ALMOTRIPTAN

Details

Stereochemistry	ACHIRAL
Molecular Formula	C17H25N3O2S
Molecular Weight	335.464
Optical Activity	NONE
Defined Stereocenters	0 / 0
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

CN(C)CCC1=CNC2=CC=C(CS(=O)(=O)N3CCCC3)C=C12

InChI

InChIKey=WKEMJKQOLOHJLZ-UHFFFAOYSA-N

InChI=1S/C17H25N3O2S/c1-19(2)10-7-15-12-18-17-6-5-14(11-16(15)17)13-23(21,22)20-8-3-4-9-20/h5-6,11-12,18H,3-4,7-10,13H2,1-2H3

HIDE SMILES / InChI

Molecular Formula	C17H25N3O2S
Molecular Weight	335.464
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Description
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021001s010s011lbl.pdf | https://www.drugs.com/cdi/almotriptan.html

Almotriptan is a triptan drug for the treatment of migraine headaches. Almotriptan is marketed under the trade name Axert. Almotriptan is used for treating acute migraine headaches with or without aura (eg, dark spots, flashing lights, wavy lines). Almotriptan binds with high affinity to 5-HT1D, 5-HT1B, and 5-HT1F receptors. Almotriptan has weak affinity for 5-HT1A and 5-HT7 receptors, but has no significant affinity or pharmacological activity at 5-HT2, 5-HT3, 5-HT4, 5-HT6; alpha or beta adrenergic; adenosine (A1, A2); angiotensin (AT1, AT2); dopamine (D1, D2); endothelin (ETA, ETB); or tachykinin (NK1, NK2, NK3) binding sites.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Serotonin 1b (5-HT1b) receptor 45 Target ID: CHEMBL1898 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021001s008s009lbl.pdf	Agonist 2662
Serotonin 1d (5-HT1d) receptor 52 Target ID: CHEMBL1983 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021001s010s011lbl.pdf	Agonist 2662
Serotonin 1f (5-HT1f) receptor 15 Target ID: CHEMBL1805 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021001s010s011lbl.pdf	Agonist 2662

Conditions

Condition	Modality	Targets	Highest Phase	Product
Migraine 103 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021001s010s011lbl.pdf	Primary		Approved 8360	AXERT Approved Use Almotriptan tablets, USP are a 5HT1B/1D receptor agonist (triptan) indicated for: •Acute treatment of migraine attacks in adults with a history of migraine with or without aura (1.1) •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 (1.1) Important Limitations: •Use only after a clear diagnosis of migraine has been established (1.2) •In adolescents age 12 to 17 years, efficacy of almotriptan tablets on migraine-associated symptoms was not established (1.2) •Not intended for the prophylactic therapy of migraine (1.2) •Not indicated for the treatment of cluster headache (1.2) 1.1 Acute Treatment of Migraine Attacks Adults Almotriptan tablets, USP are indicated for the acute treatment of migraine attacks in patients with a history of migraine with or without aura. Adolescents Age 12 to 17 Years Almotriptan tablets are indicated for the acute treatment of migraine headache pain in patients with a history of migraine attacks with or without aura usually lasting 4 hours or more (when untreated). 1.2 Important Limitations Almotriptan tablets should only be used where a clear diagnosis of migraine has been established. If a patient has no response for the first migraine attack treated with almotriptan tablets, the diagnosis of migraine should be reconsidered before almotriptan tablets are administered to treat any subsequent attacks. In adolescents age 12 to 17 years, efficacy of almotriptan tablets on migraine-associated symptoms (nausea, photophobia, and phonophobia) was not established. Almotriptan tablets are not intended for the prophylactic therapy of migraine or for use in the management of hemiplegic or basilar migraine [see Contraindications (4.7) Launch Date 9.8919357E11

C_max

Value	Dose	Co-administered	Analyte	Population
52.6 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/12723463	12.5 mg single, oral dose: 12.5 mg route of administration: Oral experiment type: SINGLE co-administered:		ALMOTRIPTAN plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED

