief (p = 0.022) when adjusted for baseline pain intensity, but not for reduction of migraine vegetative symptoms. Unadjusted 2 h pain-relief rates and sustained pain relief were significantly better with almotriptan at all doses than placebo. The drug was well tolerated. Patients aged 15–17 years responded better than those aged 14–16 years [33].
An update on acute and preventive treatments for migraine in children and adolescents
Published in Expert Review of Neurotherapeutics, 2020
A multicenter randomized, double-blind placebo-controlled trial evaluated Almotriptan for children and adolescents 12–17 years of age with migraine[9]. This was the first study that showed efficacy for an oral triptan in adolescents with migraine. The doses were randomized at 6.25 mg, 12.5 mg, 25 mg, or placebo. Two endpoints were studied including 2-h pain relief and relief of nausea, phonophobia and photophobia 2 h after administration of medication. All three doses were well tolerated and statistically significant in providing pain relief. The study did find that patients 15–17 years of age had greater pain relief at 2 hours than those 12–14 years of age when compared to placebo. The endpoint for symptoms was not statistically significant; however, they did find that Almotriptan 12.5 mg was most successful at relieving headache pain and symptoms including photophobia and phonophobia. The most common side effects were somnolence, dizziness, and nausea.
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