Almotriptan use while Breastfeeding

Summary of Use during Lactation

There is minimal published experience with almotriptan during breastfeeding, although the dose in milk appears to be low. If almotriptan is required by the mother of an older infant, it is not a reason to discontinue breastfeeding, but until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Drug Levels

Maternal Levels. One woman who was over 1 month postpartum took a single oral dose of almotriptan to treat migraine. She provided one milk sample before the dose, then additional milk samples at 1, 2, 4, 8, 12 and 24 hours after the dose. The peak milk level of 106.2 mcg/L occurred at 2 hours after the dose. The average milk level was 29.6 mcg/L and the half-life in milk was 4 hours. The infant’s daily dosage of almotriptan was estimated to be 4.4 mcg/kg and the weight-adjusted infant dosage was 1.8% of the maternal dose.[1]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Eletriptan, Rizatriptan, Sumatriptan, Zolmitriptan

References

1.

Amundsen S, Nordeng H, Fuskevåg OM, et al. Transfer of triptans into human breast milk and estimation of infant drug exposure through breastfeeding. Basic Clin Pharmacol Toxicol. 2021;128:795–804. [PubMed: 33730376]

Substance Name

Almotriptan

CAS Registry Number

154323-57-6

Drug Class

Breast Feeding

Lactation

Serotonin Receptor Agonists

Serotonin 5-HT1 Receptor Agonists

Triptans

Vasoconstrictor Agents