Migraine and headache:
Indications for ALSUMA:
Acute treatment of migraine or cluster headaches.
Limitations of Use:
Confirm diagnosis; reconsider if no response after treatment. Not for prevention of migraine attacks.
≥18yrs: one (6mg) dose SC to the lateral thigh or upper arm only. Reevaluate if no response. May repeat after 1hr; max two (6mg) doses in 24hrs. Avoid IM or IV administration.
<18yrs: not recommended.
Ischemic coronary artery disease (CAD) (eg, angina, history of MI, silent ischemia). Coronary artery vasospasm (including Prinzmetal's angina). Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders. History of stroke or TIA. History or evidence of hemiplegic or basilar migraine. Peripheral vascular disease. Ischemic bowel disease. Uncontrolled hypertension. Within 24hrs of ergot-type drugs (eg, methysergide, dihydroergotamine) or other 5-HT1 agonists. During or within 2 weeks of an MAO-A inhibitor. Severe hepatic impairment.
Exclude underlying cardiovascular disease, supervise 1st dose, and consider monitoring ECG in patients with multiple cardiovascular risk factors (eg, increased age, diabetes, hypertension, smokers, obesity, strong family history of CAD). Monitor BP, cardiovascular function in long-term intermittent use. Discontinue if serious arrhythmias or cerebrovascular events occur. Peripheral vascular or colonic ischemia following other 5-HT1 agonists. Discontinue if serotonin syndrome is suspected. History, or risk of seizures. Elderly. Pregnancy (Cat.C). Nursing mothers: avoid for 12hrs after dose.
Selective 5-HT1B/1D receptor agonist.
Ergotamines, other 5-HT1 agonists, MAO-A inhibitors: see Contraindications. Increased risk of serotonin syndrome with SSRIs, SNRIs, tricyclics, or MAO inhibitors.
Inj site reactions, tingling, dizziness/vertigo, warm/hot or burning sensation, feeling of heaviness or tightness, pressure sensation, flushing, numbness, tight feeling in head, chest or jaw/nasal cavity/sinuses discomfort, drowsiness/sedation, headache; rare: serious cardiac and cerebrovascular events (including fatalities), hypertension, vision loss, hypersensitivity reactions.
Single-use auto-injector (prefilled)—2/pack