Axert (Almotriptan Malate)

(al moh trip' tan)

Almotriptan is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound and light). Almotriptan is in a class of medications called selective serotonin receptor agonists. It works by narrowing blood vessels around the brain, stopping pain signals from being sent to the brain, and blocking the release of certain natural substances that cause pain, nausea, and other symptoms of migraine. Almotriptan does not prevent migraine attacks or reduce the number of headaches you have.

Almotriptan comes as a tablet to take by mouth. It is usually taken at the first sign of a migraine headache. If your symptoms improve after you take almotriptan but return after 2 hours or longer, you may take a second tablet. However, if your symptoms do not improve after you take almotriptan, do not take a second tablet before calling your doctor. Your doctor will tell you the maximum number of tablets you may take in a 24-hour period. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take almotriptan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. You may take your first dose of almotriptan in a doctor's office or other medical facility where you can be monitored for serious reactions. Call your doctor if your headaches do not get better or occur more frequently after taking almotriptan. If you take almotriptan more often or for longer than the recommended period of time, your headaches may get worse or may occur more frequently. You should not take almotriptan or any other headache medication for more than 10 days per month. Call your doctor if you need to take almotriptan to treat more than four headaches in a 1-month period. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before taking almotriptan,
• tell your doctor and pharmacist if you are allergic to almotriptan, any other medications, or any of the ingredients in almotriptan tablets. Ask your pharmacist for a list of the ingredients.
• do not take almotriptan if you have taken any of the following medications in the past 24 hours: other selective serotonin receptor agonists such as eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), or zolmitriptan (Zomig); or ergot-type medications such as bromocriptine (Parlodel), cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergonovine (Ergotrate), ergotamine (Cafergot, Ergomar, Wigraine), methylergonovine (Methergine), methysergide (Sansert), and pergolide (Permax).
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking, have recently stopped taking, or plan to take. Be sure to mention any of the following: acetaminophen (Tylenol); aspirin and other nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); clarithromycin (Biaxin); indinavir (Crixivan); ; nefazodone (Serzone); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft); selective serotonin/norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), sibutramine (Meridia), and venlafaxine (Effexor); troleandomycin (TAO); and zafirlukast (Accolate). Tell your doctor or pharmacist if you are taking the following medications or if you have stopped taking them within the past week: antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); erythromycin (E.E.S., E-Mycin, Erythrocin); and ritonavir (Norvir). Also tell your doctor or pharmacist if you are taking the following medications or if you have stopped taking them within the past 2 weeks: monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had heart disease; a heart attack; angina (chest pain); irregular heartbeats; stroke or 'mini-stroke'; or circulation problems such as varicose veins, blood clots in the legs, Raynaud's disease (problems with blood flow to the fingers, toes, ears, and nose), or ischemic bowel disease (bloody diarrhea and stomach pain caused by decreased blood flow to the intestines). Your doctor may tell you not to take almotriptan.
• tell your doctor if you smoke or are overweight; if you have or have ever had high blood pressure, high cholesterol, diabetes, or kidney or liver disease; if you have gone through menopause (change of life); or if any family members have or have ever had heart disease or stroke.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you plan to be sexually active while you are taking this medication, talk to your doctor about effective methods of birth control. If you become pregnant while taking almotriptan, call your doctor.
• you should know that almotriptan may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• talk to your doctor about your headache symptoms to make sure they are caused by migraine. Almotriptan should not be used to treat hemiplegic or basilar migraine or headaches caused by other conditions (such as cluster headaches).

Talk to your doctor about drinking grapefruit juice while taking this medicine.

Almotriptan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• nausea
• drowsiness
• headache
• dry mouth
• dizziness

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• hives
• rash
• itching
• tightness, pain, pressure, or heaviness in the chest, throat, neck, or jaw
• slow or difficult speech
• faintness
• weakness or numbness of an arm or leg
• sudden or severe stomach pain
• bloody diarrhea
• rapid, pounding, or irregular heartbeat
• shortness of breath
• breaking out in a cold sweat
• difficulty breathing or swallowing
• paleness or blue color of the fingers and toes
• pain, burning, or tingling in the hands or feet

Almotriptan may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor. Your blood pressure should be checked regularly. You should keep a headache diary by writing down when you have headaches and when you take almotriptan. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.