AUC

Value	Dose	Co-administered	Analyte	Population
312 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/12723463	12.5 mg single, oral dose: 12.5 mg route of administration: Oral experiment type: SINGLE co-administered:		ALMOTRIPTAN plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED

T_1/2

Value	Dose	Co-administered	Analyte	Population
6.1 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/12723463	12.5 mg single, oral dose: 12.5 mg route of administration: Oral experiment type: SINGLE co-administered:		ALMOTRIPTAN plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED
3.5 h DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021001s015lbl.pdf	unknown, oral		ALMOTRIPTAN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

F_unbound

Value	Dose	Co-administered	Analyte	Population
65% DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021001s015lbl.pdf	unknown, oral		ALMOTRIPTAN plasma	Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

Doses

Dose	Population	Adverse events
3 mg single, intravenous Dose: 3 mg Route: intravenous Route: single Dose: 3 mg Sources: https://pubmed.ncbi.nlm.nih.gov/12463724	healthy, 19-33 years n = 24 Health Status: healthy Age Group: 19-33 years Sex: M Population Size: 24 Sources: https://pubmed.ncbi.nlm.nih.gov/12463724	Sources: https://pubmed.ncbi.nlm.nih.gov/12463724
10 mg single, subcutaneous Highest studied dose Dose: 10 mg Route: subcutaneous Route: single Dose: 10 mg Sources: https://pubmed.ncbi.nlm.nih.gov/11768838	unhealthy, 42 years (range: 18-72 years) n = 31 Health Status: unhealthy Condition: acute migraine Age Group: 42 years (range: 18-72 years) Sex: M+F Population Size: 31 Sources: https://pubmed.ncbi.nlm.nih.gov/11768838	Sources: https://pubmed.ncbi.nlm.nih.gov/11768838
12.5 mg multiple, oral Recommended Dose: 12.5 mg Route: oral Route: multiple Dose: 12.5 mg Sources: https://pubmed.ncbi.nlm.nih.gov/12005273	unhealthy, 42 years (range: 18-72 years) n = 582 Health Status: unhealthy Condition: acute migraine Age Group: 42 years (range: 18-72 years) Sex: M+F Population Size: 582 Sources: https://pubmed.ncbi.nlm.nih.gov/12005273	Disc. AE: Chest pain, Electrocardiogram QTc interval prolonged... AEs leading to discontinuation/dose reduction: Chest pain (0.9%) Electrocardiogram QTc interval prolonged (0.7%) Sources: https://pubmed.ncbi.nlm.nih.gov/12005273
100 mg multiple, oral Highest studied dose Dose: 100 mg Route: oral Route: multiple Dose: 100 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_prntlbl.pdf	unhealthy, adult n = 1 Health Status: unhealthy Age Group: adult Population Size: 1 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_prntlbl.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_prntlbl.pdf
200 mg single, oral Highest studied dose Dose: 200 mg Route: oral Route: single Dose: 200 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_prntlbl.pdf	healthy, adult n = 6 Health Status: healthy Age Group: adult Population Size: 6 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_prntlbl.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_prntlbl.pdf

AEs

AE	Significance	Dose	Population
Electrocardiogram QTc interval prolonged	0.7% Disc. AE	12.5 mg multiple, oral Recommended Dose: 12.5 mg Route: oral Route: multiple Dose: 12.5 mg Sources: https://pubmed.ncbi.nlm.nih.gov/12005273	unhealthy, 42 years (range: 18-72 years) n = 582 Health Status: unhealthy Condition: acute migraine Age Group: 42 years (range: 18-72 years) Sex: M+F Population Size: 582 Sources: https://pubmed.ncbi.nlm.nih.gov/12005273
Chest pain	0.9% Disc. AE	12.5 mg multiple, oral Recommended Dose: 12.5 mg Route: oral Route: multiple Dose: 12.5 mg Sources: https://pubmed.ncbi.nlm.nih.gov/12005273	unhealthy, 42 years (range: 18-72 years) n = 582 Health Status: unhealthy Condition: acute migraine Age Group: 42 years (range: 18-72 years) Sex: M+F Population Size: 582 Sources: https://pubmed.ncbi.nlm.nih.gov/12005273

