Almotriptan: pharmacological differences and clinical results.

In this manuscript we review the key basic and clinical data of almotriptan, the new selective 5-HT(1B/D) agonist developed for the symptomatc treatment of migraine. Among triptans, almotriptan has the highest oral bioavailability, with more than two-thirds of the administered dose absorbed within the first hourboth inside and outside a migraine attack. Gender or the presence of food in the stomach do not influence this pharmacokinetic profile, and its clean metabolism results in no relevant interactions with other medications. The dose exhibiting the best efficacy/ tolerability ratio is 12.5 mg. Efficacy parameters with this dose are very comparable to those of sumatriptan 100 mg, with a recurrence rate in the lower range. The tolerability of almotriptan is similar to that for placebo. The incidence of chest symptoms is very low (<1%), even though this drug remains contraindicated in patients with ischaemic cardiomyopathy. In summary, almotriptan's promising basic profile together with its excellent tolerability/safety profile and good efficacy confirm this new 5-HT(1B/D) agonist as a drug of choice for the symptomatic treatment of migraine attacks.