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
substrate 1709	inhibitor 1752	substrate 1193 inhibitor 1837

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
CYP1A2 1509 CYP2A6 704 CYP2B6 799 CYP2C19 1463 CYP2E1 876 CYP3A4/5 273 CYP4A9/11 37	FMO3 66 CYP3A4/5 85 CYP1A2 1032 CYP2C8 688 CYP2C19 985

Drug as perpetrator

Target	Modality	Activity
CYP1A2 1673	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP2A6 736	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP2B6 985	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP2C19 1537	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP2C9 1803	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP2E1 964	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP3A4/5 330	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP4A9/11 37	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	no
CYP2D6 1875	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 49.0	weak [Ki 87 uM]

Drug as victim

Target	Modality	Activity
CYP1A2 1032	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27.0	yes
CYP2C19 985	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27.0	yes
CYP2C8 688	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27.0	yes
CYP2D6 1193	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27.0	yes
CYP3A4 1709	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27, 49	yes
CYP3A4/5 85	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27.0	yes
FMO3 66	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21001_Axert_pharmr_P1.pdf Page: 27.0	yes

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:520985	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:520985
ChemicalBook	CB7716603	https://www.chemicalbook.com/ChemicalProductProperty_EN_CB7716603
ZINC	ZINC000000018087	http://zinc15.docking.org/substances/ZINC000000018087
eMolecules	5852303	https://www.emolecules.com/cgi-bin/more?vid=5852303

PubMed

Title	Date	PubMed
Comparative aspects of triptans in treating migraine.	2001	12739316
Almotriptan: pharmacological differences and clinical results.	2001	12463281
Rizatriptan: an update of its use in the management of migraine.	2002	12093318
Spotlight on almotriptan in migraine.	2002	12056924
Use of rescue medication in trials of almotriptan versus placebo in the treatment of acute migraine.	2002 Apr	12017397
Absolute bioavailability, pharmacokinetics, and urinary excretion of the novel antimigraine agent almotriptan in healthy male volunteers.	2002 Dec	12463724
How does almotriptan compare with other triptans? A review of data from placebo-controlled clinical trials.	2002 Feb	12005302
Almotriptan versus sumatriptan in migraine treatment: direct medical costs of managing adverse chest symptoms.	2002 Feb	11859910
Health outcomes evaluations: estimating the impact of almotriptan in managed care settings.	2002 Feb	11859909
Migraine: diagnosis, management, and new treatment options.	2002 Feb	11859906
A long-term open-label study of oral almotriptan 12.5 mg for the treatment of acute migraine.	2002 Jan	12005273
Within-patient early versus delayed treatment of migraine attacks with almotriptan: the sooner the better.	2002 Jan	12005272
Impact of chest pain on cost of migraine treatment with almotriptan and sumatriptan.	2002 Jan	11966863
Almotriptan increases pain-free status in patients with acute migraine treated in placebo-controlled clinical trials.	2002 Jan	11966862
Gateways to clinical trials.	2002 Jan-Feb	11980386
Almotriptan is an effective and well-tolerated treatment for migraine pain: results of a randomized, double-blind, placebo-controlled clinical trial.	2002 Jul	12133045
Mechanisms of action of the 5-HT1B/1D receptor agonists.	2002 Jul	12117355
Cardiovascular effect of almotriptan in treated hypertensive patients.	2002 Mar	11907491
Efficacy and safety of almotriptan malate for migraine.	2002 Nov 15	12455302
Triptans (serotonin, 5-HT1B/1D agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials.	2002 Oct	12383060
Current perspectives on effective migraine treatments: are small clinical differences important for patients?	2003	15071619
Almotriptan: an effective and well-tolerated treatment for migraine pain.	2003	15071618
Newer formulations of the triptans: advances in migraine management.	2003	14524731
Gateways to clinical trials.	2003 Dec	14735233
Meta-analysis of oral triptan therapy for migraine: number needed to treat and relative cost to achieve relief within 2 hours.	2003 Jan-Feb	14613361
[Almotriptan in the treatment of migraine attacks in clinical practice: results of the TEA 2000 observational study].	2003 Jan-Feb	12590376
A review of the clinical efficacy and tolerability of almotriptan in acute migraine.	2003 Jul	12831340
Almotriptan versus rizatriptan in patients with migraine in Spain.	2003 Jul-Aug	12890128
Safety profile of the triptans.	2003 Mar	12904112
A case of carotidynia with response to almotriptan.	2003 Mar	12603374
Cost-effectiveness of almotriptan and rizatriptan in the treatment of acute migraine.	2003 Nov	14693315
Migraine: diagnosis and management.	2003 Sep-Oct	14511196
Clinical benefits of early triptan therapy for migraine.	2004	15595991
Clinical profile and practice experience of almotriptan.	2004	15595990
What do patients want from acute migraine treatment?	2004	15595989
Migraine pathophysiology and its clinical implications.	2004	15595988
Almotriptan improves response rates when treatment is within 1 hour of migraine onset.	2004 Apr	15109355
Triptans and chest symptoms: the role of pulmonary vasoconstriction.	2004 Apr	15030540
Meta-analysis of oral triptans.	2004 Aug	15265060
Evaluating triptan usage.	2004 Feb	14756865
Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease.	2004 Feb 26	14987333
Involvement of 5-HT1B receptors in triptan-induced contractile responses in guinea-pig isolated iliac artery.	2004 Jul	15185063
Patterns of use of triptans and reasons for switching them in a tertiary care migraine population.	2004 Jul-Aug	15209687
Triptans and CNS side-effects: pharmacokinetic and metabolic mechanisms.	2004 Jun	15154851
Cost considerations of acute migraine treatment.	2004 Mar	15012668
A comparison of the cost-effectiveness of almotriptan and sumatriptan in the treatment of acute migraine using a composite efficacy/tolerability end point.	2004 May-Jun	15228377
Evaluating triptan usage: a rebuttal.	2004 Oct	15447710
Pharmacokinetics and safety of oral almotriptan in healthy male volunteers.	2004 Oct	15386481
TRIPSTAR: prioritizing oral triptan treatment attributes in migraine management.	2004 Sep	15285768
Correlation between lipophilicity and triptan outcomes.	2005 Jan	15663606

Patents

Sample Use Guides

In Vivo Use Guide

Adults and adolescents age 12 to 17 years: 6.25 mg or 12.5 mg single dose; may repeat after 2 hours if headache returns; benefit of second dose in patients who have failed to respond to first dose has not been established; maximum daily dose 25 mg Patients with hepatic or severe renal impairment: 6.25 mg starting dose; maximum daily dose 12.5 mg

Route of Administration: Oral

In Vitro Use Guide

In vitro Almotriptan showed selectivity of action for migraine-related human arteries (i.e. contractile EC(50) of 30 and 700 nm for meningeal and temporal arteries, respectively), whereas the effect on arteries supplying blood to the brain was lower.

Substance Class	Chemical Created by `admin` on `Wed Jul 05 23:12:53 UTC 2023` Edited by `admin` on `Wed Jul 05 23:12:53 UTC 2023`
Record UNII	1O4XL5SN61
Record Status	`Validated (UNII)`
Record Version

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Name

Type

Language

ALMOTRIPTAN

Official Name

English

Almotriptan [WHO-DD]

Common Name

English

1-[[[3-[2-(Dimethylamino)ethyl]indol-5-yl]methyl]sulfonyl]pyrrolidine

Systematic Name

English

ALMOTRIPTAN [USAN]

Common Name

English

almotriptan [INN]

Common Name

English

LAS-31416

Code

English

LAS 31416

Code

English

ALMOTRIPTAN [VANDF]

Common Name

English

ALMOTRIPTAN [MI]

Common Name

English

PYRROLIDINE, 1-(((3-(2-(DIMETHYLAMINO)ETHYL)-1H-INDOL-5-YL)METHYL)SULFONYL)-

Systematic Name

English

NSC-760092

Code

English

Classification Tree Code System Code

WHO-VATC

QN02CC05